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Omeprazole

Omeprazole

Overview

Prilosec is the first of a new class of drugs that combat acid secretion by blocking the final step.

This so-called proton pump is prescribed for the short-term treatment of duodenal ulcer and for conditions of abnormal acidity such as serious heartburn (GERD) or the rare Zollinger-Ellison syndrome.

It has a very quick onset and is extremely effective in reducing stomach acid.

Prilosec should not be prescribed as maintenance therapy to keep ulcers from coming back.

Side Effects and Interactions

Prilosec is generally well tolerated. However, headache, diarrhea, stomachache, muscle weakness and rash have been reported.

Other adverse reactions that have been reported less commonly include constipation, cough, fatigue, sore throat and vomiting. Report any symptoms or suspected reactions to your physician promptly.

Prilosec slows the elimination of several drugs that must be processed by the liver, including the anxiety medicine Valium, the anti-epileptic Dilantin and the blood thinner Coumadin.

Blood levels of these drugs may rise and side effects become a problem. If you take both Prilosec and Coumadin, tell your doctor right away if you experience any unusual bruising, bleeding, reddish urine or blackened stools. Prilosec is also reported to blood levels of Sandimmune or Antabuse.

Many other prescription drugs require acidity for absorption. Prilosec can interfere with such medicines, which include Nizoral, ampicillin and iron supplements, among others.

People taking acid-suppressing drugs such as Prilosec should not take enteric-coated peppermint oil. The enteric coating is designed to keep the oil from being absorbed until it reaches the more alkaline lower intestine. But when there is very little stomach acid, the enteric coating may dissolve prematurely, releasing the oil into the stomach.

In older people with too little stomach acid or in patients taking a strong acid suppressor such as Prilosec, vitamin B12 absorption may be impaired. Cranberry juice appears to improve the absorption of this crucial vitamin in such cases.

Be sure to check with your pharmacist and physician about potential interactions before taking any other medication or herb in combination with Prilosec.

Special Precautions

Animal studies have shown that Prilosec is associated with a dose-related increase in stomach cancers. It is not known whether this risk also applies to humans.

In addition, because it is so effective at reducing stomach acid concentrations, patients taking this medicine have higher levels of certain microorganisms in their stomachs than would normally survive there.

Scientists do not yet know whether these bacteria have negative long-term consequences.

Regular supplementation with vitamins C and E might in theory provide protection against nitrosamines produced by the bacteria.

People with liver disease have more trouble metabolizing Prilosec. Older people also remove the drug from circulation more slowly.

Taking the Medicine

Prilosec should be taken before meals.

These delayed-release capsules should not be opened, crushed or chewed, as that might expose them to stomach acid. The medication can be inactivated by acid.

Antacids may be taken with Prilosec if they are needed.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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