Prilosec (omeprazole) is a proton pump inhibitor (PPI) designed for the clinical management of frequent heartburn and acid-related disorders. By targeting the proton pumps in gastric parietal cells, it provides sustained suppression of gastric acid production, offering both symptomatic relief and therapeutic resolution of underlying conditions. This medication is indicated for short-term treatment and maintenance therapy under professional supervision, aligning with evidence-based gastroenterological practice.

Features

• Active ingredient: Omeprazole 20 mg delayed-release tablets
• Mechanism: Irreversible inhibition of H+/K+ ATPase enzyme system
• Formulation: Enteric-coated to prevent gastric degradation
• Administration: Oral, once daily before meals
• Onset: Maximal acid suppression within 2–4 hours of dosing
• Duration: Sustained antisecretory effect for up to 72 hours

Benefits

• Provides 24-hour relief from frequent heartburn by reducing gastric acid secretion
• Promotes healing of erosive esophagitis with proven endoscopic resolution
• Reduces risk of NSAID-associated gastric ulcer formation when co-administered
• Maintains symptomatic control in gastroesophageal reflux disease (GERD)
• Supports Zollinger-Ellison syndrome management through dose-dependent acid suppression
• Offers convenient once-daily dosing regimen for improved adherence

Common use

Prilosec is clinically indicated for the short-term treatment (4–8 weeks) of active duodenal ulcer, active benign gastric ulcer, erosive esophagitis, and symptomatic GERD. Maintenance therapy is approved for healed erosive esophagitis and pathological hypersecretory conditions including Zollinger-Ellison syndrome. Off-label uses may include stress ulcer prophylaxis in critically ill patients and reduction of upper GI bleeding risk, though these applications require individualized risk-benefit assessment.

Dosage and direction

Administer one 20 mg tablet orally once daily before a meal, preferably in the morning. Swallow whole; do not crush, chew, or split tablets. For patients with difficulty swallowing, tablets may be dispersed in tablespoon of applesauce and swallowed immediately without chewing. Treatment duration varies by indication: 4 weeks for duodenal ulcer, 4–8 weeks for gastric ulcer and erosive esophagitis, and up to 12 months for maintenance therapy. Dosage adjustment may be necessary in hepatic impairment.

Precautions

Long-term use (beyond one year) requires periodic monitoring of magnesium levels, as hypomagnesemia may occur. Observe for clinical symptoms of hypomagnesemia such as tetany, arrhythmias, or seizures. Use with caution in patients with osteoporosis; PPIs may be associated with increased risk of fractures of hip, wrist, or spine. Monitor for vitamin B12 deficiency with prolonged therapy. Not intended for immediate relief of heartburn; allow 1–4 days for full therapeutic effect.

Contraindications

Hypersensitivity to omeprazole, substituted benzimidazoles, or any component of the formulation. Concomitant use with rilpivirine-containing products due to potential for reduced antiviral efficacy. Avoid use in patients with suspected gastrointestinal malignancy, as symptomatic response to omeprazole may delay diagnosis. Not recommended during third trimester of pregnancy unless potential benefit justifies potential risk to fetus.

Possible side effects

Common adverse reactions (≥1%): headache (7%), abdominal pain (5%), nausea (4%), diarrhea (4%), vomiting (3%), flatulence (3%). Serious adverse effects may include: Clostridium difficile-associated diarrhea, acute interstitial nephritis, cutaneous lupus erythematosus, systemic lupus erythematosus, cyanocobalamin (vitamin B12) deficiency, hypomagnesemia, and fundic gland polyps. Discontinue immediately and evaluate if severe dermatological reactions occur.

Drug interaction

Omeprazole may alter absorption of drugs requiring acidic gastric pH, including ketoconazole, iron salts, and digoxin. Inhibits CYP2C19 metabolism, increasing concentrations of diazepam, warfarin, and phenytoin. Concomitant use with clopidogrel may reduce antiplatelet activity. Increases systemic exposure to saquinavir and may increase toxicity of methotrexate. St. John’s wort may decrease omeprazole concentrations.

Missed dose

If a dose is missed, administer as soon as remembered unless it is nearly time for the next scheduled dose. Do not double doses to make up for missed administration. Maintain regular dosing schedule; consistency is crucial for maintaining acid suppression. If multiple doses are missed, reinitiate therapy at next scheduled time and consult healthcare provider regarding potential need for additional measures.

Overdose

Symptoms may include confusion, drowsiness, blurred vision, tachycardia, nausea, diaphoresis, flushing, headache, and dry mouth. Omeprazole is not dialyzable. Management should be supportive and symptomatic. No specific antidote exists. Gastric lavage may be considered if performed shortly after ingestion. Monitor vital signs and provide appropriate supportive therapy based on clinical presentation.

Storage

Store at room temperature 20°C to 25°C (68°F to 77°F); excursions permitted between 15°C to 30°C (59°F to 86°F). Keep container tightly closed and protect from moisture and light. Dispense in original container with desiccant canister intact. Keep out of reach of children. Do not use if blister packs are torn, broken, or show signs of tampering.

Disclaimer

This information does not replace professional medical advice. Consult a healthcare provider before starting any new medication. Individual results may vary. Use only as directed. Not all possible uses, precautions, side effects, or interactions are listed. Report any adverse reactions to your physician immediately.

Reviews

Clinical trials demonstrate healing of erosive esophagitis in approximately 85% of patients after 8 weeks of therapy. Maintenance studies show 70% of patients remain healed after 12 months of treatment. Real-world evidence supports effectiveness in GERD symptom control, though individual response varies. Some patients report inadequate symptom relief requiring alternative dosing strategies or additional medications. Long-term safety profile remains favorable with appropriate monitoring.