How Long Does It Take for Omeprazole to Work?
It begins working shortly after taking it but doesn't provide instant relief
Medically reviewed by Lindsay Cook, PharmD
Omeprazole (brand name Prilosec and Prilosec OTC) is an oral medication belonging to a drug class known as proton pump inhibitors (PPIs). It's available via prescription and over the counter (OTC).
The Food and Drug Administration (FDA) approved omeprazole for the following conditions:
Acid reflux, or gastroesophageal reflux disease (GERD)
Frequent heartburn
Erosive esophagitis (inflammation of the tube that connects your mouth to your stomach) due to acid reflux
Hypersecretory conditions due to overproduction of stomach acid (for example, Zollinger-Ellison syndrome)
Keep reading to learn more about how quickly omeprazole begins working after use, alongside other important information for safely taking this medication.
How Long Does It Take for Omeprazole to Work?
Omeprazole begins working in your body shortly after you take a dose. However, it does not provide instant symptom relief.
When taken as directed, it usually takes one to four days before you notice any improvement in your symptoms. This is true of all forms of omeprazole (capsule, tablet, and liquid suspension).
While symptom relief may begin around one to four days after starting omeprazole, receiving the medication's full benefit may take longer.
How long depends on the specific condition being treated.
For example, when healthcare providers prescribe omeprazole for erosive esophagitis, omeprazole helps reduce acid production rapidly.
However, the damage to the esophagus may take up to four weeks to heal, so painful or difficult swallowing may take longer to go away.
In contrast, when OTC omeprazole is used to treat heartburn, the reduction in stomach acid quickly reduces the frequency and severity of heartburn. This often results in significant or complete relief within 14 days.
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Prilosec OTC brand heartburn medication in a medicine cabinetOmeprazole Duration of Effect
After taking a dose of omeprazole, its acid-reducing effect may last for 24 to 72 hours.
However, depending on the treated condition, you may not notice a difference in your symptoms until you take the drug for several days to weeks.
If you stop taking omeprazole, normal stomach acid production restarts within three to five days.
This means that if you have a stomach ulcer or another condition that takes prolonged acid reduction for complete healing, you may need to take the medication for a more extended period.
Be sure to take it according to your provider’s instructions.
Treating GERD
Acid reflux affects at least 20% of adults in the United States.
It occurs when stomach contents move into the esophagus and can affect anyone from time to time.
Acid reflux is typically mild and occasional, causing temporary heartburn.
However, acid reflux often results in longer-lasting, more painful symptoms of GERD.
The most common symptoms of GERD include:
Severe heartburn
Difficult or painful swallowing
Cough or sore throat
When untreated, GERD may lead to severe complications, such as:
Esophagitis (inflammation of the esophagus)
Asthma
Laryngitis
The first step towards treating GERD involves lifestyle changes. Certain foods or drinks may trigger acid reflux. Eliminating these from your diet often reduces symptoms.
Experts also recommend elevating your head during sleep. This allows gravity to help prevent acid from entering your esophagus.
In some cases, healthcare providers may recommend an acid-reducing medication for GERD. Popular options include:
Antacids, like Tums (calcium carbonate)
H2 blockers, such as Pepcid (famotidine)
PPIs, including Prilosec and Nexium (esomeprazole)
What Is Omeprazole?
Omeprazole is an acid-reducing medication available with or without a prescription. It belongs to the PPI drug class.
Brand and generic versions of this drug are available as oral capsules, oral tablets, orally dissolving tablets, and suspension forms.
Prilosec OTC and its generic versions are FDA-approved to treat frequent heartburn that occurs two or more days a week in adults.
In addition, the FDA approves the prescription forms of omeprazole for the following indications:
To treat GERD in adults and some children
To treat gastric (stomach) or duodenal (intestinal) ulcers in adults
To prevent ulcer recurrence from a bacterial infection known as Helicobacter pylori, (H. pylori), in combination with certain antibiotics to kill the bacteria
To treat and maintain healing of erosive esophagitis (inflammation of the tube that connects your mouth to your stomach) due to acid reflux in adults and some children
To treat hypersecretory conditions in adults, such as Zollinger-Ellison syndrome
Healthcare providers sometimes recommend a drug for a reason or at a dosage outside of those approved by the FDA. This is commonly known as off-label use. Omeprazole is commonly used off-label for long-term prevention of stomach ulcers in individuals at high risk for developing them.
