What are the side effects of omeprazole

Omeprazole

This is how omeprazole works

After oral administration, the omeprazole active ingredient is absorbed in the small intestine and from there passes through the bloodstream to the parietal cells in the gastric mucosa. These are responsible for the production of stomach acid (mainly consisting of hydrochloric acid). The active ingredient blocks an enzyme called a proton pump on these cells. It "pumps" the protons as part of the hydrochloric acid into the stomach. Ultimately, omeprazole irreversibly inhibits acid production, making the environment in the stomach less acidic. The extent of the gastric acid production inhibition is dose-dependent.

As omeprazole, as a so-called “prodrug”, only reacts to its active form at its site of action in an acidic environment, it can be ensured that the active form only acts on the gastric mucosa and does not affect other cells.

When is omeprazole used?

Omeprazole is used to treat and prevent recurrence of inflammation and ulcers in the esophagus, stomach, and small intestine. The main areas of application are:

  • increased stomach acid production (hyperacidity)
  • Inflammation of the esophagus caused by reflux of gastric juice (reflux esophagitis)
  • Ulcers in the stomach (gastric ulcer)

Another area of ​​application of the gastric acid inhibitor is the so-called Zollinger-Ellison syndrome - a clinical picture with tumor-related increased gastric acid production due to hormonal overstimulation of the parietal cells.

In addition, the gastric acid inhibitor is integrated into the treatment of Helicobacter pylori infection. This is a bacterium that attacks the gastric mucosa and causes abnormally increased gastric acid production, which can lead to gastric ulcers, perforations and tumors.

This is how omeprazole is used

In the treatment of acute illnesses, the gastric acid inhibitor is taken orally as a gastric acid-stable capsule or tablet, as it should pass through the stomach for its effect and should only be dissolved and absorbed in the small intestine. The usual dose of omeprazole is 20 to 40 milligrams per tablet or capsule. In self-medication, the drug is usually taken once a day for two weeks. Omeprazole is recommended in the morning 30 minutes before breakfast on an empty stomach. If symptoms have not improved after two weeks of treatment, patients should see a doctor. In acute treatment with omeprazole, the therapy can also be prescribed by the doctor in higher doses.

To treat Helicobacter pylori infection, the gastric acid inhibitor is given together with a combination of antibiotics (clarithromycin and amoxicillin or metronidazole).

In general, it should be noted here that omeprazole only treats symptoms, not their cause. A doctor must clarify this and initiate appropriate treatment.

What are the side effects of omeprazole?

Omeprazole is very well tolerated. Every tenth to hundredth patient develops gastrointestinal complaints (such as diarrhea, constipation, flatulence) as side effects of the treatment. The reason: The bacterial populations in the intestine can no longer be regulated as strongly by the stomach acid under the influence of the gastric acid inhibitor.

Headache, dizziness, tiredness and sleep disorders are just as common as gastrointestinal complaints as omeprazole side effects. In addition, digestion is made more difficult due to the reduced gastric acid production. This can be explained by the fact that many digestive enzymes only work optimally at the low pH of the stomach acid. This mainly affects enzymes that are responsible for breaking down proteins.

When should you not take omeprazole?

Omeprazole is not suitable for children under two years of age. In addition, if possible, it should not be used during pregnancy or breastfeeding. In addition, previous liver diseases are an exclusion criterion for taking the gastric acid inhibitor.

It is not advisable to take the anticoagulant clopidogrel at the same time. This is because omeprazole inhibits the enzyme that activates clopidogrel, so that its effect is not guaranteed.

In addition, the gastric acid inhibitor can affect the breakdown of the following drugs:

  • Diazepam (sedative)
  • Warfarin (anti-coagulant)

This is how they get drugs with omeprazole

The active ingredient can be bought over the counter in packs of up to 14 pieces (corresponding to a daily intake for up to two weeks) with a maximum of 20 milligrams of omeprazole in the pharmacy. In higher doses, omeprazole requires a prescription.

How long has omeprazole been known?

Omeprazole was launched in the United States in 1989. It was the first therapeutically used proton pump inhibitor and became the figurehead of the pharmaceutical company AstraZeneca in the 1990s, with the first omeprazole preparations generating annual profits in the billions.

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