How to stop taking omeprazole

In this article:

• How to stop taking omeprazole
• Long-term side effects
• Symptom management
• Omeprazole alternatives

In this article

• How to stop taking omeprazole
• Long-term side effects
• Symptom management
• Omeprazole alternatives

Omeprazole is a generic medication used to treat conditions caused by too much stomach acid. It’s available in both prescription and over-the-counter (OTC) strengths. At prescription strengths, omeprazole is approved by the U.S. Food and Drug Administration (FDA) to treat gastroesophageal reflux disease (GERD), duodenal ulcers, Helicobacter pylori infections (H.Pylori), benign gastric ulcers, erosive esophagitis, and conditions that cause excess stomach acid production (hypersecretory conditions). When purchased OTC, omeprazole can treat frequent heartburn that occurs 2 or more days per week. 

Often referred to by its brand name, Prilosec, omeprazole belongs to a group of drugs called proton pump inhibitors (PPIs). These drugs work by blocking the mechanism that releases acid into the stomach. PPIs are one of the most popular acid-suppressing drugs worldwide. However, discontinuing omeprazole comes with risks. Due to these risks, there are different ways to stop omeprazole, and a healthcare professional can discuss the best option for you. 

How to stop taking omeprazole

While PPIs are among the most commonly used medications in the world, they can cause side effects, even when they’re stopped. Stopping omeprazole abruptly can cause rebound or increased acid secretion, especially if you’ve been taking it for over eight weeks. This can cause worsening GERD symptoms, leading to difficulty stopping the drug. Due to this risk, it’s important to consult a healthcare provider before stopping omeprazole. Together, you can discuss ways to stop the medication safely. 

Let’s explore the different ways to stop taking omeprazole. 

1. Reducing the dose gradually

Reducing your omeprazole dose slowly over time–or “tapering off”—is one strategy to avoid rebound acid reflux. However, this strategy may not be effective for everyone. In a 2021 study, people who tapered their omeprazole dose were just as successful at stopping treatment as people who stopped the drug cold turkey. Nevertheless, the study found that people who tapered their dose had fewer symptoms than those who stopped abruptly. 

2. Switching to another acid-reducing medication

Another strategy is to switch to a histamine-2 (H2) blocker for several weeks before discontinuing both drugs altogether. Examples of H2 blockers include Pepcid (famotidine) and Tagamet (cimetidine). Alternatively, some healthcare professionals may recommend tapering omeprazole and overlapping treatment with an H2 blocker. For example, your omeprazole dose will be lowered gradually, and you will alternate omeprazole one day and an H2 blocker the next. Your healthcare provider can discuss when it would be safe for you to stop treatment with each agent. 

3. Take omeprazole “on demand”

You can also try taking omeprazole “on demand” or as-needed. This means instead of taking omeprazole daily, you’ll only take it when you have symptoms. However, it’s important to note that taking PPIs such as omeprazole on demand isn’t recommended when first starting treatment. Rather, it’s a potential way to minimize rebound heartburn symptoms when discontinuing omeprazole. 

What are the long-term side effects of omeprazole and other PPIs?

In most situations, omeprazole and other PPIs should only be taken for four to eight weeks. When taken for short-term use, omeprazole is considered relatively safe. But in instances where omeprazole is indicated for longer, there may be a higher risk of serious side effects. It’s not clearly defined which medical conditions require long-term omeprazole use, but some common examples may include: 

• Barrett’s esophagus
• Severe erosive esophagitis
• Bleeding ulcers
• Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs)

A healthcare provider will determine the duration of treatment based on several factors, including your medical history and the severity of your condition. 

There are various adverse effects associated with long-term use of PPIs, such as omeprazole. These include: 

