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Key takeaways
Omeprazole, a widely used medication for GERD and ulcers, may not suit everyone due to side effects, interactions, or inefficacy, prompting consideration of alternatives like Nexium, Prevacid, Pepcid, Carafate, and Tums.
Alternatives to omeprazole include other PPIs, H2 blockers, antacids, and medications providing a protective coating, each with its own mechanism and potential benefits in treating heartburn and GERD.
Nexium, Prevacid, and Pepcid offer different mechanisms and advantages, such as avoiding certain side effects or drug interactions, and may be better suited for individuals with specific health considerations.
Natural alternatives and lifestyle changes, such as weight loss and dietary adjustments, can also effectively manage GERD symptoms, offering a non-pharmaceutical approach for those seeking to avoid medication.
The brand-name heartburn medication Prilosec, known generically as omeprazole, has such widespread usage that it is a household name. This is partly related to the prevalence of gastroesophageal reflux disease (GERD), but in addition, the drug’s impressive effectiveness has earned it this status. However, you might not be over the moon about omeprazole. You could be experiencing continued heartburn despite faithful use. Maybe its side effects are bothering you. Perhaps, you are concerned about it interacting with your important heart medications or worried about long-term use. In any of these scenarios, rest assured that you have other options. We will present you with a list of alternatives, detail common ones, and discuss natural options too.
RELATED: What’s the best heartburn medicine for you?
What can I take in place of omeprazole?
Omeprazole falls within the proton pump inhibitor (PPI) class of medications. PPIs can treat GERD, gastric ulcers, ulcers of the duodenal portion of the small intestine, and helicobacter pylori (H. pylori) stomach infections. The class has numerous members, allowing you to change drugs but stay within this category of medications. While they all bind to and block gastric acid pumps in the parietal cells of the stomach, one PPI might work better for you than another or could allow you to avoid a particular adverse effect or drug interaction.
Controlling GERD and healing ulcers does not always require a PPI. Blocking histamine H2 receptors is another effective mechanism, and you might find that H2 blockers agree with your system better. Acid-neutralizing compounds, so-called antacids, are another idea for heartburn or indigestion. Other drugs provide a protective coating to assist with ulcer healing. The point is that you may want to look beyond the PPI category. Properly considering each option means knowing more details, so let’s move along to these.
Compare omeprazole alternatives |
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|---|---|---|---|
| Drug name | Uses | Dosage | Savings options |
| Omeprazole | GERD, stomach ulcer, duodenal ulcer, H. pylori infection, hypersecretory conditions | 20 to 40 mg once daily for most indications | Omeprazole coupons |
| Nexium (esomeprazole) | GERD, H. pylori infection, hypersecretory conditions | 20 to 40 mg once daily for most indications | Nexium coupons |
| Prevacid (lansoprazole) | GERD, stomach ulcer, duodenal ulcer, H. pylori infection, hypersecretory conditions | 15 to 30 mg once daily for most indications | Prevacid coupons |
| Protonix (pantoprazole) | GERD, hypersecretory conditions | 20 to 40 mg once daily for most indications | Protonix coupons |
| Dexilant (dexlansoprazole) | GERD | 30 to 60 mg once daily | Dexilant coupons |
| Aciphex (rabeprazole) | GERD, duodenal ulcer, H. pylori infection | 20 mg once daily for most indications | Aciphex coupons |
| Zegerid (omeprazole/sodium bicarbonate) | GERD, stomach ulcer, duodenal ulcer | 20 to 40 mg once daily | Zegerid coupons |
| Nizatidine | GERD, stomach ulcer, duodenal ulcer | 150 mg once or twice daily | Nizatidine coupons |
| Pepcid AC Maximum Strength (famotidine) | Prevention or relief of heartburn | 1 tablet twice daily as needed | Pepcid coupons |
| Zantac 360 Maximum Strength (ranitidine) | Prevention or relief of heartburn | 1 tablet twice daily as needed | Zantac 360 Maximum Strength coupons |
| Tagamet HB 200 (cimetidine) | Prevention or relief of heartburn | 1 tablet twice daily as needed | Tagamet HB 200 coupons |
| Carafate (sucralfate) | Duodenal ulcer short-term treatment and maintenance | 1 gram four times daily for treatment and twice daily for maintenance | Carafate coupons |
| Tums (calcium carbonate) | Relief of heartburn or upset stomach | 2 to 4 tablets as needed up to 15 tablets maximum per 24 hours or 10 tablets per 24 hours if pregnant | Tums coupons |
| Rolaids Extra Strength (calcium carbonate-magnesium hydroxide) | Relief of heartburn or upset stomach | 2 to 4 tablets as needed up to 10 tablets maximum per 24 hours with use for up to 2 weeks | Rolaids Extra Strength coupons |
| Mylanta Maximum Strength (aluminum hydroxide-magnesium hydroxide-simethicone) | Relief of heartburn or upset stomach | 10 to 20 mL as needed up to 60 mL maximum per 24 hours with use for up to 2 weeks | Mylanta Maximum Strength coupons |
| Gaviscon (aluminum hydroxide-magnesium carbonate) | Relief of heartburn or upset stomach | 2 to 4 tablets four times daily as needed | Gaviscon Extra Strength coupons |
Top 5 omeprazole alternatives
The following are some of the most common alternatives to omeprazole.