Additionally, omeprazole is an active ingredient in a combination drug called Talicia (amoxicillin/omeprazole/rifabutin). Talicia is an oral capsule that works to eliminate harmful bacteria in the stomach known as H. pylori.
How Does Omeprazole Work?
Omeprazole reduces stomach acid through the same mechanism as other proton pump inhibitors.
It works by blocking receptors in the stomach lining responsible for releasing protons, which increase acidity.
When omeprazole binds to these pumps, it stops the release of protons, decreasing acidity.
How To Take Omeprazole
Omeprazole does not provide immediate relief from GERD, heartburn, or the other conditions it treats. This means this medication isn’t helpful if taken occasionally or “as needed.”
Instead, omeprazole takes time to start working, which can vary depending on the reason you’re taking it.
For heartburn, this drug may take one to four days before you notice some improvement in your symptoms.
In some cases, it may take up to four weeks to control stomach acid production fully.
Dosing Guidelines
The recommended dose of omeprazole varies depending on your age and the condition being treated.
The table below summarizes some of the recommended dosage guidelines for adults taking omeprazole. This is not meant to be a complete dosage guide.
Use | Recommended Dosage of Omeprazole for ages 17 years and older | Treatment Duration |
Frequent Heartburn | 20 mg once daily | 14 days |
Duodenal (Intestinal) Ulcer | 20 mg once daily | Four weeks; can repeat four weeks if needed |
Gastric (Stomach) Ulcer | 40 mg once daily | Four to eight weeks |
GERD | 20 mg once daily | Up to four weeks |
Erosive Esophagitis due to GERD | 20 mg once daily | Four to eight weeks |
Hypersecretory Conditions | 60 mg once daily | Long term or as directed by healthcare provider |
In children younger than 16 years, dosing depends on weight and product.
Omeprazole delayed-release capsules are approved for those 2 years and older.
A liquid suspension is approved for infants 1 month and older, depending on the reason for use.
The FDA approves the following doses for children receiving omeprazole capsules
Use | Recommended Dosage of Omeprazole for Children | Treatment Duration |
Symptomatic GERD | Between 10 and 20 kg: 10 mg once daily | Up to four weeks |
Erosive Esophagitis | Between 10 and 20 kg: 10 mg once daily | Between four and eight weeks |
The following doses are recommended for children using omeprazole liquid suspension.
Use | Recommended Dosage of Omeprazole for Children | Treatment Duration |
Symptomatic GERD | Between 5 and 10 kg: 5 mg once daily | Up to four weeks |
Erosive Esophagitis Between 1 and 16 years old | Between 5 and 10 kg: 5 mg once daily | Between four and eight weeks |
Erosive Esophagitis Between 1 month and 12 months old | Between 5 and 10 kg: 2.5 mg once daily | Between four and eight weeks |
Safe Consumption Guidelines
Omeprazole is typically taken once daily before a meal. Take it around the same time each day.
If a missed dose occurs, please take it as soon as possible. But if it’s almost time for your next dose, skip the missed dose.
Do not take multiple doses at once to make up for a missed dose, as this could increase the risk of side effects.
Interactions
Certain medications may interact with omeprazole, resulting in negative side effects or reduced effectiveness.
While not a complete list, some medications to avoid while using omeprazole include:
Blood thinners, such as Jantoven (warfarin): Omeprazole can increase the effects of warfarin, raising the risk of bleeding.
Antidepressants, like Celexa (citalopram): Taken together, these medications may increase the risk of heart arrhythmia.
Antiviral medications for human immunodeficiency virus (HIV), such as Edurant (rilpivirine) or Reyataz (atazanavir): Omeprazole reduces the effectiveness of these medications, which can promote the development of drug resistance.
Seizure medications, like Dilantin (phenytoin): Omeprazole slows phenytoin breakdown in the body, leading to an increased risk of toxicity from phenytoin.
