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What Does Prilosec Do?

Key Takeaways

  • Prilosec reduces stomach acid production by blocking proton pumps, helping treat heartburn, GERD, and ulcers.
  • It belongs to a class of medications called proton pump inhibitors (PPIs) that can reduce stomach acid by up to 65%.
  • Prilosec can take several days to reach its full effectiveness, unlike antacids that work immediately.
  • It is available over the counter (Prilosec OTC) and by prescription, with different dosing guidelines for each.
  • Long-term use may increase risks of bone fractures, kidney problems, and vitamin B12 deficiency.

If you have persistent heartburn or stomach pain won’t go away, your doctor may have suggested taking Prilosec. But what does Prilosec actually do, and how does it work differently from other heartburn medications? This comprehensive guide will walk you through everything you need to know about this widely used acid-blocking medication.

How Prilosec Works in Your Body

Prilosec (omeprazole) belongs to the drug class called proton pump inhibitors (PPIs). Understanding how it works helps explain why it is effective for certain conditions.

Your stomach produces acid through special pumps in your stomach lining called hydrogen-potassium ATPase pumps, or proton pumps. Prilosec blocks these proton pumps directly to prevent your stomach from making too much acid . This makes it particularly effective for treating chronic conditions like gastroesophageal reflux disease (GERD) and stomach ulcers.

When you start taking Prilosec, it doesn’t work instantly like antacids. Instead, it takes time to reach its full effects. After several days of daily use, Prilosec reduces approximately 65% of your stomach acid production.

While you won’t get immediate relief like you would from an antacid, Prilosec provides much more long-term protection against excess stomach acid.

What Conditions Does Prilosec Treat?

Prilosec is used to treat several medical conditions related to too much stomach acid. This includes:

  • Gastroesophageal Reflux Disease (GERD). This is probably the most common reason people take Prilosec. GERD occurs when stomach acid regularly flows back into your esophagus, causing chest pain, heartburn symptoms, and potentially damaging the lining of your esophagus over time.
  • Stomach ulcers and duodenal ulcers. These can develop when too much stomach acid damages the protective lining of your stomach or the first part of your small intestine. Prilosec helps these ulcers heal by reducing acid production. When ulcers are caused by H. pylori infection, doctors often prescribe Prilosec along with antibiotics to treat ulcers more effectively.
  • Erosive esophagitis. This is a more serious condition where stomach acid has actually damaged and inflamed your esophagus. Prilosec helps treat erosive esophagitis by giving your esophagus time to heal while protecting it from further acid damage.
  • Zollinger Ellison syndrome. This rare condition occurs when your stomach produces too much acid due to tumors. People with this condition need strong acid suppression, which Prilosec can acheive.

For over the counter use, Prilosec OTC specifically targets frequent heartburn. This is defined as heartburn that occurs 2 or more days per week.

How to Take Prilosec

Taking Prilosec correctly is important for getting the best results and avoiding complications. The way you take it depends on whether you’re using the prescription version or Prilosec OTC.

For prescription Prilosec, take it exactly as your healthcare provider prescribes, usually once daily before a meal. Taking it on an empty stomach about 30-60 minutes before eating helps your body absorb the medication better.

Prilosec OTC can be taken for up to 14 days, with 4 months between treatment courses. Don’t take it for longer than 14 days. If you still have symptoms after 2 weeks, call your doctor to discuss other options.

The medication comes in several dosage forms: delayed release capsules, delayed release tablets, and delayed release oral suspension. Always swallow the delayed release capsules and tablets whole. Don’t crush, chew, or break them. The delayed release coating protects the medication from your stomach acid so it can work properly.

If you have trouble swallowing capsules, you can open the delayed release capsule and sprinkle the granules on a tablespoon of applesauce. Swallow the mixture right away without chewing. For the oral suspension, mix the granules with water as directed before taking.

If you miss a dose, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose and continue with your regular schedule. Never take double or extra doses to make up for a missed dose.

Important Side Effects and Warnings

Like all medications, Prilosec can cause side effects, though not everyone experiences them. Common side effects of Prilosec include headache, nausea, vomiting, stomach cramps, abdominal pain, and cold-like symptoms. These are usually mild and often go away as your body adjusts to the medication.

However, there are some serious side effects and warnings you should know about, especially with long-term treatment. Taking it for a long time increases your risk of bone fractures, particularly fractures of the hip wrist or spine, especially if you’re over 50. This happens because reduced stomach acid can affect how well your body absorbs calcium.

