Omeprazole

Generic Name: omeprazole (oh MEP ra zol)
Brand names: Prilosec, Prilosec OTC, Zegerid (Original Formulation)

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What is omeprazole?

Omeprazole belongs to a group of drugs called proton pump inhibitors. Omeprazole decreases the amount of acid produced in the stomach.


Omeprazole is used to treat symptoms of gastroesophageal reflux disease (GERD) and other conditions caused by excess stomach acid. It is also used to promote healing of erosive esophagitis (damage to your esophagus caused by stomach acid).

Omeprazole may also be given together with antibiotics to treat gastric ulcer caused by infection with helicobacter pylori (H. pylori).

Omeprazole is not for immediate relief of heartburn symptoms.

Omeprazole may also be used for other purposes not listed in this medication guide.

Important information about omeprazole

Omeprazole is not for immediate relief of heartburn symptoms.

Some conditions are treated with a combination of omeprazole and antibiotics. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice.

You should not take this medication if you are allergic to omeprazole or to any other benzimidazole medication such as albendazole (Albenza), or mebendazole (Vermox).

Take omeprazole for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared.

Prilosec OTC (over-the-counter) should be taken only once every 24 hours for 14 days. It may take up to 4 days for full effect. Do not take more than one tablet every 24 hours.

Allow at least 4 months to pass before you start another 14-day treatment with Prilosec OTC. Call your doctor if you have additional symptoms and need treatment before the 4 months has passed.

Heartburn is often confused with the first symptoms of a heart attack. Seek emergency medical attention if you have chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, and a general ill feeling.

Ask a doctor or pharmacist if it is safe for you to take omeprazole if you have liver disease or heart disease, or low levels of magnesium in your blood.

Before taking omeprazole

You should not take this medication if you are allergic to omeprazole or to any other benzimidazole medication such as albendazole (Albenza), or mebendazole (Vermox).

Ask a doctor or pharmacist if it is safe for you to take omeprazole if you have liver disease or heart disease, or if you have low levels of magnesium in your blood.

Do not use over-the-counter omeprazole (Prilosec OTC) without the advice of a doctor if you have:

  • trouble or pain with swallowing;

  • bloody or black stools;

  • vomit that looks like blood or coffee grounds;

  • heartburn that has lasted for over 3 months;

  • frequent chest pain;

  • heartburn with wheezing;

  • unexplained weight loss;

  • nausea or vomiting; or

  • stomach pain.

Some conditions are treated with a combination of omeprazole and antibiotics. Use all medications as directed by your doctor. Read the medication guide or patient instructions provided with each medication. Do not change your doses or medication schedule without your doctor's advice.

Taking a proton pump inhibitor such as omeprazole may increase your risk of bone fracture in the hip, wrist, or spine. This effect has occurred mostly in people who have taken the medication long term or at high doses, and in those who are age 50 and older. It is not clear whether omeprazole is the actual cause of an increased risk of fracture. Before you take this medication, tell your doctor if you have osteoporosis or osteopenia (low bone mineral density).

FDA pregnancy category C. It is not known whether omeprazole will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Omeprazole can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are taking omeprazole. Do not give this medication to a child younger than 1 year old without the advice of a doctor.

See also: Omeprazole pregnancy and breastfeeding warnings (in more detail)

How should I take omeprazole?

Take omeprazole exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Omeprazole is usually taken before eating. Follow your doctor's instructions.

Do not crush, chew, or break an enteric-coated omeprazole tablet. Swallow the pill whole. The enteric-coated pill has a special coating to protect your stomach. Breaking the pill could damage this coating.

You may open the omeprazole delayed-release capsule and sprinkle the medicine into a spoonful of applesauce to make swallowing easier. Swallow this mixture right away without chewing. Do not save the mixture for later use. Discard the empty capsule.

Dissolve the powder in a small amount of water. Use 1 teaspoon of water for the 2.5-mg packet, or 1 Tablespoon of water for the 10-mg packet. Let the mixture stand for 2 or 3 minutes, then stir and drink right away. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away.

Prilosec OTC (over-the-counter) should be taken only once every 24 hours for 14 days. Take the medicine in the morning before you eat breakfast. It may take up to 4 days for full effect. Do not take more than one tablet every 24 hours.

Allow at least 4 months to pass before you start another 14-day treatment with Prilosec OTC. Call your doctor if you have additional symptoms and need treatment before the 4 months has passed.

Do not crush, chew, or break a Prilosec OTC tablet. Swallow the pill whole. Take omeprazole for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Call your doctor if your symptoms do not improve or if they get worse while you are taking this medicine.

Store omeprazole at room temperature away from moisture and heat.

See also: Omeprazole dosage (in more detail)

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include drowsiness, blurred vision, fast heartbeat, nausea, vomiting, sweating, headache, or dry mouth.

