Standard Omeprazole Dosing for Pediatric GERD
Omeprazole, a proton pump inhibitor, treats gastroesophageal reflux disease (GERD) in children by reducing stomach acid. Dosing is weight-based, typically 0.7 to 3.3 mg/kg/day, given once daily before a meal. For most kids aged 1-16 years weighing over 5 kg, the starting dose is 1 mg/kg/day (up to 20 mg maximum), adjusted based on response and up to 2 mg/kg/day (max 40 mg).[1][2]
| Weight Range | Typical Starting Dose | Max Daily Dose |
|--------------|-----------------------|---------------|
| 5-10 kg | 5 mg once daily | 10 mg |
| >10-20 kg | 10 mg once daily | 20 mg |
| >20 kg | 20 mg once daily | 40 mg |
Guidelines from the American Academy of Pediatrics and FDA labeling recommend this for erosive esophagitis or symptomatic GERD, with treatment limited to 8 weeks unless healing is confirmed.[1][3]
How Long to Give It and When to Adjust
Start with the lowest effective dose for 4-8 weeks. If symptoms persist, increase to 2 mg/kg/day or split into twice-daily dosing. Endoscopy may guide duration in severe cases. Taper off gradually to avoid rebound acid hypersecretion.[2][4]
Differences by Age Group
- Infants under 1 year (≥1-12 months, >5 kg): 1 mg/kg/day; not FDA-approved under 1 month due to limited data.[1]
- Children 1-16 years: 0.7-3.3 mg/kg/day, with efficacy shown in trials at 1-2.4 mg/kg/day.[3]
- Under 5 kg: Not recommended; alternatives like thickened feeds or H2 blockers preferred.[2]
Common Side Effects Kids Experience
Headache, abdominal pain, nausea, diarrhea, and constipation occur in 1-5% of pediatric patients. Long-term use (>12 weeks) raises risks of fractures, hypomagnesemia, or infections like C. difficile. Monitor growth and bone health.[1][4]
What If Overdose or Missed Dose Happens
Overdose (e.g., >40 mg) causes few symptoms but seek emergency care. For missed doses, give as soon as remembered unless near next dose—don't double up.[1]
Alternatives for Kids with GERD