Omeprazole vs Zantac

What is the difference between Zantac and Omeprazole for GERD?

Omeprazole and Zantac (ranitidine) work by blocking the production of gastric acid in the stomach however with different mechanisms. Studies showed that both drugs effectively treated heartburn symptoms, but omeprazole provides greater relief of heartburn symptoms during 2 to 4 weeks. Both are available as a prescription or OTC, depending on the dosage. So there are many differences between these two drugs.

Omeprazole is a Proton Pump Inhibitor (PPI) while Zantac (ranitidine) is an H2 histamine blocker. Studies of both drugs showed significant inhibition in the production of acid in the stomach. Zantac has faster onset of action and starts working within 24 hours. Omeprazole also starts working within 24 hours, though it may take from 1 to 4 days for the full effect. Omeprazole effects are more potent and complete than Zantac’s. Over long-term use omeprazole is more effective than ranitidine.

These drugs are used to treat similar conditions, including:

  • heartburn
  • stomach upset
  • GERD
  • stomach or duodenal ulcers
  • erosive esophagitis
  • hypersecretory conditions
  • peptic ulcers due to certain types of cancer

In addition Omeprazole can be also used to treat H. pylori infection and Barrett’s esophagus.

In the treatment of Gastric and Peptic Ulcers Omeprazole is more preferable than Zantac due to more effective and long lasting acid secretion inhibition. However the Zantac is still used for its antiemetic properties as a prophylactic drug. It can also be given in a combination theraoy with NSAIDS to reduce the chances of acidity and gastric ulcers. Long term use of Omeprazole can lead to vitamine B12 deficiency as Omeprazole lowers its absorption by reducing the acidic environment. Omeprazole is especially effective in the treatment of a rare condition known as Zollinger-Ellison syndrome, the condition where stomach produces too much of acid. On the other hand Zantac is usally not prescribed in the treatment of Zollinger-Ellison syndrome.

Common side effects of Omeprazole include gas, constipation, nausea, vomiting and headache. Rare but severe side effects include excessive dizziness, tiredness, lightheadedness, muscle spasms, seizures, uncontrollable shaking of a part of the body, stomach pain, diarrhea with watery stools, fever and irregular, fast, or pounding heartbeat.

Zantac may have side effects like headache, constipation or diarrhea. Rare but severe side effects include easy bleeding or bruising, blurred vision, enlarged breasts, severe stomach, severe tiredness or abdominal pain, dark urine and yellowing skin or eyes. Other severe side effects include mental or mood changes such as confusion, agitation, depression, and hallucinations, changes in heartbeat; and signs of infection such as persistent sore throat, cough and fever. Patients who stop taking either omeprazole or Zantac may experience the recurrence of regular heartburn and other symptoms of the original illness. Stoppage of omeprazole may cause acid reflux, while stoppage of Zantac may cause recurrent dyspepsia.

A 30-count package of 20 milligram Prilosec pills starts at $10.05. A 30-count package of 150 milligram Zantac tablets starts at $4.

Omeprazole vs Lansoprazole vs Pantoprazole vs Esomeprazole

Omeprazole vs Lansoprazole vs Pantoprazole vs Esomeprazole

Omeprazole vs Lansoprazole vs Pantoprazole vs Esomeprazole in the treatment of reflux esophagitis

One comparative study was conducted in order to clarify whether there is any difference in the symptom relief in patients with reflux esophagitis after administration of four Proton pump inhibitors (PPIs): Omeprazole, Lansoprazole, Pantoprazole and Esomeprazole. Study compared their symptom relief in the first 7 days of reflux esophagitis treatment. It has been showed that esomeprazole was most effective for symptom relief within 2 days compared to omeprazole, pantoprazole and lansoprazole administration; however this difference disappeared 5 days after beginning of drug administration. Study also confirmed that esomeprazole use of 40 mg daily was more effective than omeprazole 20 mg, lansoprazole 30 mg, pantoprazole 40 mg daily in the relief of heartburn symptoms during the first day and the first 5 days after the begining of administration. A consequence of such results is because esomeprazole has been shown to have a faster onset of antisecretory activity comapraed to omeprazole, lansoprazole and pantoprazole. The healing rate of reflux esophagitis after 8 weeks of treatment tended to be higher in patients administered esomeprazole than in patients who administered omeprazole, lansoprazole or pantoprazole, although these differences did not reach a statistically significant level.

Omeprazole Vs Lansoprazole

There have been many debates into the similarities differences between omeprazole and lansoprazole. Both drugs belong to the same class of drugs called PPIs and can be used as an effective acid reflux treatment. Although they are from the same family of drugs and have the same mechanism of action, there are slight differences that may need to be considered when taking these drugs.

