Injectable omeprazole is now used widely as a first choice treatment for glandular gastric disease due to the poor rates of healing with oral omeprazole (with or without sucralfate). It is also used in severe or refractory squamous disease. Many owners prefer a weekly injection to having to administer daily oral medication and the injection is useful in situations where compliance with oral treatment is expected to be poor.

Injectable omeprazole is not intended for preventing gastric ulcers in horses.

Injectable omeprazole is intended for short-term use and is not recommended for extended or indefinite therapy as the risk of reactions is likely to increase with repeated injection of the same sites. Although they are not as potent, it should be possible to prevent gastric disease with oral proton pump inhibitors.

Epicur’s omeprazole injection begins working almost immediately – faster and more consistently than oral omeprazole.

Injectable omeprazole differs from oral formulations in both how it’s administered and how reliably it works. Because it is given as an injectable, it bypasses the gastrointestinal tract so the whole dose reaches the systemic circulation rather than around 10% of the dose with oral preparations. This results in more consistent and more profound gastric acid suppression. It also eliminates challenges with palatability and handling, offering veterinarians and owners a practical alternative when compliance is an issue.

The dose of injectable omeprazole is 4 mg/kg intramuscular (gluteal or neck preferred, avoid pectorals) once every 5–7 days

The pectoral muscles are too small to comfortably accommodate a 20 mL injection. The pecs will consistently swell with that amount of volume. According to reviewed and published data, it is recommended to give the injection intramuscularly in the upper middle gluteal muscles or the neck, where there is sufficient muscle mass to tolerate the volume.

The hamstring area is also a smaller muscle mass and the risk of pain or swelling is higher. Soreness in this area will have a greater effect on soundness and performance than the recommended sites.

Based on published studies, it is recommended to use an 18-gauge needle.

While the risk with other injectable omeprazole products has been reported to be high, with the Bova formulation only 1-6% of injections were associated with localized swelling in published studies.

There are no long-term reactions based on published studies. Injection site reactions typically resolve spontaneously within a few days.

It is important to ensure the suspension is well mixed by shaking it thoroughly. Warming the vial to body temperature before administration will help with reconstitution, will make the formulation easier to inject, and may reduce local irritation. It can also be helpful to warm up the horse’s muscles beforehand—walking or lunging the horse for 10–15 minutes prior to injection may improve muscle circulation and comfort during administration. Ensure the site is aseptically prepared or at least cleaned prior to injection.

The injectable omeprazole available from Epicur Pharma is manufactured under FDA guidelines, which allows for longer, validated expiration dates compared with traditional compounding pharmacies that assign shorter, beyond-use dates. Veterinarians can easily view the current expiration dating for each lot, along with real-time pricing, through Epicur’s free online ordering platform, iFill. This system allows clinics to review product details before placing an order, ensuring transparency and helping with inventory planning.