acid | Consult-Afya Telehealth

Omeprazole is used alone or with other medications to treat the symptoms of conditions in which the stomach produces too much acid such as Zollinger-Ellison syndrome, Peptic ulcer disease, gastroesophageal reflux disease (GERD), a condition in which backward flow of acid from the stomach causes heartburn and possible injury of the esophagus.

Omeprazole is used to treat damage from GERD in adults and children 1 month of age and older. Prescription omeprazole is used to allow the esophagus to heal and prevent further damage to the esophagus in adults and children 1 year of age and older with GERD.

Prescription omeprazole is also used to treat conditions in which the stomach produces too much acid such as Zollinger-Ellison syndrome in adults.

Prescription omeprazole is also used to treat ulcers (sores in the lining of the stomach or intestine) and it is also used with other medications to treat and prevent the return of ulcers caused by a certain type of bacteria (H. pylori) in adults.

Nonprescription (over-the-counter) omeprazole is used to treat frequent heartburn (heartburn that occurs at least 2 or more days a week) in adults. Omeprazole is in a class of medications called proton-pump inhibitors. It works by decreasing the amount of acid made in the stomach.

Omeprazole Dosage and Prescription

Prescription omeprazole comes as a delayed-release (releases the medication in the intestine to prevent break-down of the medication by stomach acids) capsule, and packets of delayed-release (releases the medication in the intestine to prevent break-down of the medication by stomach acids) granules for suspension (to be mixed with liquid) to take by mouth or give through a feeding tube.

Nonprescription (over-the-counter) omeprazole comes as a delayed-release tablet to take by mouth. Prescription omeprazole is usually taken once a day before a meal but may be taken twice a day when used with other medications to eliminate H. pylori, or up to three times a day, before meals when used to treat conditions in which the stomach produces too much acid.

The nonprescription delayed-release tablets are usually taken once a day in the morning at least 1 hour before eating for 14 days in a row. If needed, additional 14-day treatments may be repeated, not more often than once every 4 months. To help you remember to take omeprazole, take it at around the same time(s) every day. Follow the directions on your prescription label or the package label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take omeprazole exactly as directed.

Do not take more or less of it or take it more often or for a longer period of time than prescribed by your doctor or stated on the package.

If you are taking the delayed-release tablets, swallow them whole with a full glass of water. Do not split, chew, or crush them or crush and mix them into food.

Swallow the delayed-release capsules whole. If you have difficulty swallowing the delayed-release capsules, place one tablespoon of soft, cool applesauce in an empty bowl. Open the delayed-release capsule and carefully empty all the granules inside the capsule onto the applesauce. Mix the granules with the applesauce and swallow the mixture immediately with a glass of cool water. Do not chew or crush the granules. Do not store the applesauce/granule mixture for future use.

Do not take nonprescription omeprazole for immediate relief of heartburn symptoms. It may take 1 to 4 days for you to feel the full benefit of the medication. Call your doctor if your symptoms get worse or do not improve after 14 days or if your symptoms return sooner than 4 months after you finish your treatment. Do not take nonprescription omeprazole for longer than 14 days or treat yourself with omeprazole more often than once every 4 months without talking to your doctor.

Continue to take prescription omeprazole even if you feel well. Do not stop taking prescription omeprazole without talking to your doctor. If your condition does not improve or gets worse, call your doctor.

What special precautions should I follow?

Before taking omeprazole,

tell your doctor and pharmacist if you are allergic to omeprazole, dexlansoprazole (Dexilant), esomeprazole (Nexium), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex), any other medications, or any of the ingredients in the omeprazole product you will be taking. Ask your pharmacist or check the package label for a list of the ingredients.

tell your doctor if you are taking rilpivirine (Edurant, in Cabenuva, Complera, Odefsey). Your doctor will probably tell you not to take omeprazole if you are taking this medication.

tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: anticoagulants (‘blood thinners’) such as warfarin (Jantoven), atazanavir (Reyataz, in Evotaz), cilostazol, citalopram (Celexa), clopidogrel (Plavix), cyclosporine (Gengraf, Neoral, Sandimmune), dasatinib (Sprycel), diazepam (Valium, Valtoco), digoxin ( Lanoxin), disulfiram, diuretics (‘water pills’), erlotinib (Tarceva), iron supplements, itraconazole (Sporanox, Tolsura), ketoconazole, methotrexate (Trexall, Xatmep), mycophenolate mofetil (Cellcept, Myfortic), nelfinavir (Viracept), nilotinib (Tasigna), phenytoin (Dilantin, Phenytek), rifampin (Rifadin, Rimactane), ritonavir (Norvir, in Kaletra), saquinavir (Invirase), tacrolimus (Astagraf, Envarsus, Prograf), and voriconazole (Vfend). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

tell your doctor what herbal products you are taking, especially St. John’s wort. Your doctor may tell you not to take St. John’s wort while taking omeprazole.

