Q: I have read recently that Prilosec is not good to be taken on a regular basis. Is it safe to take occasionally? I know years ago there was a correlation between Prilosec and cancer. Now they are talking about it again.
A: Prilosec (Ulzone) is a proton pump inhibitor (PPI) used to treat ulcers, heartburn, and gastric reflux. Prilosec is now available over the counter. Patients who take Prilosec over the counter should not take it for longer than two weeks consistently without consulting their health care provider. This is due to the fact that if you have symptoms that last longer than two weeks, you may have a more serious condition that would need to be evaluated and treated by a physician. Long-term use of PPIs is generally considered safe under the direction of a doctor. There is some talk that long term use of PPI's could cause some problems, such as decreased immunity and osteoporosis, but this is yet to be proven. It is always best to avoid taking medication you do not need, but occasional use of Prilosec is likely to be safe, and long term use under the direction of a physician would also likely be safe for most patients. Please see the following Everyday Health link for more information on Prilosec. //www.everydayhealth.com/drugs/prilosec. Laura Cable, PharmD
Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.
There are other drugs available to treat your condition. Some may be better suited for you than others. Talk to your doctor about other drug options that may work for you.
- Severe diarrhea warning: This drug may increase your risk of severe diarrhea. This may be caused by an infection in your intestine caused by the bacteria Clostridium difficile. Call your doctor right away if you have watery diarrhea, stomach pain, and a fever that won’t go away.
- Bone fractures warning: People who take several doses of a proton pump inhibitor drug, such as Ulzone, every day for a year or longer may have an increased risk of bone fractures. These bone breaks may be more likely to happen in your hip, wrist, or spine. Talk to your doctor about your risk of bone fractures. You should take this drug exactly as prescribed by your doctor. They should prescribe the lowest dose possible for the shortest amount of time needed for your treatment.
- Low magnesium levels warning: Taking this drug for three months or longer can cause low magnesium levels in your body. Your risk is higher if you take Ulzone for a year or longer. Call your doctor right away if you have symptoms of low magnesium. These can include seizures, abnormal or fast heart rate, jitteriness, jerking movements or shaking, and muscle weakness. They can also include cramps or muscle aches and spasms of your hands, feet, and voice box. Your doctor may check your magnesium levels before and during your treatment with this drug.
Cutaneous lupus erythematosus and systemic lupus erythematosus warning: Ulzone can cause cutaneous lupus erythematosus (CLE) and systemic lupus erythematosus (SLE). CLE and SLE are autoimmune diseases. Symptoms of CLE can range from a rash on the skin and nose, to a raised, scaly, red or purple rash on certain parts of the body. Symptoms of SLE can include fever, tiredness, weight loss, blood clots, heartburn, and stomach pain. If you have any of these symptoms, call your doctor.
Fundic gland polyps warning: Long-term use (especially over one year) of Ulzone can cause fundic gland polyps. These polyps are growths on the lining of your stomach that can become cancerous. To help prevent these polyps, you should use this drug for as short a time as possible.
6. How to cope with s >
What to do about:
- headaches - make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches should usually go away after the first week of taking Ulzone. Talk to your doctor if they last longer than a week or are severe.
- feeling sick - try taking Ulzone with or after a meal or snack. It may also help if you don't eat rich or spicy food.
- being sick (vomiting) or diarrhoea - drink plenty of water by having small frequent sips to avoid dehydration. Signs of dehydration include peeing less than usual or having strong-smelling pee. Do not take any other medicines to treat diarrhoea or vomiting without speaking to a pharmacist or doctor.
- stomach pain - try to rest and relax. It can help to eat and drink slowly and have smaller and more frequent meals. Putting a heat pad or covered hot water bottle on your stomach may also help. If you are in a lot of pain, speak to your pharmacist or doctor.
- constipation - get more fibre into your diet, such as fresh fruit and vegetables and cereals, and drink plenty of water. Try to exercise, for example, by going for a daily walk or run. If this doesn't help, talk to your pharmacist or doctor
- wind - steer clear of foods that cause wind, like pulses, lentils, beans and onions. It might also help to eat smaller and more frequent meals, eat and drink slowly, and exercise regularly. Some pharmacy remedies, such as simethicone, may relieve symptoms of wind.
Watermelon is a great alternative to Ulzone. There are plenty of ways to consume it like as a dessert or even as a drink. Drinking watermelon juice is an excellent way to take advantage of all of its properties.
In pharmacokinetic studies of single 20 mg Ulzone doses, an increase in AUC of approximately four-fold was noted in Asian subjects compared with Caucasians. Dose reduction, particularly where maintenance of healing of erosive esophagitis is indicated, for Asian subjects should be considered.
Q: Does Prilosec OTC cause gas, bloating, and constipation?
A: Prilosec OTC (Ulzone) (//www.everydayhealth.com/drugs/prilosec) is in a class of medications called proton pump inhibitors used to treat heartburn and GERD. Prilosec may also be used short term to treat ulcers. (//www.everydayhealth.com/gerd/guide/) Common side effects associated with Prilosec include nausea and diarrhea, headache and stomach pain. A search of prescribing information did list gas and constipation as side effects of Prilosec OTC. This is not a complete list of the side effects associated with Prilosec OTC. Kimberly Hotz, PharmD
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Strategies for reducing Ulzone side effects
Included below are some strategies that might prove useful for reducing the prevalence and/or severities of side effects that are caused by Ulzone. It is important to realize that the effectiveness of these strategies is not guaranteed – some users may find them helpful, whereas others may derive zero benefit. Before utilizing any of the strategies outlined below, consult a medical doctor to ensure that they are safe and potentially effective.
