Omeprazole 40 MG Cap UD (Prilosec)

Omeprazole 40 MG Cap UD (Prilosec)

Advisories: Deference is given to the local P&T Committee for appropriate management of the following: 1. Patient does NOT have Non-Ulcer Dyspepsia: Patient should be referred to commissary. 2. GERD: supported by current objective findings. 3. Documented doses of ranitidine 750 mg per day divided into qid dosing 4. Documentation of chronic need for NSAIDS with prior history of GI bleed 5. Documented Zollinger-Ellison Syndrome 6. Documented Schatzki’s Ring 7. Documented Barrett’s Esophagus 8. Documented Esophageal Stricture Formulary OTC medications may only be prescribed as a maintenance medication associated with ongoing follow up in a chronic care clinic and is supported by an appropriate and commensurate indication. Refer to the Formulary OTC Prescribing Criteria Matrix contained within the BOP National Formulary, Part I.

Dr. M Blatstein

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