Studies showed that lansoprazole can be more potent and thus effective in acid lowering for acid reflux treatment and in some cases, it is considered as faster acting than omeprazole. However antacids such as Gaviscon are able to reduce the absorption of this drug from the gastrointestinal tract and may also decrease its efficiency. Antacids can also lower the effects of the same time administered omeprazole but not in rates as they do to lansoprazole. Therefore Lansoprazole should not be taken within an hour of taking antacids. It has been also showed that lansoprazole is more likely to cause anemia or iron deficiency than omeprazole. On the other hand, omeprazole may enhance anti-clotting effects of the anticoagulants such as warfarin or thrombocyte antiaggregation drugs such as clopidogrel. You should monitor your INR levels before taking this medication and upon stopping it. Both medications are suggested by recent studies that increase the risk of bone fractures when they are taken on a long term basis. This can be managed by taking enough calcium and vitamin D to reduce this risk.

Studies also showed that both drugs begin to work within 24 hours, but it may take up to 4 days pass before their effects become noticeable. After long-term use, it has been showed that lansoprazole is more effective than omeprazole.

Both drugs have almost the same structured indications; however omeprazole is label indicated for initially treatment of Zollinger-Ellison Syndrome while lansoprazole is not.

Omeprazole has a higher potential to cause allergic reactions compared to lansoprazole. For either drug, patients should warn their doctors if they have a history of liver disease. Potential lansoprazole users need to tell their healthcare providers of any previous medical history that includes sweating, lightheadedness or dizziness along with the heartburn; chest pain or shoulder pain; pain that spreads to the arms, neck, or shoulders; shortness of breath or wheezing; unexplained weight loss; nausea or vomiting. Also both drugs may cause withdrawal symptoms if they are taken for a long time. Patients who stop taking either omeprazole or lansoprazole may experience the return of regular heartburn but also the other symptoms of the original illness. Ending use of either of these drugs may cause acid reflux.

Lansoprazole is classified in the category B by the FDA pregnancy list of drugs while pantoprazole is in category C. This means that, omeprazole is not safe during pregnancy, but potential benefits may warrant use of the drug in pregnant women despite potential risks. Lansoprazole should only be used during pregnancy if benefits outweigh risks.

30-count package of 15mg Prevacid capsules cost about $38 at most pharmacies, while a similar supply of 20 mg Prilosec capsules cost about $10. Both are one-month supplies. The drugs may be found more cheaply online in some cases.

Omeprazole vs Esomeprazole

Both drugs belong to the same class of medications known as proton pump inhibitors and have similar mechanism of action, however there are some differences. Omeprazole is a pro-drug which is converted in the gastric parietal cells to the active drug compared to Esomeprazole which is the active drug. Studies showed that esomeprazole is more potent than Omeprazole because omeprazole is a racemic mixture and esomeprazole may give the same degree of acid suppression with lower doses in comparison to omeprazole. Esomeprazole has higher bioavailability of Omeprazole ranging from 30-76% while Esomeprazole ranges from 50 – 90 %. Approximately 95% of Omeprazole is bound to blood plasma compared to 97% in case of Esomeprazole. Both medications are prescribed for same indications, but omeprazole can be used for both adults and children, while esomeprazole is only prescribed for adult patients.

One study conducted by NIH showed that esomeprazole was more beneficial and safer for patients with gastroesophageal reflux disease (GERD). Esomeprazole was also superior to omeprazole for all secondary measures and had a similar safety profile. Esomeprazole in doses of 40 mg was more effective in controlling acid production in GERD patients than twice the dose of omeprazole.

Both esomeprazole and omeprazole have similar side effects profiles. Common side effects include diarrhea, nausea, gas, headache and abdominal pain. In addition, esomeprazole can also cause dry mouth, constipation and drowsiness. Omeprazole can cause vomiting in higher rates. In children, esomeprazole can cause headache, diarrhea, abdominal pain, nausea. Omeprazole, in addition may also cause respiratory problems and fever.

Esomeprazole (Nexium) is a prescription drug and has no generic equivalent available. Prilosec costs much less, and it can be bought as OTC in generic form.

Omeprazole and kidney damage

Omeprazole and kidney damage

Could Omeprazole damage the kidney?

Many factors may contribute to the development of kidney disease, and new findings has been linked some of those caused by a certain pharmaceuticals, including proton pump inhibitors drugs. Proton pump inhibitors (PPIs) such as Prevacid, Prilosec (omeprazole) and Nexium have been associated with renal failure. Numerous studies suggested that these drugs may cause kidney disease. Dr. Cynthia A. Naughton of the North Dakota State University College of Pharmacy said that PPIs cause 20 % of acute kidney injury. However, researchers are still seeking for exact mechanism and to explain the reason why, but one theory is that PPIs may cause kidney injury by lowering levels of magnesium, that is crucial to proper kidney function. Interstitial nephritis has been most commonly assocoiated to PPI usage. A 2015 study published by the Pharmaceutical Journal stated, “All PPIs are associated with acute interstitial nephritis.” Older study from 2013 published by BMC Nephrology, looked at 184,480 patients on PPIs therapy and also found a positive link between renal disease and PPI usage, even after adjusting for other possible contributing factors. Further studies into PPIs’ impact on the kidneys are in progress.