if you plan to take nonprescription omeprazole, tell your doctor if your heartburn has lasted 3 months or longer, if you have taken nonprescription omeprazole for a longer period of time than stated on the package, or if you have experienced any of the following symptoms: lightheadedness, sweating, or dizziness along with your heartburn; chest pain or shoulder pain; shortness of breath or wheezing; pain that spreads to your arms, neck, or shoulders; unexplained weight loss; nausea; vomiting, especially if the vomit is bloody; stomach pain; difficulty swallowing food or pain when you swallow food; or black or bloody stools. You may have a more serious condition that cannot be treated with nonprescription medication.

tell your doctor if you are of Asian descent and if you have or have ever had a low level of magnesium, calcium, or potassium in your blood; hypoparathyroidism (condition in which the body does not produce enough parathyroid hormone [PTH; a natural substance needed to control the amount of calcium in the blood]); low levels of vitamin B12 in your body; osteoporosis (a condition in which the bones become thin and weak and break easily); an autoimmune disease (condition in which the body attacks its own organs, causing swelling and loss of function) such as systemic lupus erythematosus; or liver disease.

What side effects can Omeprazole cause?

Omeprazole may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

constipation

gas

nausea

diarrhea

vomiting

headache

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately, or get emergency medical help:

blisters, peeling, or bleeding skin; sores on the lips, nose, mouth, or genitals; swollen glands; shortness of breath; fever; or flu-like symptoms

rash; hives; itching; swelling of the eyes, face, lips, mouth, throat, or tongue; difficulty breathing or swallowing; or hoarseness

irregular, fast, or pounding heartbeat; muscle spasms; uncontrollable shaking of a part of the body; excessive tiredness; lightheadedness; dizziness; or seizures

severe diarrhea with watery stools, stomach pain, or fever that does not go away

new or worsening joint pain; rash on cheeks or arms that is sensitive to sunlight

increased or decreased urination, blood in urine, fatigue, nausea, loss of appetite, fever, rash, or joint pain

People who take proton pump inhibitors such as omeprazole may be more likely to fracture their wrists, hips, or spine than people who do not take one of these medications. People who take proton pump inhibitors may also develop fundic gland polyps (a type of growth on the stomach lining). These risks are highest in people who take high doses of one of these medications or take them for one year or longer. Talk to your doctor about the risk of taking omeprazole.

Symptoms of overdose may include the following:

confusion

drowsiness

blurred vision

fast or pounding heartbeat

nausea

vomiting

sweating

flushing (feeling of warmth)

headache

dry mouth

What other information should I know about Omeprazole?

Keep all appointments with your doctor and the laboratory. Your doctor may order certain laboratory tests before and during your treatment.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking omeprazole.

Do not let anyone else take your medication. If you are taking prescription omeprazole, ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

This is a painful burning feeling just below or behind the breastbone. Most of the time, it comes from the esophagus. The pain often rises in your chest from your stomach. It may also spread to your neck or throat.

Causes of Heartburn

Almost everyone has heartburn at some time. If you have heartburn very often, you may have gastroesophageal reflux disease (GERD) or Peptic Ulcer Disease

Normally when food or liquid enters your stomach, a band of muscle at the lower end of your esophagus closes off the esophagus. This band is called the lower esophageal sphincter (LES).

If this band does not close tightly enough, food or stomach acid can back up (reflux) into the esophagus. The stomach contents can irritate the esophagus and cause heartburn and other symptoms.

Heartburn is more likely if you have a hiatal hernia. A hiatal hernia is a condition which occurs when the top part of the stomach pokes into the chest cavity. This weakens the LES so that it is easier for acid to back up from the stomach into the esophagus.

Pregnancy and many medicines can bring on heartburn or make it worse.

