Reliving 25 years of Experience with Omeprazole in Acid-peptic Diseases.

Background Acid-peptic diseases (APDs) are commonly encountered in clinical practice. The identification of proton pump and the subsequent introduction of proton pump inhibitors (PPIs) can be heralded as a milestone in the treatment of APDs. They have been used for the past 25 years with a good track record of safety. Omeprazole is a well-established and most studied drug in the PPI class. Objectives and methods This review is an objective overview of the efficacy and safety of PPIs in APDs, with special focus on omeprazole. Results The efficacy of omeprazole in gastroesophageal reflux disease (GERD) and peptic ulcer disease (PUD), including those caused by non-steroidal antiinflammatory drugs (NSAIDs) is well documented. In clinical studies, the newer, more potent PPIs, used at comparable doses, have not shown greater efficacy than omeprazole. The PPIs are in general well-tolerated. Most of the concerns regarding their long-term safety have been unfounded. Conclusion Twenty five years after the introduction of omeprazole, the first of the PPIs, omeprazole has still remained a valuable drug in the armamentarium of clinicians.