Omeprazole

Some medicines and omeprazole can affect each other and make it more likely that side effects happen or will stop one of the medicines working properly.[1]

Tell a doctor if taking these medicines before starting start omeprazole treatment:[1]

• heart medicines, such as digoxin
• cilostazol, a medicine that treats peripheral arterial disease (PAD)
• antifungal medicines, such as itraconazole, ketoconazole, posaconazole and voriconazole
• methotrexate, a medicine that treats psoriasis and rheumatoid arthritis
• HIV medicines (see also: antiviral drug, but not all antivirals)
• phenytoin, an epilepsy medicine
• rifampicin, an antibiotic
• clopidogrel and warfarin, medicines to prevent or treat blood clots

These are not all the medicines that may not mix well with omeprazole. For a full list, see the leaflet inside the medicine packet.[1]

It is safe to take painkillers such as paracetamol or ibuprofen at the same time as omeprazole. But it is best to take ibuprofen with, or just after, a meal so it does not cause an upset stomach.[1]

Do not take St John's wort, the herbal remedy for depression, whilst taking omeprazole. It may stop omeprazole working as well as it should.[1]

There is not enough information to say that other complementary medicines and herbal remedies are safe to take with omeprazole. They are not tested in the same way as pharmacy and prescription medicines. They are generally not tested for the effect they have on other medicines.[1]

Report to a doctor or pharmacist taking any other medicines, including herbal remedies, vitamins or supplements.[1]

There are things that can to help cope. These common side effects of omeprazole happen in more than 1 in 100 people:[1]

• headaches
• feeling sick (nausea)
• being sick (vomiting) or diarrhoea
• stomach pain
• constipation
• farting (flatulence)

If coping does not help and any of these side effects continue affect life, or are a bother, then tell a doctor or pharmacist.

Serious side effects are rare and happen in less than 1 in 1,000 people. Call a doctor or call non-emergency services straight away if:[1]

• the skin becomes more yellow (although this may be less obvious on brown or black skin), pee becomes darker and the person taking it feels more tired – these can be signs of liver problems
• joint pain along with a red skin rash, especially on parts of the body exposed to the sun, such as the arms, cheeks and nose – these can be signs of a rare condition called subacute cutaneous lupus erythematosus (see also lupus). This can happen even after taking omeprazole for a long time with no problems
• severe or persistent diarrhoea – this can be a sign of an inflamed bowel

Taking omeprazole for more than 3 months may cause levels of magnesium in the blood to fall.[1] Low magnesium can make people feel tired, confused, dizzy and cause muscle twitches, shakiness and an irregular heartbeat. Report these symptoms to a doctor.[1]

Taking omeprazole for more than a year may increase the chances (risk) of certain side effects, including:[1]

• bone fractures
• gut infections
• vitamin B12 deficiency (not enough) – symptoms include feeling very tired, a sore and red tongue, mouth ulcers and pins and needles

If taking omeprazole for longer than 1 year, a doctor will regularly check the person's health to see if they should carry on taking it.[1]

It is not known if omeprazole works less well the longer that it is taken.

If omeprazole is not working any more, talk to the doctor.[1]

There is some research to suggest that taking medicines to reduce stomach acid, like PPIs and H2 blockers, may slightly increase the chance of developing stomach cancer. It also suggested that it could be more likely in people taking them for longer than 3 years. But studies involving more people need to be done to be sure that PPIs and H2 blockers cause stomach cancer, rather than something else causing it.

PPIs, like most medicines, have side effects so it is best to take them for the shortest time possible. It is also important to speak to a doctor if noticing any of these symptoms which can be signs of stomach cancer:[1]

• having problems swallowing (dysphagia)
• feeling or being sick
• feeling full very quickly when eating
• losing weight without trying

Speak to a doctor or pharmacist if there are concerns.

These are not all the side effects of omeprazole. For a full list, see the leaflet inside the medicine packet.

Each tablet or capsule contains 10mg, 20mg or 40mg of omeprazole. Liquid omeprazole comes labelled as either 2mg/1ml or 4mg/1ml.[1]

The usual dose to treat:[1]

• indigestion
  • 10mg to 20mg a day
• heartburn and acid reflux
  • 20mg to 40mg a day
• stomach ulcers
  • 20mg to 40mg a day
• Zollinger-Ellison syndrome
  • 20mg to 120mg a day

Doses are usually lower for children and people with liver problems.[1]

Sometimes a doctor will increase the dose of omeprazole if it is not working well enough.[1]

Depending on the reason why omeprazole is being taken, someone may take a higher dose to begin with, usually for a few weeks. After this, the doctor may recommend that the dose is lowered.[1]

Usually, omeprazole is taken once a day, first thing in the morning. It will not affect the stomach, so it can be taken with or without food.[1]

If taking omeprazole twice a day, take 1 dose in the morning and 1 dose in the evening. Swallow tablets and capsules whole with a drink of water or squash.[1] For having problems swallowing capsules, most brands of omeprazole capsules are easy to open. This means that someone can empty the granules inside and mix them into a small amount of water or squash. They could also be sprinkled on soft food, such as yoghurt or apple puree.[1]

Talk to a pharmacist if unsure whether the capsules can be opened.[1]

Omeprazole 20mg tablets can be bought from pharmacies and supermarkets. But omeprazole capsules, because they are prescription only. Omeprazole tablets bought from pharmacies or supermarkets can be taken by adults for up to 14 days.[1]

Liquid omeprazole can be prescribed by a doctor for children and people who cannot swallow capsules or tablets. Omeprazole also comes as a tablet that melts in the mouth.[1]

If omeprazole is being taken in liquid form, it will usually come already made by a pharmacist. It will come with a syringe or spoon to help the person take the right amount. If there is no syringe or spoon, ask the pharmacist for one. Do not use a kitchen teaspoon because it will not measure the right amount.[1]

If the medicine is bought from a pharmacy or supermarket to self treat, it can be taken for up to 14 days.[1] If feeling no better after taking omeprazole for 14 days, tell a doctor. They may want to do tests to find out what is causing the symptoms or change to a different medicine.[1]

Depending on the condition or the reason why omeprazole, it may be needed only for a few weeks or months. Sometimes, it might be needed for longer, even for many years.[1]

Some people do not need to take omeprazole every day and take it only when they have symptoms. Once feeling better (often after a few days or weeks), people can stop taking it.[1]

But taking omeprazole for a short time to treat symptoms is not suitable for everyone. Talk to a doctor about what is best for you.[1]

If usually taking it once a day, take the missed dose as soon as it is remembered. If it is 12 hours or less to the next dose, do not take it.

If usually taking it twice a day, take the missed dose as soon as it is remembered. If it is 4 hours or less to the next dose, do not take it.

Do not take 2 doses to make up for a forgotten one.

If forgetting doses often, it may help to set an alarm to remembwr. A pharmacist will have advice on other ways to help people remember to take their medicine.

Usually, people can stop taking omeprazole without reducing their dose first.[1] But if someone has been taking omeprazole for a long time, they should speak to the doctor before stopping taking it. Stopping suddenly could make the stomach produce a lot more acid, and make the symptoms come back. Reducing the dose gradually before stopping completely will prevent this happening.[1]

It's very unlikely that taking 1 or 2 extra doses by accident will cause any problems.[1]

But check first if ever worried.[1]

Side effects from taking too much omeprazole:[1]

• feeling sick
• being sick
• feeling dizzy
• stomach pain
• diarrhoea
• headache

If too much of the medicine has been taken, call a doctor or non-emergency services.[1]