1. Nexium
A hierarchy of PPIs has not been established and agreed upon. Therefore, you will not always hear that any one PPI is better than another. One might work better than another for an individual, so it makes sense to try a different PPI if omeprazole is just not eliminating your symptoms. In such a circumstance, Nexium (esomeprazole) could be a good pick. One effectiveness review did find that esomeprazole 40 mg, taken daily, outperformed the PPIs omeprazole, rabeprazole, lansoprazole, and pantoprazole in treatment of erosive esophagitis, an inflamed and damaged esophagus typically from severe GERD.
If the cost of omeprazole is part of your motivation to change, a better price could be possible with a different PPI or a drug from a different class. Getting a SingleCare discount card and showing it at your local pharmacy is another way to save money.
2. Prevacid
PPIs are metabolized by the liver’s cytochrome P450 enzyme system. Primarily by the CYP2C19 enzyme for most PPIs. This same enzyme plays a role in the metabolism of other drugs, such as the blood thinning agents clopidogrel and warfarin and anti-seizure meds phenytoin and diazepam. An individual who has a genetic mutation of CYP2C19 may be deficient in the enzyme and not be able to properly handle the combination of two drugs that rely on it. Like most of us, you probably do not know your CYP2C19 genetics – it is rarely tested. So if you take clopidogrel for an indication such as a coronary stent that is protecting against a heart attack, you might wonder if taking omeprazole is safe. The answer is controversial, but you could consider taking Prevacid instead, since CYP2C19 is a secondary and not primary enzyme for its metabolism.
RELATED: Prevacid vs. Prilosec: Differences, similarities, and which is better for you
3. Pepcid
Pepcid, like its fellow H2 blockers Zantac, nizatidine, and Tagamet, presents you with an opportunity to treat heartburn symptoms without using a PPI. There are pros and cons to the H2 antagonists. On one hand, they can be more effective and last longer than antacids like Tums, but on the other hand, they may take longer to kick in than antacids and be less effective than PPIs. Less potency in the form of Pepcid compared to omeprazole is not all negative; having more acidity in the stomach may be helpful in reducing the risk of certain infections including C. difficile intestinal infection and increasing nutrient absorption of vitamins like magnesium, calcium, and vitamin B12. If you can be effectively treated with an H2 blocker such as Pepcid instead of a PPI like omeprazole, it might be worth the switch. As a convenient bonus, you do not have to take Pepcid or other H2 blocks after a prolonged fast for maximum effectiveness like you do PPIs.
4. Carafate
Carafate adheres to the stomach and lower esophagus to help provide a protective barrier against stomach acid. The effects can be satisfactory if frequent dosing is not a concern. The lack of systemic absorption means less adverse effect potential, making Carafate an option for GERD in pregnancy. Carafate is not considered as potent as a PPI and may not meet your expectations for relief.
5. Tums
The fast-acting nature of an antacid like Tums, Rolaids, or Gaviscon can be handy for relief of heartburn. They work within a few minutes. Unfortunately, the effects can wear off in an hour. For frequent heartburn, a once-daily pill like omeprazole is better, but if you only have an occasional issue, Tums could be an option.
Natural alternatives to omeprazole
Before turning to prescription or over-the-counter (OTC) omeprazole or another heartburn drug, a few lifestyle changes could prove very helpful. Weight loss and quitting smoking are big challenges with significant potential payoffs in regards to less acid reflux symptoms. Elevating the head of your bed is an easier and still beneficial change to make. Limiting caffeine, soda, alcohol, chocolate, and fatty foods can also be helpful.
If you are looking for natural supplements to augment or replace omeprazole in treating GERD symptoms, apple cider vinegar and aloe vera syrup have a small amount of support from gastrointestinal research. Just because they are natural does not mean they are safe for you, so check with your healthcare provider before adding or subtracting anything from your regimen.
RELATED: 12 home remedies for heartburn
How to switch to a omeprazole alternative
The options to replace omeprazole are plentiful, including natural treatments, OTC pills, and prescription remedies. Hopefully, you have gained an understanding of the attributes of each. The next step is to have a conversation with the prescribing healthcare professional for medical advice. Voice your concerns with omeprazole and present your ideas for an alternative. After listening to your input, the medical expert can give you their opinion on the best option.