Prilosec (omeprazole) is a proton pump inhibitor (PPI) used to treat symptoms of heartburn, ulcers, gastroesophageal reflux disease (GERD), and erosive esophagitis . Prilosek blocks an enzyme that allows acid to be released from proton pumps in stomach cells (a type of stomach cell). This prevents too much acid from damaging the tissues that line the esophagus, stomach, and intestines.
Prescription Prilosec is for medical conditions that require diagnosis and monitoring by a healthcare provider, while over-the-counter Prilosec is used only for heartburn. Generics are available for both drugs.
Prilosek is available as a delayed-release capsule and an oral suspension that can be mixed with water and drunk. Prilosec OTC is available in sustained-release tablets.
Prilosec OTC is used to treat heartburn . It is approved for adults over 18 years of age .
Prescription Prilosek is also used for heartburn and is the standard treatment for GERD, stomach ulcers (ulcers of the stomach lining), and duodenal ulcers (located in the duodenum of the small intestine ). Additionally, prescription Prilosek can be used to treat erosive esophagitis or to treat Helicobacter pylori ( H. pylori, a common bacteria that causes ulcers) as a combination therapy with antibiotics.
Prescription Prilosec can also be used to treat rare hypersecretory conditions such as Zollinger-Ellison syndrome , multiple endocrine adenomas, and systemic mastocytosis . In each of these conditions, tumors or clusters of cells can produce excess stomach acid.
Prilosek is a prescription medicine approved for use in children 1 year of age and older who have GERD or erosive esophagitis. For all other permitted uses, it is approved for those 17 and older.
It is important to note that you may experience improvement in your symptoms while taking Prilosec, even if you have a serious condition that requires evaluation and treatment. Be sure to consult your doctor.
Prilosec OTC is not an effective treatment for acute heartburn symptoms (the ones you are currently experiencing). It is used daily for two weeks and takes one to four days for it to have a full effect.
Check with your doctor before taking Prilosec OTC, especially if you've had heartburn for more than three months. This could be a sign of a more serious medical condition.
Before prescribing Prilosek or recommending Prilosek without a prescription, your doctor will review your medical history and may perform a blood test for H. pylori, or a barium swallow X-ray or other images to look for ulcers.
Endoscopy , a procedure in which a thin tube with a light source and a camera is inserted into the throat to view the upper part of the digestive system, may also be recommended if you are concerned about your esophagus. This interior view can help identify ulcers or erosive esophagitis, tumors, and other conditions of the esophagus.
Ambulatory acid (pH) monitoring is an outpatient procedure in which a tube is inserted into the esophagus for 24 hours to measure acid. And esophageal manometry is a diagnostic procedure in which a tube is inserted to measure muscle contractions in the esophagus and assess the action of the sphincter muscle .
Other PPI medications that are also available by prescription or over-the-counter include Prevacid (lansoprazole) and Nexium (esomeprazole). Similar prescription-only options include AcipHex (rabeprazole), Protonix (pantoprazole), and Dexilant (dexlansoprazole).
There is no significant difference in the performance of any of the different PPIs on the market.
Several studies show that drugs like Prilosek provide better relief and overall healing from acid damage than H2-blocking drugs like Pepcid (famotidine) , which reduce stomach acid by blocking histamine-2 (H2) receptors. This is true for both erosive and non-erosive inflammation of the esophagus, stomach, and intestines.
However, your healthcare provider may also recommend an H2 blocker if you have nocturnal acid reflux that Prilosec does not control.
Precautions and contraindications.
Certain medical circumstances can make taking Prilosek risky or even prohibit its use. This includes:
- Allergies or Hypersensitivity: Serious allergic reactions to Prilosek can occur. If you are allergic or hypersensitive to omeprazole, other PPIs, or substituted benzimidazoles, do not take Prilosec.
- Black stools or bright red blood in stools : If you have black or bright red stools, you should seek medical attention instead of using Prilosec. This could be a sign of gastrointestinal bleeding, so it is important to see a doctor.
- Pregnancy: There are no adequate and well-controlled studies on the use of omeprazole during pregnancy. Although some preliminary research suggests that taking PPIs during the first trimester does not increase the risk of birth defects or adverse outcomes, you should discuss your options with your healthcare provider if you are pregnant or planning to become pregnant.
- Breastfeeding: Breastfeeding people may need to avoid taking Prilosek, as it can be passed to the baby through breast milk.
Talk to your doctor about all the medications, supplements, and vitamins that you are currently taking. While some medications carry little risk of interactions, others may directly contraindicate their use or cause careful consideration of whether the benefits of treatment outweigh the disadvantages in your case.
