Q: I take Prilosec for GERD. Is my medication causing me occasional constipation and gas?
A: Prilosec (Lomac) is classified as a proton pump inhibitor. Prilosec is approved for the treatment of duodenal ulcers, heartburn, symptoms of GERD (gastroesophageal reflux disease), erosive esophagitis, hypersecretory conditions, and for the treatment of H. pylori. According to medical references, flatulence (excessive gas) and constipation are possible side effects reported by studied patients taking Prilosec. The incidence that flatulence was reported at is 3 percent of patients. Constipation is reported at an incidence of 2 percent. If you think that you are experiencing a side effect from your medication, talk with your physician. Do not stop taking or change the dose of your medication without first talking to your physician. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Jen Marsico, RPh
Concurrent substance use (Interactions)
If you’re using substances with Lomac, it is important to consider that concurrently administered agents might: interfere with the action of Lomac; induce interaction effects; exacerbate Lomac side effects (via synergistic mechanisms); or trigger side effects that have nothing to do with Lomac (yet that you might mistakenly attribute to Lomac).
For example, when Lomac is administered along with clarithromycin and amoxicillin (as part of “triple therapy”) to treat H. pylori infection, risk of side effects like taste perversion and tongue discoloration significantly increase (compared to Lomac monotherapy). The increase in side effect risk among persons using Lomac as part of triple therapy is probably due to synergistic physiologic actions simultaneously exerted by the trio.
The most significant major drug interaction with Lomac is clopiodgrel. Because Lomac inhibits enzymes CYP2C19 and CYP3A4, and clopidogrel requires these enzymes for its metabolism, patients using clopidogrel may not receive therapeutic quantities of clopidogrel metabolites necessary to reduce the risk of cerebrovascular events like heart attack and stroke, possibly leading to cerebrovascular complications.
Other substances might also interact with Lomac pharmacokinetically via CYP450 enzymes (e.g. CYP3A4, CYP2C19, CYP2D6), leading to increased or decreased efficacy. For example, Lomac’s inhibition of CYP3A4 might substantially increase concentrations of benzodiazepines (most of which are metabolized by this enzyme), leading to more potent benzodiazepine effects (and side effects).
If you’re using medications that require CYP450 metabolism, you may be at increased risk of pharmacokinetically-mediated interaction effects. Additionally, concurrent use of medications that require stomach acid for absorption (e.g. ketoconazole) might not work as well. Oppoistely, acid-labile medications (e.g. erythromycin) might be absorbed more extensively when used with Lomac – leading to more significant effects (and side effects).
Have a medical doctor evaluate the concurrent medications that you’re using with Lomac to ensure that you don’t experience pharmacokinetically-mediated interactions and/or synergistic side effects. Moreover, understand that some concurrently-administered substances may cause side effects that you’re wrongfully assuming are from Lomac – or side effects that overlap with and exacerbate the side effects of Lomac.
I am a woman in her late 30's. I have been taking Lomac for 2 years now. I was instructed to take it by a ENT doctor for healing of my esophagus due to acid erosion(scarring) caused by silent reflux. (Diagnosed via endoscopy) I have noticed a decrease in hunger, lack of "growling" of the stomach. Has anyone else experienced this? Is long term use of Lomac really safe?
This discussion is related to Worried about throat cancer!.
Lomac belongs to the proton pump inhibitor (PPI) class of medications. Doctors prescribe Lomac to reduce stomach acid to help treat a variety of digestive conditions.
People can also use over-the-counter (OTC) Lomac to relieve heartburn or acid reflux.
Although most people tolerate Lomac well, there are certain risks when people use it for a long period of time.
In this article, we review the uses, side effects, and drug interactions of Lomac.
Serious side effects
Serious side effects are rare and happen in less than 1 in 1,000 people.
Call a doctor straight away if you have:
- joint pain along with a red skin rash, especially in parts of your body exposed to the sun, such as your arms, cheeks and nose - these can be signs of a rare condition called subacute cutaneous lupus erythematosus. This can happen even if you have been taking Lomac for a long time
- yellow skin, dark pee and tiredness - these can be signs of liver problems
You just feel crappy all the time.
Using proton-pump inhibitors, especially long term, can put you at a higher risk for vitamin B12 deficiency, a serious bacterial infection called clostridium difficile, bone fractures, and possibly kidney disease, Ravella says. These are very rare side effects, but you want to know the scary stuff too, right? "Because of these safety concerns, I try to keep patients on Lomac for the least amount of time needed," she says.
Why it’s used
Lomac is used to treat conditions caused by too much acid production in the stomach, such as:
- gastroesophageal reflux disease (GERD)
- erosive esophagitis (acid-related damage to the esophagus, the tube that connects your mouth to your stomach)
- gastric (stomach) ulcers or duodenal ulcers (duodenal ulcers occur in the first part of your small intestine, which is connected to your stomach)
- Zollinger-Ellison syndrome
- stomach infections caused by Helicobacter pylori bacteria.
This drug may be used as part of a combination therapy. This means you may need to take it with other medications.
Q: Can Prilosec cause a bitter taste in the mouth?