Prilosec may also cause kidney problems. Watch for signs like decreased urination, blood in your urine, or unexplained weight loss, and contact your doctor immediately if you notice these symptoms.

Long-term use can lead to low magnesium levels in your blood, which can cause muscle cramps, muscle spasms, muscle pain, irregular heartbeat, or worsening joint pain. Your doctor may need to check your magnesium levels with laboratory tests if you’re taking Prilosec for an extended period.

Some people develop fundic gland polyps (abnormal tissue growth in the upper part of your stomach) with chronic use. While these are usually harmless, your doctor should monitor for them.

Serious allergic reactions are rare but require immediate medical attention. Call your doctor immediately if you experience trouble breathing, hives, or swelling of your face or throat. You can also expericence severe skin reactions such as Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN).

Prilosec may also increase your risk of severe diarrhea caused by C. difficile bacteria. If you develop persistent diarrhea, especially if it’s bloody or black stools, contact your healthcare provider right away.

Drug Interactions and Precautions

Prilosec can interact with other medications in ways that affect omeprazole or change how other medicines work in your body. Some interactions are serious enough to avoid certain combinations entirely.

Never take Prilosec with rilpivirine-containing antiretroviral medicines used to treat HIV. This combination can be dangerous and reduce the effectiveness of the HIV medication.

Prilosec can affect the levels of several other medications in your body, including digoxin (a heart medication), clopidogrel (a blood thinner), and methotrexate (used for cancer and autoimmune conditions). It can also interact with certain antibiotics and may change how well they work.

Tell your doctor about all other medications you’re taking, including over the counter drugs, supplements, and herbal products like St. John’s wort. Some diuretic medications and other medicines can also interact with Prilosec.

Before any medical tests or procedures, inform your healthcare provider that you’re taking Prilosec, as it can affect certain laboratory tests and may need to be stopped temporarily.

People of Asian descent may metabolize Prilosec differently and might need lower doses, especially when using it to treat erosive esophagitis. Your doctor will determine the right dose based on your individual needs.

If you have liver disease or kidney disease, your doctor may need to adjust your dose or monitor you more closely while you’re taking Prilosec.

Frequently Asked Questions

How long does it take for Prilosec to start working?

Prilosec takes 24 hours to 4 days to reach full effectiveness in reducing stomach acid production. You might notice some improvement in your symptoms within the first day or two, but maximum benefits usually take several days. For immediate relief of heartburn symptoms, you can use antacids alongside Prilosec, as they work within minutes but don’t last as long. Remember that Prilosec is designed for sustained acid control rather than immediate relief.

Can I take Prilosec with other heartburn medications?

You can safely take antacids with Prilosec for additional relief from indigestion or breakthrough symptoms. However, you should avoid taking other proton pump inhibitors or H2 blockers like Pepcid or Tagamet at the same time unless your doctor specifically tells you to. Combining different acid-reducing medications without medical supervision can lead to too much acid suppression or unexpected drug interactions. Always check with your healthcare provider before adding any new medications, even over the counter ones.

Is it safe to use Prilosec OTC for longer than 14 days?

No, Prilosec OTC should only be used for 14 consecutive days, and you must wait at least 4 months before starting another 14-day course. This limitation exists because longer use requires medical supervision to monitor for potential side effects and ensure the medication is still appropriate for your condition. If your symptoms persist after 14 days or come back frequently, you should consult a healthcare provider about prescription options or alternative treatments.

What’s the difference between Prilosec and other acid reducers like Pepcid?

Prilosec is a proton pump inhibitor (PPI) that provides stronger and longer-lasting acid reduction but takes several days to reach full effectiveness. It can reduce stomach acid production by up to 65% and is better for treating chronic conditions like GERD or gastric and duodenal ulcers. Pepcid (famotidine) is an H2 blocker that works faster – usually within an hour – but provides less overall acid reduction and is better suited for occasional heartburn or as-needed use. Both have their place in treating different types of acid-related problems.

Should I be concerned about taking Prilosec long-term?

Long-term use of Prilosec does come with increased risk of certain side effects, including bone fractures, kidney problems, vitamin B12 deficiency, and low magnesium levels. However, for many people with chronic conditions like GERD or recurrent gastric ulcers, the benefits often outweigh these risks. Your doctor should regularly monitor you if you need long-term treatment and will use the shortest effective duration possible. If you have concerns about long-term use, discuss them with your healthcare provider – they can help you weigh the benefits and risks for your specific situation and may suggest ways to minimize potential problems.

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