Prilosec OTC is available in doses of 20 milligrams (mg) once a day for 14 days. An additional 14-day treatment can be repeated every four months. If this is not enough to relieve symptoms, see your doctor.
The prescription for Prilosec comes in capsules, available in 10, 20, or 40 mg strengths. It is also available in 2.5 or 10 mg sachets for oral suspension to add to water. It usually takes between 30 minutes and 3.5 hours for the medicine to work.
Typical prescription doses of Prilosec include 20, 40, or 60 mg once a day for adults. However, your healthcare provider may ask you to try 20 mg twice a day if you have relief from symptoms during the day but experience nocturnal acid reflux or if you are taking Prilosek as part of your H. pylori combination therapy.
Typical prescribed doses of Prilosec for children are 5, 10, or 20 mg once a day; The doctor makes recommendations based on body weight.
It is important that you follow your healthcare provider's dosing instructions, as more Prilosec does not mean better results.
|Prilosec prescription dosage|
|Duodenal ulcers||20 mg||Once a day for four weeks (sometimes an additional four weeks are required)|
|Stomach ulcer||40 mg||Once a day for four to eight weeks.|
|GERD in adults||20 mg||Once a day for four to eight weeks.|
|Erosive esophagitis in adults||20 mg||Once a day|
|GERD or erosive esophagitis in children|| The dose depends on the body weight.
11 to 22 pounds: 5 mg
22 to 44 pounds: 10 mg
44 pounds or more: 20 mg
|Once a day|
|Helicobacter pylori||20 to 40 mg (depending on combination therapy with antibiotics)||40 mg once a day or 20 mg twice a day|
|Hypersecretory pathological conditions.||60 mg (may vary)||Once a day|
All indicated doses are indicated by the manufacturer of the drug. Check your prescription and talk to your doctor to make sure you are taking the correct dose.
Omeprazole has been shown to be twice as effective and last a few hours longer in patients with chronic liver disease. People with liver failure taking Prilosek, especially if it is used for the long-term treatment of erosive esophagitis, may need a lower dose .
Older patients may take longer to clear the drug from the body and may require a lower dose.
How to take and store
Prilosek should be taken without a prescription in the morning before meals.
Prescription Prilosek should be taken at least one hour before meals; preferably before breakfast. The capsules should be swallowed whole and not chewed. If you have trouble swallowing, the contents of the Prilosec capsule can be mixed with applesauce or similar soft foods. Make sure the capsule granules are not crushed or chewed when swallowed.
Store over-the-counter tablets in a dry place at room temperature, ideally between 68 and 77 degrees F. Store prescription capsules at room temperature, between 59 and 86 degrees F. Keep container tightly closed and store in a dry place. does not get much light.
When mixing the oral suspension with water:
- Use a syringe to measure the liquid. You will mix 5 milliliters (ml) with each 2.5 mg pack and 15 ml with each 10 mg pack.
- Stir the medicine and water in a glass and let it thicken for two to three minutes.
- Stir again and drink within 30 minutes. If more time has passed, throw away the dose and prepare a new one.
- If any medication remains after drinking, add more water, stir, and drink immediately.
Store the oral suspension at room temperature, ideally between 68 and 77 degrees Fahrenheit.
If you miss a dose (of any medicine), take it as soon as you remember. If it is time for your next dose, skip the missed dose. Do not take a double dose to make up for a forgotten dose. If you take too much Prilosec, contact your doctor immediately.
Prilosec is generally well tolerated, but it can have serious side effects and these are important to consider when you start taking the medication.
The main side effects of Prilosek in adults and children include:
- Abdominal pain
- Threw up
In addition to this, children have two additional common side effects:
- Respiratory infections
Tell your doctor if you have any side effect that bothers you or that does not go away over time.
Serious or life-threatening side effects can occur with proton pump inhibitors, including allergic reactions or dangerously low levels of magnesium. Seek emergency medical attention for any of the following symptoms:
- Fast or abnormal heartbeat
- Shaking or tremors (tremors)
- Muscular weakness
- Hand and foot spasms
- Muscle cramps or aches
- Spasm of the vocal apparatus
- Rash, hives, or other skin reactions
- Difficulty breathing
- Difficulty to swallow
- Unexpected weight loss
Warnings and interactions
A drug-induced decrease in gastric acidity can interfere with diagnostic tests for neuroendocrine tumors. Always tell your doctor what medications you are taking, especially if you are going to have any tests.