Medicines that can cause heartburn include:

Anticholinergics (used for sea sickness)

Beta-blockers for high blood pressure or heart disease

Calcium channel blockers ie nifedipine for high blood pressure

Dopamine-like drugs for Parkinson disease

Progestin for abnormal menstrual bleeding or birth control

Sedatives for anxiety or sleep problems (insomnia)

Theophylline (for asthma or other lung diseases)

Tricyclic antidepressants

Talk to your health care provider if you think one of your medicines may be causing heartburn. Never change or stop taking medicine without talking to your provider first.

Home Care for Heartburns

You should treat heartburn because reflux can damage the lining of your esophagus. This can cause serious problems over time. Changing your habits can be helpful in preventing heartburn and other symptoms of GERD.

The following tips will help you avoid heartburn and other GERD symptoms. Talk to your provider if you are still bothered by heartburn after trying these steps.

First, avoid foods and drinks that can trigger reflux, such as:

Alcohol

Caffeine and chocolate

Carbonated drinks

Citrus fruits and juices

Peppermint and spearmint

Spicy or fatty foods, full-fat dairy products

Tomatoes and tomato sauces

Next, try changing your eating habits:

Avoid bending over or exercising just after eating.

Avoid eating within 3 to 4 hours of bedtime. Lying down with a full stomach causes the stomach contents to press harder against the lower esophageal sphincter (LES). This allows reflux to occur.

Eat smaller meals.

Make other lifestyle changes as needed:

Avoid tight-fitting belts or clothes that are snug around the waist. These items can squeeze the stomach, and may force food to reflux.

Lose weight if you are overweight. Obesity increases pressure in the stomach. This pressure can push the stomach contents into the esophagus. In some cases, GERD symptoms go away after an overweight person loses 10 to 15 pounds (4.5 to 6.75 kilograms).

Sleep with your head raised about 6 inches (15 centimeters). Sleeping with the head higher than the stomach helps prevent digested food from backing up into the esophagus. Place books, bricks, or blocks under the legs at the head of your bed. You can also use a wedge-shaped pillow under your mattress. Sleeping on extra pillows does NOT work well for relieving heartburn because you can slip off the pillows during the night.

Stop smoking or using tobacco. Chemicals in cigarette smoke or tobacco products weaken the LES.

Reduce stress. Try yoga, tai chi, or meditation to help relax.

If you still do not have full relief, try over-the-counter medicines:

Antacids, like Maalox, Mylanta, or Tums help neutralize stomach acid.

H2 blockers, like Pepcid AC, Tagamet HB, and Axid AR reduce stomach acid production.

Proton pump inhibitors, like Prilosec OTC, Prevacid 24 HR, and Nexium 24 HR stop nearly all stomach acid production.

When to Contact a Medical Professional

Get urgent medical care if:

You vomit material that is bloody or looks like coffee grounds.

Your stools are black (like tar) or maroon.

You have a burning feeling and a squeezing, crushing, or pressure in your chest.

Sometimes people who think they have heartburn are having a heart attack.

Call your provider if:

You have heartburn often or it does not go away after a few weeks of self-care.

You lose weight that you did not want to lose.

You have trouble swallowing (food feels stuck as it goes down).

You have a cough or wheezing that does not go away.

Your symptoms get worse with antacids, H2 blockers, or other treatments.

You think one of your medicines may be causing heartburn. DO NOT change or stop taking your medicine on your own.

What to Expect at Your Hospital Visit

Heartburn is easy to diagnose from your symptoms in most cases. Sometimes, heartburn can be confused with another stomach problem called dyspepsia. If the diagnosis is unclear, you may be sent to a doctor called a gastroenterologist for more testing.

First, your provider will do a physical exam and ask questions about your heartburn, such as:

When did it begin?

How long does each episode last?

Is this the first time you have had heartburn?

What do you usually eat at each meal? Before you feel heartburn, have you eaten a spicy or fatty meal?

Do you drink a lot of coffee, other drinks with caffeine, or alcohol? Do you smoke?

Do you wear clothing that is tight in the chest or belly?

Do you also have pain in the chest, jaw, arm, or somewhere else?

What medicines are you taking?

Have you vomited blood or black material?

Do you have blood in your stools?

Do ,you have black, tarry stools?

Are there other symptoms with your heartburn?

Your provider may suggest one or more of the following tests:

Esophageal motility to measure the pressure of your LES

Esophagogastroduodenoscopy (upper endoscopy) to look at the inside lining of your esophagus and stomach

Upper GI series (most often done for swallowing problems)

If your symptoms do not get better with home care, you may need to take medicine to reduce acid that is stronger than over-the-counter medicines. Any sign of bleeding will need more testing and treatment.

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