Five Things You May Not Know About Omeprazole

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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Omeprazole (Prilosec) is a cheap, generic medication available both over the counter, or with a prescription. Used for the treatment of reflux disease, ulcers, and stomach protection from NSAIDS (non-steroidal anti-inflammatory drugs), it is one of the most common medications used by adults. Omeprazole is a proton pump inhibitor (PPI), a class of drugs that are used to treat GERD, ulcers and heartburn.

Even if you’ve been taking omeprazole for a while, there may be some things you aren’t aware of:

  1. Omeprazole can prevent illnesses? Studies have shown that people treated with omeprazole have different communities of bacteria than untreated patients. Specifically, people taking omeprazole have higher counts of bacteria (not a good thing) like enterococcus, streptococcus, staphylococcus and some species of escherichia coli. The significance of this is not fully known, but the gut bacteria play an important role in our defense against pathogens, so disrupting the gut flora may be a downside of omeprazole. Disrupting the gut flora—which allows some “bad” bacteria to overcome the “good” bacteria—may be why people taking omeprazole are at higher risk of clostridium difficile infections. We may learn that omeprazole, and other proton pump inhibitors, have more prominent effects on the gut bacteria than antibiotics.
  2. Is it the best medication for stomach issues? Studies show omeprazole works better than rabeprazole (Aciphex) for more stomach issues, but it does not work as well for GERD as esomeprazole (Nexium).
  3. Omeprazole and risk of heart attack?! A study released in August 2016 found that taking PPIs, like omeprazole, could be a risk factor for cardiovascular adverse events. The full impact of this has not been fully explored, but in this study, the sustained use of PPIs was associated with a 70% increased cardiovascular risk–and that was higher in those taking omeprazole for an extended period of time.
  4. What about acupuncture? Acupuncture worked better than Omeprazole in a recent study out of China in 2016. The researchers compared the outcomes of GERD in patients taking omeprazole versus those undergoing acupuncture treatments. After 8 weeks, both groups had improved symptoms but the effect of acupuncture was significantly superior to that of omeprazole for improving symptoms. Worth a try!
  5. Can I take omeprazole “as needed” when I have symptoms? Unfortunately, it doesn’t work that way! Taking omeprazole once a day will only inhibit the acid in your stomach after five days. So, taking it on an “as needed” basis will not provide enough acid suppression and symptom relief. However, some histamine-2 antagonists, like Tagamet, Ranitidine or Zantac, are better for that.

Dr O.

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