What should I avoid while taking omeprazole?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Omeprazole side effects

Get emergency medical help if you have any of these signs of an allergic reaction to omeprazole: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these symptoms of low magnesium:

  • dizziness, confusion;

  • fast or uneven heart rate;

  • jerking muscle movements;

  • feeling jittery;

  • muscle cramps, muscle weakness or limp feeling;

  • cough or choking feeling; or

  • seizure (convulsions).

Less serious omeprazole side effects may include:

fever;

cold symptoms such as stuffy nose, sneezing, sore throat;

stomach pain, gas;

nausea, vomiting, diarrhea; or

headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Omeprazole side effects (in more detail)

Omeprazole Dosing Information

Usual Adult Omeprazole Dose for Duodenal Ulcer:

20 mg orally once a day before a meal. Most patients heal within 4 to 8 weeks.

Usual Adult Omeprazole Dose for Helicobacter pylori Infection:

Dual therapy: omeprazole 40 mg orally once a day in the morning plus clarithromycin 500 mg orally 3 times a day on days 1 to 14. Beginning on day 15, omeprazole 20 mg orally once a day in the morning on days 15 to 28.

Triple therapy: omeprazole 20 mg plus clarithromycin 500 mg plus amoxicillin 1000 mg all given orally twice a day for 10 days. If an ulcer is present at the initiation of therapy, continue omeprazole 20 mg orally once a day for an additional 18 days.

Study (n=294) - Canadian Adult Dyspepsia Empiric Treatment-Helicobacter pylori positive (CADET-Hp): omeprazole 20 mg, metronidazole 500 mg, and clarithromycin 500 mg, twice daily for 7 days.

Usual Adult Omeprazole Dose for Gastric Ulcer:

40 mg orally once a day before a meal for 4 to 8 weeks.

Usual Adult Omeprazole Dose for Erosive Esophagitis:

20 mg orally once a day before a meal. This dosage may be increased to 40 mg per day based on desired clinical response and patient tolerance. Studies have been completed up to 12 months for maintenance therapy of erosive esophagitis.

Usual Adult Dose for Zollinger-Ellison Syndrome:

Initial: 60 mg orally once a day. Dosage should be individualized to patient's needs.

Maintenance: doses up to 120 mg 3 times a day have been administered. Daily doses greater than 80 mg should be divided.

Usual Adult Dose for Gastroesophageal Reflux Disease:

Initial: 20 mg orally once a day before a meal for 4 to 8 weeks. This dosage may be increased to 40 mg per day if needed.

Maintenance: long-term treatment with doses of 10 to 20 mg per day may be required for maintenance therapy of refractory disease and appears to be safe.

Usual Adult Dose for Multiple Endocrine Adenomas:

Initial: 60 mg orally once a day before a meal. This dosage may be titrated based on desired clinical response and patient tolerance.

Maintenance: doses up to 120 mg 3 times a day have been administered. Daily doses greater than 80 mg should be divided.

Usual Adult Dose for Systemic Mastocytosis:

Initial: 60 mg orally once a day before a meal. This dosage may be titrated based on desired clinical response and patient tolerance.

Maintenance: doses up to 120 mg 3 times a day have been administered. Daily doses greater than 80 mg should be divided.

Usual Adult Dose for Dyspepsia:

Prevention of frequent heartburn: 20 mg orally once daily, before a meal, for 14 days.

Usual Pediatric Omeprazole Dose for Gastroesophageal Reflux Disease:

>2 years
<20 kg: 10 mg once a day.
>=20 kg: 20 mg once a day

Studies:
>1 year: 0.7 to 3.5 mg/kg/day, given in 2 divided doses, not to exceed 80 mg daily.

Study (n=115)
<1 year: 1 to 1.5 mg/kg once daily for 56 days. Omeprazole was administered orally as a 2 mg/mL bicarbonate suspension.

Usual Pediatric Omeprazole Dose for Erosive Esophagitis:

>1 years: 0.7 to 3.5 mg/kg/day (maximum 80 mg/day), for 3 months. Dosage increments of 0.7 mg/kg/day to achieve stomach pH of <4.

What other drugs will affect omeprazole?

Tell your doctor about all other medicines you use, especially:

  • a blood thinner such as warfarin (Coumadin, Jantoven);

  • a diuretic (water pill);

  • cilostazol (Pletal);

  • clopidogrel (Plavix);

  • diazepam (Valium);

  • digoxin (Lanoxin, Lanoxicaps);

  • disulfiram (Antabuse);

  • cyclosporine (Gengraf, Neoral, Sandimmune);

  • tacrolimus (Prograf);

  • phenytoin (Dilantin);

  • ketoconazole (Nizoral), voriconazole (Vfend);

  • ampicillin (Principen, Unasyn);

  • HIV or AIDS medications such as atazanavir (Reyataz), nelfinavir (Viracept), saquinavir (Invirase); or

  • iron (Feosol, Mol-Iron, Fergon, Femiron, others).

This list is not complete and other drugs may interact with omeprazole. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.