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LOSEC MUPS is a brand name for Omeprazole, supplied as a tablet (delayed-release). The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: LOSEC MUPS (omeprazole magnesium) tablets are indicated in the treatment of conditions where a reduction of gastric acid secretion is required, such as: • duodenal ulcer • gastric ulcer • NSAID-associated gastric and duodenal ulcers • reflux esophagitis • symptomatic gastroesophageal reflux disease (GERD), i.e.,…
Verbatim from this product's HC label. Tap a section to expand.
1 Dosing Considerations • No dose adjustment is required in patients with renal insufficiency, hepatic insufficiency, or in elderly patients. 3 Pharmacokinetics). 4 Drug-Drug Interactions). • Patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated.
2 Recommended Dose and Dosage Adjustment LOSEC MUPS (omeprazole magnesium) 20 mg tablets and LOSEC 20 mg capsules have an equivalent effect on 24-hour intragastric pH (proportion of time with intragastric pH ≥ 4). These data support the conclusion that LOSEC MUPS tablet and the LOSEC capsule can be used with equal efficacy in the treatment of conditions where a reduction of gastric acid secretion is required.
Duodenal Ulcer Acute Therapy:
The recommended adult oral dose is 20 mg given once daily. Healing usually occurs within 2 weeks. For patients not healed after this initial course of therapy, an additional 2 weeks of treatment is recommended.
Refractory Patients:
In patients with duodenal ulcer refractory to other treatment regimens, the recommended adult doses are 20 mg - 40 mg given once daily. Healing is usually achieved within 4 weeks in such patients.
Maintenance Therapy for Duodenal Ulcer:
Over 95% of duodenal ulcer patients are H. pylori-positive, and should be treated with eradication therapy, as described below. A small percentage of patients who are H. pylori-negative will experience a disease recurrence and will require maintenance treatment with an antisecretory agent.
The recommended LOSEC dose is 10 mg once daily, increased to 20-40 mg once daily as necessary.
Gastric Ulcer Acute Therapy:
The recommended adult dose is 20 mg given once daily. Healing usually occurs within 4 weeks. For patients not healed after this initial course of therapy, an additional 4 weeks of treatment is recommended.
Refractory Patients:
In patients with benign gastric ulcer refractory to other treatment regimens, the recommended adult dose is 40 mg given once daily. Healing is usually achieved within 8 weeks.
1 Adverse Reaction Overview Omeprazole is well tolerated. Most adverse reactions have been mild and transient, and have shown no consistent relationship with treatment. Adverse events have been recorded during controlled clinical investigations in 2,764 patients exposed to omeprazole (data taken from controlled clinical studies with omeprazole capsules) or reported from routine use.
2 Clinical Trial Adverse Reactions Clinical trials are conducted under very specific conditions. The adverse reaction rates observed in the clinical trials; therefore, may not reflect the rates observed in practice and should not be compared to the rates in the clinical trials of another drug.
Adverse reaction information from clinical trials may be useful in identifying and approximating rates of adverse drug reactions in real-world use. In a controlled clinical trial comparing omeprazole to placebo, the prevalence of adverse events with omeprazole 40 mg once daily was similar to that with placebo.
In short-term comparative double-blind studies with histamine H2-receptor antagonists, there was no significant difference in the prevalence of adverse events between omeprazole capsules and the H2-receptor antagonists. An extensive evaluation of laboratory variables has not revealed any significant changes during omeprazole treatment which are considered to be clinically important.
In two short-term studies (20 mg tablet once daily for a maximum duration of 7 days) in a limited number of patients with symptomatic gastroesophageal reflux disease, the adverse event profile seen with the LOSEC MUPS 20 mg tablet is similar to that seen with the LOSEC 20 mg capsule.