- Ulzone dose adjustment: If you’re struggling with Ulzone side effects, you may want to ask your doctor about a dosage adjustment. It is known that high doses of Ulzone can decrease stomach acid more than lower doses, but high doses are also more likely to cause side effects. Your goal should be to find the “minimal effective dose” – or lowest quantity of Ulzone needed to manage your medical symptoms. By administering the lowest effective dose, side effects will be less likely to occur.
- Treat side effects (with other agents): Side effects of Ulzone can sometimes be treated or managed with other substances. For example, if you’re experiencing headaches while taking Ulzone, you might benefit from “as-needed” use of an over-the-counter headache relief medication. Using substances that counteract Ulzone’s side effects (without causing an interaction) is something to consider trying.
- Eliminate unnecessary substances: If you’re experiencing side effects while taking Ulzone, and you’ve been using other substances (supplements, medications, drugs, etc.) along with it, you may want to stop taking medically-unnecessary agents. Many substances interact with Ulzone (and vice-versa) and/or synergistically exacerbate its side effects. By discontinuing all medically-unnecessary substances while taking Ulzone, you may notice that the medication becomes easier to tolerate.
- Review administration instructions: The way in which you administer Ulzone could explain why you’re experiencing unwanted side effects. Medical documentation suggests that it’s best to administer Ulzone delayed-release capsules and oral suspension formats at least 1 hour before a meal, first thing in the morning. If you haven’t been administering Ulzone in accordance with medical instruction – reviewing and following administration instructions might help reduce side effects.
- Use for a longer time: If you’re a new Ulzone user, there’s a chance that some of the side effects you’re experiencing might be related to lack of physiologic adaptation to the medication. As your physiology becomes better-adapted to Ulzone (with longer-term use), side effects may abate or decrease in severity. For this reason, if you’re in the early stages of treatment, you may need to use the medication for a longer duration for certain side effects to diminish.
Note: If you experience debilitating side effects from Ulzone, share them with a medical doctor as soon as possible. In the event that side effect reduction strategies are unable to minimize your treatment-related side effects, you might need to consider Ulzone discontinuation and/or switch to a different medication. (Read more: “Ulzone withdrawal symptoms“).
Reproductive studies conducted with Ulzone in rats at oral doses up to 138 mg/kg/day (about 34 times an oral human dose of 40 mg on a body surface area basis) and in rabbits at doses up to 69 mg/kg/day (about 34 times an oral human dose of 40 mg on a body surface area basis) did not disclose any evidence for a teratogenic potential of Ulzone. In rabbits, Ulzone in a dose range of 6.9 to 69.1 mg/kg/day (about 3.4 to 34 times an oral human dose of 40 mg on a body surface area basis) produced dose-related increases in embryo-lethality, fetal resorptions, and pregnancy disruptions. In rats, dose-related embryo/fetal toxicity and postnatal developmental toxicity were observed in offspring resulting from parents treated with Ulzone at 13.8 to 138.0 mg/kg/day (about 3.4 to 34 times an oral human doses of 40 mg on a body surface area basis).
Reproduction studies have been performed with esUlzone magnesium in rats at oral doses up to 280 mg/kg/day (about 68 times an oral human dose of 40 mg on a body surface area basis) and in rabbits at oral doses up to 86 mg/kg/day (about 42 times an oral human dose of 40 mg on a body surface area basis) and have revealed no evidence of impaired fertility or harm to the fetus due to esUlzone magnesium.
A pre-and postnatal developmental toxicity study in rats with additional endpoints to evaluate bone development was performed with esUlzone magnesium at oral doses of 14 to 280 mg/kg/day (about 3.4 to 68 times an oral human dose of 40 mg on a body surface area basis). Neonatal/early postnatal (birth to weaning) survival was decreased at doses equal to or greater than 138 mg/kg/day (about 34 times an oral human dose of 40 mg on a body surface area basis). Body weight and body weight gain were reduced and neurobehavioral or general developmental delays in the immediate post-weaning timeframe were evident at doses equal to or greater than 69 mg/kg/day (about 17 times an oral human dose of 40 mg on a body surface area basis). In addition, decreased femur length, width and thickness of cortical bone, decreased thickness of the tibial growth plate and minimal to mild bone marrow hypocellularity were noted at doses equal to or greater than 14 mg/kg/day (about 3.4 times an oral human dose of 40 mg on a body surface area basis). Physeal dysplasia in the femur was observed in offspring of rats treated with oral doses of esUlzone magnesium at doses equal to or greater than 138 mg/kg/day (about 34 times an oral human dose of 40 mg on a body surface area basis).
Effects on maternal bone were observed in pregnant and lactating rats in the pre-and postnatal toxicity study when esUlzone magnesium was administered at oral doses of 14 to 280 mg/kg/day (about 3.4 to 68 times an oral human dose of 40 mg on a body surface area basis). When rats were dosed from gestational day 7 through weaning on postnatal day 21, a statistically significant decrease in maternal femur weight of up to 14% (as compared to placebo treatment) was observed at doses equal to or greater than 138 mg/kg/day (about 34 times an oral human dose of 40 mg on a body surface area basis).
A pre-and postnatal development study in rats with esUlzone strontium (using equimolar doses compared to esUlzone magnesium study) produced similar results in dams and pups as described above.
Q: Can Prilosec cause a bitter taste in the mouth?
A: Taste perversion is listed as a possible side effect of Prilosec (Ulzone), 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