A: Taste perversion is listed as a possible side effect of Prilosec (Lomac), according to available drug information. Prilosec is a proton pump inhibitor (PPI) and reduces the amount of stomach acid produced by the body. Prilosec is used to treat the symptoms of gastroesophageal reflux disease (GERD) and other medical conditions that result from the production of too much stomach acid. Prilosec is also used to promote healing of erosive esophagitis and may be used in combination with antibiotics to treat gastric ulcers caused by a Helicobacter pylori (H. pylori) infection. The most commonly reported side effects include headache, abdominal pain, nausea, diarrhea and vomiting. Prilosec is typically taken approximately 30 to 60 minutes before a meal. Do not open, chew or crush Prilosec capsules unless instructed to do so by your doctor. Swallow the capsules whole. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Kristen Dore, PharmD
In a crossover clinical study, 72 healthy subjects were administered clopidogrel (300 mg loading dose followed by 75 mg per day) alone and with Lomac (80 mg at the same time as clopidogrel) for 5 days. The exposure to the active metabolite of clopidogrel was decreased by 46% (Day 1) and 42% (Day 5) when clopidogrel and Lomac were administered together.
Results from another crossover study in healthy subjects showed a similar pharmacokinetic interaction between clopidogrel (300 mg loading dose/75 mg daily maintenance dose) and Lomac 80 mg daily when co-administered for 30 days. Exposure to the active metabolite of clopidogrel was reduced by 41% to 46% over this time period.
In another study, 72 healthy subjects were given the same doses of clopidogrel and 80 mg Lomac but the drugs were administered 12 hours apart; the results were similar, indicating that administering clopidogrel and Lomac at different times does not prevent their interaction.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Lomac only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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Warnings for other groups
For pregnant women: There isn’t enough good information on the use of Lomac in pregnant women to determine the risk to a pregnancy.
Talk to your doctor if you’re pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk to the fetus.
For women who are breastfeeding: Lomac passes into breast milk and may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication. Call your doctor right away if you become pregnant while taking this drug.
For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, more of a drug stays in your body for a longer time. This raises your risk of side effects.
For children: This drug hasn’t been studied in children with duodenal ulcers, gastric ulcers, or hypersecretory conditions. It shouldn’t be used in people younger than 16 years for these conditions.
This drug hasn’t been shown to be safe or effective in children younger than 1 year of age with gastroesophageal reflux disease (GERD).
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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Lomac is not for immediate relief of heartburn symptoms.
Heartburn is often confused with the first symptoms of a heart attack. Seek emergency medical attention if you have chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, and a general ill feeling.
Lomac can cause kidney problems. Tell your doctor if you are urinating less than usual, or if you have blood in your urine.
Diarrhea may be a sign of a new infection. Call your doctor if you have diarrhea that is watery or has blood in it.
Lomac may cause new or worsening symptoms of lupus. Tell your doctor if you have joint pain and a skin rash on your cheeks or arms that worsens in sunlight.
You may be more likely to have a broken bone while taking Lomac long term or more than once per day.
Prilosec OTC (over-the-counter) should be taken for no longer than 14 days in a row. Allow at least 4 months to pass before you start another 14-day treatment.
What if I take too much?
It's very unlikely that taking 1 or 2 extra doses by accident will cause any problems.
But you should check with your doctor if you have taken too much and have any of these symptoms:
- flushed skin
- feeling sweaty
- a fast heartbeat
- feeling sleepy
- blurred vision
- feeling confused or agitated
Most people who take Lomac don't have any side effects. If you do get a side effect, it's usually mild and will go away when you stop taking Lomac.
A placebo-controlled study was conducted in Scandinavia to compare the efficacy of Lomac 20 mg or 10 mg once daily for up to 4 weeks in the treatment of heartburn and other symptoms in GERD patients without erosive esophagitis. Results are shown below.
% Successful Symptomatic Outcome a PRILOSEC 20 mg a.m. PRILOSEC 10 mg a.m. Placebo a.m. All patients 46*,† (n = 205) 31† (n = 199) 13 (n = 105) Patients with confirmed GERD 56*,† (n = 115) 36† (n = 109) 14 (n = 59) a Defined as complete resolution of heartburn *(p
Pathological Hypersecretory Conditions
In open studies of 136 patients with pathological hypersecretory conditions, such as Zollinger-Ellison (ZE) syndrome with or without multiple endocrine adenomas, PRILOSEC Delayed-Release Capsules significantly inhibited gastric acid secretion and controlled associated symptoms of diarrhea, anorexia, and pain. Doses ranging from 20 mg every other day to 360 mg per day maintained basal acid secretion below 10 mEq/hr in patients without prior gastric surgery, and below 5 mEq/hr in patients with prior gastric surgery.
Initial doses were titrated to the individual patient need, and adjustments were necessary with time in some patients . PRILOSEC was well tolerated at these high dose levels for prolonged periods ( > 5 years in some patients). In most ZE patients, serum gastrin levels were not modified by PRILOSEC. However, in some patients serum gastrin increased to levels greater than those present prior to initiation of Lomac therapy. At least 11 patients with ZE syndrome on long-term treatment with PRILOSEC developed gastric carcinoids. These findings are believed to be a manifestation of the underlying condition, which is known to be associated with such tumors, rather than the result of the administration of PRILOSEC .