Omeprazole (patient information)

# Why is this medication prescribed
Prescription omeprazole is used alone or with other medications to treat ulcers (sores in the lining of the stomach or small intestine), gastroesophageal reflux disease (GERD), a condition in which backward flow of acid from the stomach causes heartburn and injury of the esophagus (tube that connects the mouth and stomach), and erosive esophagitis (swelling and wearing away of the lining of the esophagus). Omeprazole delayed-release capsules are also used to treat conditions in which the stomach produces too much acid. Omeprazole delayed-release capsules are also used in combination with other medications to eliminate H. pylori(a bacteria that causes ulcers) and possibly prevent new ulcers from developing in patients who have or have had ulcers of the small intestine. Omeprazole powder for suspension (to be mixed with water) is also used to prevent bleeding from the esophagus, stomach, or the top of the small intestine in people who have life-threatening illnesses. Nonprescription omeprazole is used to treat frequent heartburn (heartburn that occurs at least 2 days a week). Omeprazole is in a class of medications called proton-pump inhibitors. It works by decreasing the amount of acid made in the stomach.

# How should this medicine be used
Omeprazole comes as a delayed-release capsule, a nonprescription delayed-release tablet, a powder for suspension, and a regular capsule. The powder and regular capsule also contain sodium bicarbonate, a medication that decreases the amount of acid in the stomach and helps omeprazole to work quickly. The delayed-release capsules are usually taken once a day before a meal, but may be taken twice a day when used with other medications to eliminate H. pylori or up to three times a day when used to treat conditions in which the stomach produces too much acid. The capsules are usually taken once a day in the morning on an empty stomach one hour before a meal. The powder is usually taken once a day on an empty stomach one hour before a meal either in the morning or at bedtime. The nonprescription delayed-release tablets are usually taken once a day in the morning before eating. The nonprescription tablets should be taken for 14 days in a row, and additional 14-day treatments may be repeated once every 4 months if needed. To help you remember to take omeprazole, take it at around the same time(s) every day. Follow the directions on your prescription label or the package label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take omeprazole exactly as directed. Do not take more or less of it or take it more often or for a longer period of time than prescribed by your doctor or stated on the package.
Swallow the regular omeprazole capsules with water. Do not swallow the capsules with any other liquid.
Swallow the delayed-release omeprazole capsules, the regular capsules, and the nonprescription delayed-release tablets whole; do not split, open, chew or crush them. Do not crush the nonprescription delayed-release tablets in food and do not open the regular capsules and mix the contents with food.
If you have difficulty swallowing the delayed-release capsules, you may add the contents of a delayed-release capsule to applesauce. Place one tablespoon of soft, cool applesauce in an empty bowl. Open the delayed-release capsule and carefully empty all the pellets inside the capsule onto the applesauce. Mix the pellets with the applesauce and swallow the mixture immediately with a glass of cool water. Do not chew or crush the pellets. Do not store the applesauce/pellet mixture for future use.
If you are taking the powder, you must mix it with water before use. Place 1-2 tablespoons of water into a small cup and add the contents of one powder packet. Mix well and drink the mixture immediately. Refill the cup with water and drink the water to be sure that you swallow all of the medication. Do not mix the medication with any other liquid or with food.
If you are taking the powder or the regular capsules, be sure that you are taking the strength and the number of capsules or powder packets that your doctor prescribed. If you were told to take one 40 mg capsule or powder packet, do not take two 20 mg capsules or powder packets instead. They do not contain the same amount of medication as one 40 mg capsule or packet.Ask your doctor or pharmacist if you have any questions about how many capsules or packets you should take.
Do not take nonprescription omeprazole for immediate relief of heartburn symptoms. It may take 1-4 days for you to feel the full benefit of the medication. Call your doctor if your symptoms get worse or do not improve after 14 days or if your symptoms return sooner than 4 months after you finish your treatmentDo not take nonprescription omeprazole for longer than 14 days or more often than once every 4 months without talking to your doctor.
Your doctor may prescribe omeprazole for 10-14 days to eliminate H. pylori or for 4-8 weeks or longer to treat other conditions. Continue to take omeprazole even if you feel well. Do not stop taking prescription omeprazole without talking to your doctor.

# Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

# What special precautions should I follow
Before taking omeprazole
- tell your doctor and pharmacist if you are allergic to omeprazole,esomeprazole (Nexium), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex), any other medications,or any of the ingredients in the type of omeprazole you will be taking. Ask your pharmacist or check the package label for a list of the ingredients.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: ampicillin (in Principen, in Unasyn);anticoagulants ('blood thinners') such as warfarin (Coumadin); atazanavir (Reyataz); cyclosporine (Neoral, Sandimmune); diazepam (Valium); digoxin (Lanoxicaps, Lanoxin)disulfiram (Antabuse); ketoconazole (Nizoral); medications for anxiety and seizures;phenytoin (Dilantin); sedatives; sleeping pills; tacrolimus (Prograf); tranquilizers; and vitamins or supplements containing iron. If you will be taking the regular capsules or powder, tell your doctor if you are taking any antacids or calcium supplements.Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- if you will be taking the regular capsules or the powder, tell your doctor if you have or have ever had low levels of calcium or potassium in your blood or excessive vomiting. Your doctor may tell you not to take omeprazole capsules or powder.
- if you plan to take nonprescription omeprazole, first tell your doctor if your heartburn has lasted 3 months or longer or if you have experienced any of the following symptoms: lightheadedness, sweating, or dizziness along with your heartburn; chest pain or shoulder pain; shortness of breath or wheezing; pain that spreads to your arms, neck, or shoulders; unexplained weight loss; nausea; vomiting, especially vomiting blood; stomach pain; difficulty swallowing or pain when you swallow; or black or bloody stools. You may have a more serious condition that cannot be treated with nonprescription medication.
- tell your doctor if you have or have ever had liver disease.If you will be taking the regular capsules or the powder, also tell your doctor if you have been told to limit the amount of sodium in your diet, if you have or have ever had low levels of potassium in your blood, or if you have or have ever had Bartter's syndrome (condition in which the kidneys cannot absorb potassium from the blood properly).
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking omeprazole, call your doctor.

# What special dietary instructions should I follow
If you will be taking the regular capsules or the powder, your doctor may tell you to limit the amount of milk and other foods and drinks that are high in calcium that you eat and drink during your treatment. Follow these instructions carefully.
If you will be taking any other form of omeprazole, continue your normal diet unless your doctor tells you otherwise.

# What should I do if I forget a dose
Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

# Side effects

## Mild side effects
Omeprazole may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
- stomach pain
- diarrhea
- constipation
- dizziness
- cough
- back pain

## Severe side effects
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
- rash
- hives
- itching
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- difficulty breathing or swallowing
- hoarseness
- seizures
- muscle spasms, tightening, aching, or cramping
- burning or tingling of the lips, tongue, hands, or feet
Omeprazole may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

# What storage conditions are needed for this medicine
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light,excess heat, and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

# In case of emergency/overdose
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
Symptoms of overdose may include:
- confusion
- drowsiness
- blurred vision
- fast or pounding heartbeat
- nausea
- vomiting
- sweating
- flushing (feeling of warmth)
- headache
- dry mouth

# What other information should I know
Keep all appointments with your doctor.
Do not let anyone else take your medication. If you are taking prescription omeprazole, ask your pharmacist any questions you have about refilling your prescription.

# Brand names
- Prilosec
- Prilosec OTC
- Zegerid