1%). The following is a list of adverse events reported in clinical trials or reported from routine use. Events are categorized by system organ class proposed by MedDRA in alphabetical order. 01%), including isolated reports Table 2: Adverse drug reactions reported in clinical trials or reported from routine use presented by MedDRA System Organ Class and frequency System Organ Class Frequency Adverse Reaction(s) Blood and lymphatic system disorders Rare Leukopenia, thrombocytopenia, agranulocytosis and pancytopenia Product Monograph Date: September 2023 LOSEC MUPS (omeprazole magnesium delayed release tablets) Page 13 of 44 System Organ Class Frequency Adverse Reaction(s) Ear and labyrinth disorders Uncommon Vertigo Eye disorders Rare Blurred vision Gastrointestinal disorders Common Diarrhea, constipation, abdominal pain, nausea/vomiting and flatulence Rare Dry mouth, stomatitis, gastrointestinal candidiasis General disorders and administration site conditions Uncommon Malaise Rare Increased sweating, peripheral edema Hepatobiliary disorders: Uncommon Increased liver enzyme levels Rare Encephalopathy in patients with pre-existing severe liver disease; hepatitis with or without jaundice and hepatic failure Immune system disorders Rare Hypersensitive reactions including angioedema, fever and anaphylactic shock Metabolism and nutrition disorders Rare Hyponatremia Very rare Hypomagnesemia (severe hypomagnesemia may result in hypocalcemia, and hypomagnesemia may also result in hypokalemia) Musculoskeletal and connective tissue disorders Rare Arthralgia, muscular weakness and myalgia Nervous system disorders Common Headache Uncommon Dizziness, paresthesia, somnolence Rare Taste disturbances Psychiatric disorders Uncommon Insomnia Product Monograph Date: September 2023 LOSEC MUPS (omeprazole magnesium delayed release tablets) Page 14 of 44 System Organ Class Frequency Adverse Reaction(s) Rare Reversible mental confusion, agitation, aggression, depression and hallucination occurring predominantly in severely ill patients Renal and urinary disorders Rare Interstitial nephritis Reproductive system and breast disorders Rare Gynecomastia Respiratory, thoracic and mediastinal disorders Rare Bronchospasm Skin and subcutaneous tissue disorders Uncommon Rash, dermatitis and/or pruritus, and urticaria Rare Photosensitivity, erythema multiforme, Stevens-Johnsons syndrome, toxic epidermal necrolysis (TEN), alopecia H.
10/2023 TABLE OF CONTENTS Sections or subsections that are not applicable at the time of authorization are not listed. RECENT MAJOR LABEL CHANGES .........................................................................................................
2 TABLE OF CONTENTS ........................................................................................................................... 2 PART I: HEALTH PROFESSIONAL INFORMATION ..................................................................................
4 1 INDICATIONS .......................................................................................................................... 4 2 CONTRAINDICATIONS .............................................................................................................
4 4 DOSAGE AND ADMINISTRATION ............................................................................................. 7 5 OVERDOSAGE .........................................................................................................................
8 6 DOSAGE FORMS, STRENGTHS, COMPOSITION AND PACKAGING ............................................. 8 7 WARNINGS AND PRECAUTIONS .............................................................................................. 1 Special Populations ...........................................................................................................
1 Pregnant Women ....................................................................................................... 2 Breast-feeding ............................................................................................................
3 Pediatrics .................................................................................................................... 4 Geriatrics ....................................................................................................................
• LOSEC MUPS is contraindicated in patients who are hypersensitive to omeprazole, substituted benzimidazoles or to any ingredient in the formulation, including any non-medicinal ingredient, or component of the container. For a complete listing, see 6 DOSAGE FORMS, STRENGTHS, COMPOSITION AND PACKAGING.
• LOSEC MUPS is contraindicated with co-administration of rilpirivine due to significant decrease in rilpivirine exposure and loss of therapeutic effect.
Product Monograph Date:
September 2023 LOSEC MUPS (omeprazole magnesium delayed release tablets) Page 5 of 44
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
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Maintenance Therapy for Gastric Ulcer:
About 80% of gastric ulcer patients are H. pylori-positive, and should be treated with eradication therapy, as described below. A small percentage of patients who are H. pylori-negative will experience a disease recurrence and will require maintenance treatment with an antisecretory agent.
The recommended LOSEC MUPS dose is 20 mg once daily, increased to 40 mg once daily as necessary. NSAID-Associated Gastric or Duodenal Ulcers The issue of whether or not eradication of H. pylori in patients with NSAID-associated ulcers might have beneficial preventive effects has not yet been settled.
Product Monograph Date:
September 2023 LOSEC MUPS (omeprazole magnesium delayed release tablets) Page 6 of 44 Acute Therapy: In patients with NSAID-associated gastric or duodenal ulcers, the recommended adult dose is 20 mg given once daily. Symptom resolution is rapid and healing usually occurs within 4 weeks.
For those patients not healed after this initial course of therapy, an additional 4 weeks of treatment is recommended.
Maintenance Therapy:
For the prevention of relapse in patients with NSAID-associated gastric or duodenal ulcers, the recommended adult dose is 20 mg given once daily, for up to 6 months. Dyspepsia Prior to treating patients presenting with dyspeptic symptoms, it should be determined that these symptoms are originating from the upper gastrointestinal tract.
Patients presenting alarm symptoms (see 7 WARNINGS AND PRECAUTIONS), and older patients who are at a greater risk of having a serious organic disease, should be investigated prior to the initiation of therapy. If the dyspeptic symptoms are known to be related to a diagnosis of organic disease, the appropriate treatment regimen listed in the sections above should be employed.