• Kidney problems: According to the Chonnam Medical Journal, several studies have found a connection between PPIs and renal conditions, including acute kidney injury, chronic kidney disease, acute interstitial nephritis, and end-stage renal disease. There is some evidence that greater exposure to PPIs can increase the risk of worsening chronic kidney disease. 
• Cardiovascular problems: Certain cardiovascular side effects, including heart attacks and strokes, may be linked to PPI exposure. While there is conflicting evidence connecting PPI use and heart attacks, there are several studies that found PPI use increases the risk of stroke, according to the Chonnam Medical Journal. 
• Bone fractures: Long-term PPI use is also linked to an increased risk of hip, spine, and wrist fractures. In fact, in 2010, the FDA issued a safety alert about the possible increased risk of hip, wrist, and spine fractures with PPI use. The safety alert notes that the greatest risk occurred in people who took high doses of PPIs, used PPIs for one year or longer, or were 50 years of age and older. 
• Infections: According to the Chonnam Medical Journal, certain infections, such as Clostridium difficile, pneumonia, and COVID-19, have also been linked to long-term PPI use. Researchers believe PPIs affect the gut microbiota, which is crucial in fighting off pathogens and the immune system response. 
• Nutrient deficiencies: Long-term PPI use is also associated with low magnesium, hemoglobin, vitamin B12, and calcium levels. In 2011, the FDA issued a safety alert regarding the risk of low blood magnesium levels if PPIs are taken for a long time (longer than one year). In some cases, low magnesium levels can lead to muscle spasms, irregular heartbeats, and seizures. To lower this risk, healthcare professionals may order tests to monitor your magnesium levels to see if you will take omeprazole for a long time or if you take certain medications with omeprazole. 
• Certain cancers: Taking PPIs for a long time may increase the risk of gastric, pancreatic, colorectal, and liver cancer. Therefore, before prescribing a PPI for prolonged periods, a healthcare provider will likely thoroughly evaluate it to determine if it’s truly needed. 
• Dementia: According to the Chonnam Medical Journal, there is conflicting evidence on whether PPI use is linked to dementia. And more research is needed to confirm whether the two have a true link. 

It’s important to note that the evidence linking long-term PPI use to these adverse effects is low. More research is needed to understand if omeprazole or other PPIs can cause these complications. 

Managing potential withdrawal symptoms

As discussed above, suddenly stopping omeprazole can cause rebound or increased GERD symptoms. This can make it difficult to stop taking omeprazole and cause some people to be reliant on the drug. According to Harvard Health, stopping omeprazole cold turkey can even lead to heartburn that’s worse than it was before. 

If this occurs, the strategies discussed above may help. If they don’t and you’re still experiencing rebound heartburn symptoms, consult a healthcare provider. They can help determine if a more serious medical issue is occurring or if you would benefit from longer treatment. 

Alternatives to omeprazole

All PPIs are associated with similar risks as omeprazole. Luckily, there are alternative treatments you and your doctor may consider, including prescription, over-the-counter, and natural medications, as well as lifestyle changes. These include:

• H2 blockers: H2 blockers are commonly used for heartburn, duodenal ulcers, and erosive esophagitis. Similar to PPIs, H2 blockers are available as both prescription and OTC drugs. However, they work differently than PPIs, as they block the receptors on stomach cells to decrease gastric acid secretion. As with all medications, there are pros and cons to using an H2 blocker. On one hand, they can be more effective than antacids. However, they may be less effective than PPIs. Examples include Pepcid (famotidine), Tagamet (cimetidine), and Axid (nizatidine).
• Antacids: Antacids, such as Tums or Rolaids, relieve heartburn quickly. They can start working within minutes, but the effects don’t last as long as those of H2 blockers or PPIs. 
• Carafate (sucralfate): Carafate is a drug used to treat and prevent ulcers. It works by coating the ulcer, protecting it from stomach acid, and allowing it to heal. It tends to cause fewer side effects than PPIs, but it may be less effective. 
• Apple cider vinegar and aloe vera syrup: A small amount of research supports using apple cider vinegar and aloe vera syrup for GERD. However, these remedies may not be right for everyone. Discuss their use with a healthcare provider before adding these natural ingredients to your treatment plan. 
• Lifestyle changes: Certain lifestyle changes may help treat GERD. These include quitting smoking, elevating the head of the bed, and limiting caffeine, soda, alcohol, chocolate, and fatty foods.

The bottom line

Omeprazole is generally prescribed for a short period. However, some medical conditions require longer treatment. Stopping omeprazole, especially after long-term treatment, can cause rebound or increased GERD symptoms. 

Luckily, three strategies can help. These include tapering off your omeprazole dosage, switching to another heartburn medicine, and taking omeprazole on demand. 

If you’re ready to stop omeprazole treatment, talk with a healthcare provider to determine which strategy is best for you. Regardless of which method you and your healthcare provider choose, it is important to monitor your health and report any bothersome or severe symptoms to a healthcare provider.