Side Effects
Long-term use of omeprazole raises the risk of side effects.
Only take over-the-counter omeprazole for 14 days as instructed on the medication label.
Similarly, prescription omeprazole should only be taken for the duration prescribed by a healthcare provider (usually four to eight weeks).
In some cases, longer treatment is required, but only under the direction of a healthcare provider.
When used as directed for short periods of time, omeprazole doesn’t usually cause side effects. However, mild side effects are possible, including:
Nausea
Gas
Additionally, children ages 2 to 16 may have an increased risk of respiratory infections. Symptoms may include:
Fever
Cough
Runny nose
Nasal congestion
Severe Side Effects
Rarely, omeprazole has been associated with more severe side effects, such as:
Severe skin reactions
Short-term kidney damage
Lupus erythematosus, an autoimmune response to the medication
Fundic gland polyps (stomach growths)
Risk of Clostridium difficile infection (C. diff)
Typically, healthcare providers limit how long patients use omeprazole use.
However, when omeprazole is taken for a year or longer, additional serious side effects may occur. These include the following:
Severe changes to vitamin and mineral levels in the body leading to vitamin b12 deficiency
Low magnesium levels in the blood
Decreased bone density and higher likelihood of fractures
Precautions
Omeprazole may not be safe for certain people, such as those:
With a history of an allergic reaction to omeprazole or another proton pump inhibitor
Currently receiving another medication containing Edurant
With active or previous osteoporosis
In these cases, individuals should not take omeprazole unless advised and monitored closely by a healthcare provider.
Alternative Treatment Options
Lifestyle changes can be a practical approach to treating and preventing GERD. The American Gastroenterological Association (AGA) recommends the following strategies:
Modify your diet: Diet is a primary trigger for GERD. Certain trigger foods are associated with worse acid reflux. While these vary from person to person, cutting triggers out of the regular diet reduces the frequency and severity of symptoms. Similarly, eating meals close to bedtime often makes reflux worse. Reach out to a registered dietitian or registered dietitian nutritionist (RD or RDN) to support your healthy eating plan.
Elevate the head of your bed: If acid reflux primarily occurs in the evening, the best strategy involves raising the head during sleep. This allows gravity to assist in preventing stomach contents from entering your esophagus.
Reduce stress: Increased stress leads to increased stomach acid production. Trying meditation or cognitive behavioral therapy (CBT) to a daily or weekly routine helps reduce acid production.
Stop smoking: Smoking is a key risk factor in the development of GERD. Reducing or entirely stopping smoking rapidly improves acid reflux and GERD symptoms.
Lose weight: For individuals who are overweight, weight loss often results in improved GERD symptoms. For those at a healthy weight, it is vital to maintain a healthy weight to prevent the worsening of acid reflux symptoms.
Summary
Gastroesophageal reflux disease (GERD) occurs when stomach acid enters the esophagus, resulting in heartburn, nausea, and painful swallowing.
Prilosec (omeprazole) is a proton pump inhibitor (PPI) used to treat GERD, gastrointestinal ulcers, and heartburn, among other conditions.
However, omeprazole does not provide instant relief. It may take one to four days of treatment before you notice an improvement in your symptoms. Complete relief may take two to four weeks or longer, depending on the specific condition being treated.
For more information and to learn if omeprazole is right for you, contact a healthcare provider for personalized advice.
Frequently Asked Questions
How can I safely store omeprazole?
To safely store omeprazole, keep the medication at room temperature and out of the reach of children or pets. Be sure to keep the product away from moisture.
What is the difference, if any, between OTC omeprazole and prescription omeprazole?
Both the prescription and over-the-counter versions of Prilosec contain the same active ingredient: omeprazole. The OTC form is only available in a 20 mg strength, while Rx omeprazole comes in multiple strengths.
In addition, the OTC version is only FDA-approved for treating heartburn; the prescription version is approved for treating GERD, stomach ulcers, and other conditions involving the effects of stomach acid. For severe acid reflux or symptoms that keep coming back, see a healthcare provider for advice.
Read the original article on Verywell Health.
