OMEPRAZOLE FOR REFRACTORY GASTROESOPHAGEAL REFLUX DISEASE DURING PREGNANCY AND LACTATION

Symptomatic gastroesophageal reflux is a common complication of pregna ncy and lactation. However, the safety of many effective medical thera pies, including oral proton pump inhibitors, has not been well defined . The administration of oral omeprazole to a 41-year-old female during the third trimester of pregnancy, after ranitidine and cisapride fail ed to control her refractory gastroesophageal reflux, is reported. No adverse fetal effects were apparent, and the patient elected to contin ue omeprazole therapy (20 mg/day) while breastfeeding. Peak omeprazole concentrations in breast milk (58 nM, 3 h after ingestion) were less than 7% of the peak serum concentration (950 nM at 4 h), indicating mi nimal secretion. Although omeprazole is a potentially useful therapy f or refractory gastroesophageal reflux during pregnancy and lactation, further data are needed to define better its safety and efficacy.