It is especially important that you tell your doctor if you are taking any of the following medications or supplements, as they can interact with Prilosec. This list is incomplete. Your doctor or pharmacist can check for interactions between your prescription drugs.
- Antifungal or Yeast Medications: The effectiveness of any of these may be affected. Omeprazole causes the pH of the stomach to increase, which can affect how much of the antifungal drug Nizoral (ketoconazole) your body can use, making it less effective. The combination of omeprazole with the antifungal Vfend (voriconazole) may increase the effectiveness of omeprazole. The dose may need to be adjusted.
- Benzodiazepines: the removal of your body of central nervous system (CNS) depressants, including sedatives and anxiolytics such as Valium (diazepam), it can be extended if taken with omeprazole. Blood tests may be needed to see if dosage adjustments are necessary.
- Synthroid ( levothyroxine ): PPIs can make this drug less effective in hypothyroidism and increase thyroid-stimulating hormone (TSH) levels. Blood tests may be needed to see if dosage adjustments are necessary.
- Lanoxin (Digoxin) – Your body's use of lanoxin, which is used to treat heart failure or irregular heartbeat, can also be affected by the pH of stomach acid. In this case, a higher gastric pH can make digoxin at least 10% more potent. Patients taking both drugs may need to be monitored for digoxin toxicity.
- Calcium Supplements : The absorption of some calcium supplements, such as calcium carbonate, can be affected due to the pH of the gastric juice. If you are taking calcium carbonate, it is best to take it with meals. You may also consider switching to calcium citrate, which may not be affected by gastric pH.
- Iron supplements (iron salts): The amount of supplemented iron that enters the bloodstream may decrease due to the pH of the stomach acid while taking omeprazole.
- Trexall ( methotrexate ): The blood levels of this drug, which is used to treat cancer, rheumatoid arthritis, and psoriasis, may be elevated or elevated when taken with omeprazole. Blood tests may be required to verify the dose.
- Dilantin (phenytoin): The elimination of this anticonvulsant drug from the body can also be prolonged if it is taken with Prilosek. Blood tests may be needed to see if dosage adjustments are necessary.
- Antiretroviral Medications : Taking omeprazole with HIV antiviral medications can cause interactions that increase or decrease the effectiveness of antiretroviral medications. Prilosec with Reyataz (atazanavir) or Viracept (nelfinavir) can significantly reduce the blood levels of these anti-HIV drugs, while taking Prilosec with Norvir (saquinavir) can increase the effectiveness of Norvir.
- Immunosuppressive drugs: Blood levels of Prograf (tacrolimus), which is used to reduce the risk of rejection of transplanted organs, may increase when taken with omeprazole. The body's elimination of sandimmune ( cyclosporine ), another drug used for transplantation, can be prolonged by taking omeprazole. Tests may be required to verify the dose.
- Antabuse (disulfiram): The elimination of this drug, used to treat chronic alcohol dependence, can be prolonged when taken with omeprazole. Tests may be required to verify the dose.
- Ampicillin – This antibiotic can also be affected by gastric pH and may become less effective.
- Rifadin (rifampin): Rifadin, which is used to treat tuberculosis (TB), can speed up the processing of omeprazole in the liver, making omeprazole less potent and effective.
- Pletal (cilostazol): This drug, used to improve blood flow in the legs and treat leg pain, increases when taken with omeprazole. The dose of cilostazol can be reduced from 100 mg twice a day to 50 mg twice a day.
- St. John's Wort: This supplement can speed up the digestion of omeprazole in the liver, making omeprazole less potent and effective.
If you are using combination therapy for H. pylori, other drugs in the regimen, such as the antibiotic Bioxin (clarithromycin), can have other serious drug interactions.
Complications with prolonged use
Over-the-counter PPIs should only be taken for a few weeks and ideally under the supervision of a physician. If you need these medications for a long time, you should discuss this treatment with your doctor.
Prilosec and other proton pump inhibitors can interfere with certain tests and are associated with certain medical risks with long-term use, such as:
- Bone fractures: Long-term use of Prilosek several times a day may increase the risk of bone fractures, including fractures of the wrist, spine, and hip. Most of these fractures occur in people who take these drugs in high doses for a year or more.
- Low magnesium levels: In rare cases, long-term treatment with omeprazole can lead to low magnesium levels, which can become serious and life-threatening, as magnesium is necessary for many body processes and organ functions. Your healthcare provider may want to have regular blood tests to monitor your magnesium levels if you plan to take Prilosec for more than three months.
- Gastritis : Chronic inflammation of the stomach lining can occur with long-term use of omeprazole.