Gastroenterology: Medications

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All About Prilosec

Many patients are not as well informed about prescription medications as they ought to be. We believe the more you know about your medications, the better. This leaflet has been written to help you understand more about what Prilosec is and the importance of taking it properly. If any of the information in this leaflet causes you special concern or if you want additional information about this medication and its use, check with your doctor or pharmacist.

Remember to keep all prescription drugs out of reach and sight of children when not in use. Store all medicines in a cool dry place in their original labeled containers. Always read the label before using.

What is Prilosec?

Introduced in 1990, Prilosec is first in a new class of drugs that almost totally block the production of stomach acid. It is primarily used in the treatment of heartburn due to regurgitation of stomach acid into the esophagus. This also creates a more favorable environment for the healing of peptic ulcers. So it may also sometimes be used to treat and prevent ulcers of the stomach and duodenum. Taken by mouth, Prilosec is a man-made compound and is much more potent than Tagamet, Zantac, Pepcid, and Axid. Prilosec is a delayed-release tablet. It begins working within one hour and provides relief for over 24 hours.

Omeprazole (om-EP-rah-zahl) is the chemical name for this drug. It is still under protected patent and not yet available in a generic form. Unfortunately, it is quite expensive.

What Prilosec is not.

Prilosec has a different chemical structure and means of action than other drugs used for treatment of heartburn and peptic ulcers. It is not an antacid. Prilosec is not habit forming. It does not cause any drowsiness, sexual dysfunction, or breast enlargement.

Taking Prilosec properly

    1. Take the dose as prescribed. There is no fixed rule for the correct dose of Prilosec. Each case is different. Your doctor will determine what initial dose is best for you depending on the activity of your symptoms, your age, your weight, and any other medical conditions you may have. In general, most adults require a single 20 mg. tablet of Prilosec per day. Some conditions such as severe reflux esophagitis may require higher doses.

    Do not alter the dose on your own. Your doctor will routinely reassess what dose is necessary for you. The goal, of course, is to control your illness with the lowest effective dose of Prilosec possible.

    2. Prilosec can be taken either on an empty stomach or with food or milk. It is usually prescribed once or twice daily. If taken only once a day, it is best to take the medication at bedtime. Do not crush or chew the capsules. There are no food or beverage restrictions due to the Prilosec.

    3. Do not miss doses. If you do miss a dose, take your normal dose of Prilosec as soon as you remember and resume your normal schedule with the following dose. If it is almost time for the next dose, skip the missed dose and go back to your regular dosing schedule. While an occasional unintentional extra dose is unlikely to be harmful, do not double doses.

    4. Do not stop taking this medication on your own. If you have a peptic ulcer or severe esophagitis, you should take the full course of treatment as prescribed by your doctor. Keep taking Prilosec even if your symptoms quickly disappear. The painful symptoms can rapidly improve due to Prilosec even before the healing process is complete. The usual duration of therapy is from 4 to 8 weeks.

What are the side effects?

All medicines - even those purchased without a prescription - may sometimes produce unwanted side effects. In general, the risk of serious side effects from Prilosec has been extremely low. You can help limit side effects by taking the medication exactly as prescribed and promptly reporting any problems to your doctor. It is important that you keep all your appointments with your doctor so that he can be sure the medication is working and check for possible side effects.

These side effects should be reported to your doctor:

  • Severe skin rash, severe itching
  • Unexplained fever
The following side effects usually do not require medical attention. They often will go away as your body becomes used to the medication. However, if they continue or are bothersome, check with your doctor:
  • Mild headache
  • Dizziness
Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor, nurse, or pharmacist.


It is safe to take antacids as needed while you are taking Prilosec but do not take antacids at the same time as your dose of Prilosec. If you need antacids, take them at least 2 hours before or after your Prilosec. Cigarette smoking will block the beneficial effects of Prilosec. You should not smoke or chew tobacco when taking this drug.

Be sure your doctor knows if you are on Valium, Coumadin, Dilantin, or have severe liver disease. Tell your doctor if you are breast-feeding, pregnant, or plan to become pregnant in the near future. We feel it is best to avoid all potent prescription drugs during pregnancy whenever possible.

While Prilosec is quite effective in healing peptic ulcers and treating severe reflux esophagitis, it does not exert any long-term protective action once the medication has been discontinued. In most patients, Prilosec, or a less medication, must be taken on a long term basis to keep the problem under control. This is especially true for patients with chronic heartburn due to acid reflux. Patients with gastric or duodenal ulcers due to Helicobacter pylori may often stop all ulcer medications once the infection is cured. You should be alert to the possibility of recurrence of symptoms anytime after stopping the drug. If you suspect that your problem has returned, contact your doctor.


Prilosec is a powerful drug with many helpful properties, but as with all medications, side effects may occur. You can best limit problems with this medication by taking it exactly as prescribed. If you have any questions or concerns, please discuss them with your doctor.

Text & Images Courtesy of Three Rivers Endoscopy Center
© Dr. Robert Fusco, Three Rivers Endoscopy Center, All Rights Reserved

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