Do Over-the-Counter PPIs Work?

You might wonder why you need a prescription for GERD if many proton pump inhibitors are available over the counter. Get the answers to this and other questions about OTC PPIs.

OTC PPIs work just like their prescription counterparts, as they both contain the same active ingredients. OTC PPIs have been available since 2003, when Prilosec OTC was first approved by the U.S. Food and Drug Administration.

Currently, there are three OTC PPIs available:

  • Prilosec OTC
  • Prevacid 24 Hour
  • Zegerid OTC

Here are some answers to commonly asked questions about OTC PPIs.

What Are OTC PPIs Used For?

OTC PPIs are approved to treat frequent heartburn, which is heartburn that occurs more than twice weekly. For this condition, OTC PPIs are taken daily for 14 days. You may repeat this 14-day treatment up to once every four months. If you feel that this dosing does not control your condition, you should consult your health care provider.


How Do I Take OTC PPIs?

OTC PPIs should be taken daily before the morning meal (Zegerid OTC should be taken at least one hour before breakfast). Capsules or tablets should be swallowed whole and not crushed or chewed. You shouldn’t take more than one dose daily unless directed by your health care provider.

Why Can’t I Treat Persistent Heartburn on My Own?

Heartburn that occurs more than twice-weekly and has continued for weeks or months could be a sign of a serious condition that should be assessed by your health care provider.

For Immediate Relief of My Heartburn, Can I Use an OTC PPI?

Although effective in treating heartburn, PPIs may not provide fast relief. While some people will feel better in the first day, PPIs may take up to four days to relieve heartburn. Antacids, such as Tums or Rolaids, and H2 blockers, like Zantac or Pepcid, may be options when more immediate relief is needed.

Are OTC PPIs as Strong as Prescription PPIs?

Yes, OTC versions are formulated in the same strength as some prescription dosages of the same drugs. However, prescription PPIs are made in a variety of strengths and dosage forms to address a broader range of digestive issues. Here’s a side-by-side comparison of OTC and prescription PPIs: OTCPrescription PrilosecOmeprazole magnesium 20.6mg tabletOmeprazole 10mg, 20mg, and 40mg capsules PrevacidLansoprazole 15mg capsuleLansoprazole 15mg and 30mg capsules ZegeridOmeprazole 20mg capsule with sodium bicarbonateOmeprazole 20mg and 40mg capsules with sodium bicarbonate

In addition, some prescription PPIs are available as soluble tablets or powder for oral suspension.

Why Does Prilosec OTCCome as a Tablet?

Tablets are more tamper resistant than capsules. Tampering is a particular concern for OTC products. To formulate the tablet, omeprazole magnesium must be used. This is why Prilosec OTC comes in omeprazole magnesium tablets and prescription Prilosec comes in omeprazole capsules. Despite these differences, Prilosec OTC works the same as prescription Prilosec.

Can I Take Zegerid OTC if I Am on a Salt-Restricted Diet?

Consult with your health care provider. Zegerid OTC is a combination of omeprazole and sodium bicarbonate. Because Zegerid OTC contains sodium (salt), it may not be appropriate for people who must restrict their salt intake. The purpose of sodium bicarbonate in Zegerid OTC is to help protect the omeprazole from the acid in the stomach.

Can Children Use OTC PPIs?

OTC PPIs are only approved for adults 18 years of age and older. However, some prescription PPIs are approved for use in children.

When Should I Contact My Doctor?

Consult your health care provider if you’re experiencing heartburn along with any of the following symptoms:

  • Vomiting
  • Chest pain
  • Weight loss
  • Difficulty swallowing or pain when swallowing
  • Choking
  • Bloody or black stools
  • Lightheadedness, dizziness, or sweating

OTC PPIs provide effective treatment for people with frequent heartburn. But remember, unlike prescription PPIs, OTC versions are not approved to treat other digestive conditions. Talk to your health care provider about appropriate treatment options.

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