Prilosec and/or Equivalents
|Drug||Related Drug Names|
|Prilosec 10mg and/or Equivalents||Losec, Omeprazole|
|Prilosec 20mg and/or Equivalents||Apo-Omeprazole, Losec, Mylan-Omeprazole, Omeprazole|
|Prilosec 40mg and/or Equivalents||Losec, Omeprazole|
Prilosec is recommended for the treatment of reflux esophagitis, gastric and duodenal ulcers and the Zollinger-Ellison syndrome. It employs a completely new principle of action called ‘proton pump inhibition’. It is more rapidly effective than H2 blockers in case of esophagitis and peptic ulcers and can apparently also bring about a cure in some otherwise intractable cases. Ulcer disease and gastroesophageal reflux disease are more prone to recurrence, and H2 administration many a times doesn’t provide a cure.
The effect of a Prilosec single dose of 20 mg lasts (independent of the relatively short plasma half-life) at least 24 hours. The long duration of action may be due to the fact that the enzymic reaction is irreversibly bound and acid production is in transition again only after synthesis of the enzyme. Prilosec inhibits both basal pentagastrin and peptone stimulated acid secretion. The gastric juice volume is reduced slightly, and the pepsin secretion may also be slightly reduced. However, the gastric emptying rate remains unchanged. For every Prilosec dosage, the basal and postprandial plasma gastrin levels drop sharply. But a prolonged treatment with higher doses of Prilosec can lead to gastrointestinal problems.
AstraZeneca produced Prilosec in 1989. Omeprazol, a weak alkaline base, is the main component of this drug. It is available in enteric-coated capsules, since the compound is unstable in acidic aqueous solutions. Its complete absorption in the small intestine varies from person to person. For some patients it can take only 5 hours to reach the maximum plasma levels.
The biological availability of a single dose is about 35%, as a large part of the dose is metabolized in the liver. With repeated administration, the availability increases within a few days to about 60%, possibly due to saturation of hepatic enzyme. The plasma half-life is about 1 hour. Since the acid inhibitory effect lasts much longer, it cannot be associated with the plasma concentration. Prilosec is considerably eliminated inside the liver and its remnant metabolites are pharmacologically inactive. About 20% of those metabolites are found in the stool, 80% in the urine.
Conditions Treated by Prilosec
The following is a list of conditions that Prilosec may be used to treat:
- duodenal ulcer
- stomach ulcer
- reflux of gastric juice causing inflammation of the esophagus (reflux esophagitis)
- symptoms caused by the backflow of stomach acid into the esophagus (reflux disease, heartburn)
- Zollinger-Ellison syndrome
- Prevent the recurrence of esophageal inflammation or ulceration of the stomach and duodenum
- Combination therapy for Helicobacter pylori infection
Prilosec Dosage Information
a.) Typical Dosage Recommendations
Prilosec is available in pharmaceutical stores as enteric-coated capsules of 20 mg and as dry ampoules of 40 mg (with 10 ml of solvent, which is to be used with a slow intravenous injection within at least two and a half minutes). The manufacturer recommends one capsule daily (before breakfast) for the treatment of peptic ulcers or reflux esophagitis. Patients of Zollinger-Ellison syndrome, in whom other treatment has failed, should double the dose.
The efficacy of Prilosec in comparative studies with placebo and the H2 cimetidine and ranitidine has been documented. The previously published studies, which usually lasted four to eight weeks, had included about 3000 patients. In a double blind study with endoscopic control, 162 patients with reflux esophagitis were treated with either Prilosec (40 mg/day) or ranitidine (150 mg 2 times each day) for 4 to 12 weeks. Prilosec was significantly faster and more effective. The cumulative healing rate at 12 weeks was higher with Prilosec (95%) than ranitidine (70%).
It was established that Prilosec-treated patients experience a better healing process with regard to symptom relief was found. With a daily dose of 60 mg, it was observed in another study that Prilosec within 4 to 8 weeks caused more improvement than a strong ranitidine dose (2 times 150 mg/day). Studies show that even a small daily dose of Prilosec (20 mg once daily) is extremely effective in case of many patients. A doctor should only prescribe an increased dosage.
b.) Missing a Dose
Never attempt to make up for a missed dose by taking two doses at the same time. You can afford skip a dose once in a long while.
Overdosing symptoms include increased palpitation, perplexity, fuzzy vision, and sickness. Call and consult your doctor immediately if you experience such symptoms.
Prilosec should always be used during pregnancy as a second choice if antacids, ranitidine or cimetidine prove to be inadequate. During pregnancy and lactation this drug should not be used unless the doctor considers it absolutely necessary. According to the manufacturer.dose adjustment is also necessary for renal or liver insufficiency.
The knowledge about possible risks of long-term use of Prilosec is still not enough. There are concerns that this drug can affect human carcinogen when it is not completely eliminated from the body. Therefore Prilosec doses are administered very carefully and generally prescribed as a last ditch medical measure, after common H2 blockers fail.
Prilosec Side Effects
According to a recent study, a short-term administration of Prilosec caused similar adverse effects as of ranitidine. Individual cases are of:
- colicky abdominal pain
- rash and a transient increase in alanine aminotransferase (ALT)
- Higher long-term doses of Prilosec can cause carcinoid tumors in the stomach
These are apparently caused by hypergastrinemia. In specific animal species, long-term medication of omeprazole can lead to hyperplasia of argyrophilic cells in the gastric mucosa. Although in humans, long-term administered omeprazole dose cause only a non-significant increase in the volume density of these cells. This finding, however, refers to a small number of patients. Very rare side effects such as:
- blood dyscrasias
- Stevens-Johnson syndrome
- visual disturbances have also been observed
Possible Drug Interactions with Prilosec
Rare drug interactions with Dilantin (phenytoin) and benzodiazepines have been observed. Similarly, a mutation of the hepatic cytochrome P-450 monooxygenase is known to sometimes cause slower degradation of Prilosec inside the human body. The clinical significance of the resulting interaction is not clearly defined yet, although the half-life is greatly extended.
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Notice: The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.