If the dyspeptic symptoms are not known to be related to an organic disease, the recommended daily dose of LOSEC MUPS is 20 mg once daily for 4 weeks. If after 2 weeks’ treatment the patient does not respond to therapy, or there is an early clinical indication of a lack of efficacy, the patient should be thoroughly investigated in order to rule out organic disease (see 7 WARNINGS AND PRECAUTIONS).
If there are indications of a clinical response following the initial 2 weeks of treatment, LOSEC MUPS may be continued for an additional 2 weeks. Patients may respond adequately to 10 mg once daily; therefore, individual dose adjustment may be considered.
Epigastric pain/discomfort (with or without heartburn and regurgitation) as predominant symptoms are likely to respond to acid suppression therapy. In all cases, patients who do not respond to 4 weeks’ treatment, or whose symptoms recur shortly after discontinuation of treatment, with LOSEC MUPS should be investigated for underlying organic diseases.
Helicobacter pylori Associated Peptic Ulcer Disease Omeprazole, Amoxicillin and Clarithromycin Triple Therapy: The recommended dose for eradication of H. pylori is LOSEC MUPS 20 mg, amoxicillin 1,000 mg and clarithromycin 500 mg, all twice daily for seven days.
Omeprazole, Metronidazole and Clarithromycin Triple Therapy:
The recommended dose for eradication of H. pylori is LOSEC MUPS 20 mg, metronidazole 500 mg and clarithromycin 250 mg, all twice daily for seven days. To ensure healing and/or symptom control, further treatment with 20 mg LOSEC once daily for up to three weeks is recommended for patients with active duodenal ulcer, and with 20 – 40 mg LOSEC once daily for up to twelve weeks for patients with active gastric ulcer.
Patient compliance with treatment regimens for the eradication of H. pylori has been demonstrated to have a positive effect on eradication outcome. In clinical trials, patients treated with triple-therapy regimens have shown high compliance rates.
Susceptibility testing (MIC values […]
pylori Eradication Combination Therapy: The following adverse events (at a rate of more than 1%) were recorded during controlled clinical trials in 493 patients receiving omeprazole, amoxicillin and clarithromycin: diarrhea (28%), taste disturbances (15%), headache (5%), flatulence (4%), nausea (3%), abdominal pain (2%), ALT increased (1%), epigastric pain (1%), pharyngitis (1%) and glossitis (1%).
The following adverse events (at a rate of more than 1%) were recorded during controlled clinical trials in 494 patients receiving omeprazole, metronidazole and clarithromycin: taste disturbances (14%), diarrhea (13%), headache (6%), ALT increased (6%), flatulence (5%), nausea (5%), AST increased (5%), dyspepsia (3%), dry mouth (2%), dizziness/vertigo (2%), epigastric pain (1%), pharyngitis (1%), eructation (1%) and fatigue (1%).
5 Post-Market Adverse Reactions Gastrointestinal disorders Withdrawal of long-term PPI therapy can lead to aggravation of acid related symptoms and may result in rebound acid hypersecretion. There have been post-marketing reports of microscopic colitis and fundic gland polyps (PGPs) (see 7 WARNINGS AND PRECAUTIONS).
Musculoskeletal, connective tissue and bone disorders Osteoporosis and osteoporosis-related fractures have been reported with multiple daily doses and long-term PPI therapy (see 7 WARNINGS AND PRECAUTIONS). […]
11 8 ADVERSE REACTIONS ............................................................................................................ 1 Adverse Reaction Overview ..............................................................................................
2 Clinical Trial Adverse Reactions ........................................................................................ 5 Post-Market Adverse Reactions ........................................................................................
14 9 DRUG INTERACTIONS............................................................................................................ 1 Serious Drug Interactions ..................................................................................................
2 Drug Interactions Overview .............................................................................................. 3 Drug-Behavioural Interactions ..........................................................................................
4 Drug-Drug Interactions ..................................................................................................... 5 Drug-Food Interactions .....................................................................................................
6 Drug-Herb Interactions ..................................................................................................... 7 Drug-Laboratory Test Interactions ....................................................................................
22 10 CLINICAL PHARMACOLOGY ................................................................................................... 1 Mechanism of Action ..................................................................................................
2 Pharmacodynamics .................................................................................................... 3 Pharmacokinetics .......................................................................................................
24 11 STORAGE, STABILITY AND DISPOSAL ..................................................................................... 27 12 SPECIAL HANDLING INSTRUCTIONS.......................................................................................
27 PART II: SCIENTIFIC INFORMATION ................................................................................................... 28 13 PHARMACEUTICAL INFORMATION........................................................................................
28 14 CLINICAL TRIALS.................................................................................................................... 1 Clinical Trials by Indications........................................................................................
28 15 MICROBIOLOGY .................................................................................................................... 32 16 NON-CLINICAL TOXICOLOGY .................................................................................................
32 PATIENT MEDICATION INFORMATION […]