In early 2016, a significant number of researches has been published and linked PPI use to kidney disease. In April, researchers at the Veterans Affairs St. Louis Health Care System released a report showing that PPIs patients were more likely than those who used alternative heartburn drugs such as antacids and H2-antagonist to have CKD or ESRD within five years from the start of PPI usage. In January, a study published in the JAMA Network Journals stated that PPI users had a 15.9 percent risk of developing kidney disease over 10 years, whereas non-PPI users only had a 13.9 percent risk. Several academic and medical institutions are currently performing deeper research into this link.

Omeprazole and stomach flu

Omeprazole and stomach flu

Could Omeprazole cause Stomach flu?

Recent studies found that patients who use proton pump inhibitors drugs to control stomach acid production are more likely to suffer from infectious gastroenteritis, also known as stomach flu. Yingxi Chen and colleagues of the Australian National University followed about 38,000 patients for more than six years. They found that patients who use PPIs such as esomeprazole and omeprazole were about one and a half times more likely to suffer gastroenteritis that required hospitalization compared to non-users. The incidence of gastroenteritis was also dose related. Elderly users of PPIs and those who had a higher BMI were at the highest risk of infection.

According to this data it has been suggested that PPIs may lower ability to fight infections. PPIs lower gastric acidity, which is the first line defense against ingested pathogens. This may lead to bacterial colonization, thus increasing an individual’s susceptibility to enteric infection. Also, another recent study from this year by Robert-Jan Hassing and colleagues published in the European Journal of Epidemiology found similar results. The initial results were that PPIs users are six times more likely compared to non-users to be infected with stomach flu. However after refining data researchers reduced that to about two times. The most frequently used PPI was esomeprazole, available in the brand name Nexium, which made up 30.1 % of all prescriptions. Omeprazole came on second place, under the brand name Prilosec, followed with 25.2 % and pantoprazole with brand name Protonix took 21.4 % of prescriptions.

Can I take Omeprazole with Warfarin?

Can I take Omeprazole with Warfarin?

Can I take Prilosec with coumadin?

Using omeprazole together with warfarin in some rare cases may increase the risk of bleeding. If these medications are prescribed together, patients may need a dose adjustment or frequent monitoring of prothrombin time or International Normalized Ratio (INR) to safely use both medications. Patients should call their doctor promptly if they experience any unusual bleeding or bruising, vomiting, blood in your urine or stools, swelling, headache, dizziness, or weakness.

Can I take Omeprazole with St. John’s Wort?

Can I take Omeprazole with Peppermint

Does Peppermint Oil or capsules interact with Omeprazole?

Omeprazole lowers the amount of acid in the stomach so if enteric-coated peppermint capsules that are meant to dissolve in intestines which are low-acid location, are taken together with omeprazole, the peppermint will be released in the stomach instead of the intestines. The peppermint oil can enhance the production of more stomach acid so the effectiveness of both peppermint and omeprazole may be reduced. Acid indigestion and heartburn may not be controlled and intestinal spasms may not be relieved. That’s why peppermint oil should not be used at the same time as omeprazole. If omeprazole and peppermint-oil capsules are both used, peppermint capsules should be taken at least 2 hours apart from omeprazole. It should be known that peppermint flavors in teas or foods do not contain enough peppermint oil to cause a problem. Always ask your healthcare provider about this potential interaction if you think you are having problems.

Can I take Omeprazole with Macrobid?

Can I take Omeprazole with Metformin?

Metformin and Prilosec Drug Interactions

A recent in-vitro study revealed that PPIs including omeprazole may inhibit metformin uptake by organic cation transporters (OCTs). This interaction may have the influence on metformin disposition and/or efficacy. Since there is a possibility for the concomitant administration of metformin and omeprazole in patients with chronic diabetes, bigger studies are planned for further investigatigtion.

Also, it is known that both drugs may cause the possibility of developing a vitamin B12 deficiency if these drugs are taken together for a long time. There are many diabetics with gastric problems so this combination is not uncommon, and it may cause particular problems for older adults with difficulties absorbing vitamin B12. Elderly people on metformin should be monitored closely a vitamin B12 deficiency.

Low levels of vitamin B12 may cause irreversible nerve damage. Symptoms include numbness, trouble walking, tingling or pain in toes, feet or fingers, memory problems, confusion, depression or burning tongue. Other symptoms can include constipation, loss of appetite and anemia. People with inadequate vitamin B12 levels in the body are always at higher risk of cardiovascular conditions. Diabetics appear to be at higher risk of inflammation and less control of blood sugar levels when their vitamin B12 levels are low

Patients taking any acid reducer drugs along with metformin should test their vitamin B12 levels at least once a year. If a vitamin B12 deficiency develops, it should be treated with supplemental vitamin B12.

Can I take Omeprazole with Lamictal?