- Carafate vs. omeprazole: What's the difference?
- What is Carafate? What is omeprazole?
- What are the side effects of Carafate and omeprazole?
- What is the dosage of Carafate vs. omeprazole?
- What drugs interact with Carafate and omeprazole?
- Are Carafate and omeprazole safe to use while pregnant or breastfeeding?
Carafate vs. omeprazole: What's the difference?
- Carafate (sucralfate) and omeprazole are used to treat ulcers and gastroesophageal reflux disease (GERD).
- Omeprazole is also used to treat Zollinger-Ellison syndrome, duodenitis, erosive esophagitis, heartburn, and H. pylori infection.
- Brand names for omeprazole include OmePPi, Zegerid, Prilosec, Zegerid, Prilosec OTC, and Zegerid OTC.
- Some versions of omeprazole are available over-the-counter (OTC).
- Carafate and omeprazole belong to different drug classes. Carafate is an anti-ulcer drug and omeprazole is a proton pump inhibitor (PPI).
- Side effects of Carafate and omeprazole that are similar include headache, dizziness, diarrhea, nausea, and vomiting.
- Side effects of Carafate that are different from omeprazole include constipation, trouble sleeping (insomnia), spinning sensation (vertigo), indigestion, dry mouth, dizziness, and gas.
- Side effects of omeprazole that are different from Carafate include rash, nervousness, abnormal heartbeat, muscle pain, and weakness.
What is Carafate? What is omeprazole?
Carafate (sucralfate) is an anti-ulcer drug used to treat ulcers of the upper gastrointestinal tract, peptic ulcer disease, to prevent recurrent ulcers after the ulcer has healed, to relieve or prevent ulcers caused by nonsteroidal anti-inflammatory drugs (NSAIDs), and to treat gastroesophageal reflux disease (GERD). Chemically, Carafate is a complex of the disaccharide sugar, sucrose, combined with sulfate and aluminum. It is minimally absorbed into the body, and it acts solely on the lining of the stomach and duodenum. Carafate is thought to work by attaching to exposed proteins on the surface of ulcer and coating the ulcer, protecting the surface from further injury by acid and pepsin (an enzyme that breaks apart proteins). Carafate also inhibits pepsin in the presence of stomach acid, binds bile salts from the liver via the bile thus protecting the stomach lining from injury caused by the bile acids, and it may increase prostaglandin production which can also protect the lining of the stomach.
Omeprazole is a proton pump inhibitor (PPI) that blocks the production of acid by the stomach used to treat ulcers, gastroesophageal reflux disease (GERD), Zollinger-Ellison syndrome, duodenitis, erosive esophagitis, heartburn, and H. pylori infection. Other drugs in the class include lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), and esomeprazole (Nexium). Proton pump inhibitors are used for the treatment of conditions such as ulcers, gastroesophageal reflux disease (GERD) and the Zollinger-Ellison syndrome, which are all caused by stomach acid. Omeprazole, like other proton-pump inhibitors, blocks the enzyme in the wall of the stomach that produces acid. By blocking the enzyme, the production of acid is decreased, and this allows the stomach and esophagus to heal.
What are the side effects of Carafate and omeprazole?
Carafate is well tolerated. Constipation is the most frequent side effect.
Other side effects include:
Omeprazole like other PPIs is well-tolerated. The most common side effects are:
Other important side effects include:
- abnormal heartbeat,
- muscle pain,
- leg cramps and water retention occur infrequently.
Each packet of Zegerid powder for oral suspension contains 460 mg of sodium and each capsule contains 304 mg of sodium. This should be taken into consideration in patients who need a sodium-restricted diet.
Proton pump inhibitors may increase the risk of Clostridium difficile infection. High doses and long-term use (1 year or longer) may increase the risk of osteoporosis-related fractures of the hip, wrist, or spine. Prolonged use also reduces absorption of vitamin B12 (cyanocobalamin).
Long-term use of PPIs has also been associated with low levels of magnesium (hypomagnesemia). Analysis of patients taking PPIs for long periods of time showed an increased risk of heart attacks.
Therefore, it is important to use the lowest doses and shortest duration of treatment necessary for the condition being treated.
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What is the dosage of Carafate vs. omeprazole?
- The recommended dose for treatment of active ulcers is 1 gram four times daily for 4-8 weeks.
- Carafate is administered on an empty stomach, at least one hour prior to meals, for best results.
- The dose for maintenance (preventing recurrent ulcers) is 1 gram twice daily.
For ulcers, GERD, erosive esophagitis and eradication of H. pylori the recommended dose for adults is 20-40 mg daily. Ulcer healing usually occurs within 4-8 weeks.
H. pylori infections are treated for 10-28 days.
The usual dose for prevention of upper gastrointestinal bleeding in critically ill patients is 40 mg daily for 14 days.
Prilosec OTC is used for treating heartburn for up to two weeks, and the usual dose is 20 mg daily.
For the management of Zollinger-Ellison syndrome the starting dose for adults is 60 mg daily, and the dose is adjusted based on either the response of symptoms or the actual measurement of acid production. Doses greater than 80 mg should be divided. Doses up to 120 mg three times a day have been used in the treatment of Zollinger-Ellison Syndrome.
For maximal efficacy, omeprazole tablets should be taken before meals, swallowed whole and should not be crushed, chewed or opened.
What drugs interact with Carafate and omeprazole?
When administered with other drugs sucralfate may bind to the drugs in the stomach and reduce absorption of the drugs. Sucralfate reduces the absorption of:
- dolutegravir (Tivicay),
- cimetidine (Tagamet),
- digoxin (Lanoxin),
- ketoconazole (Nizoral),
- levothyroxine (Synthroid),
- phenytoin (Dilantin),
- quinidine (Quinidex, Quinaglute),
- ranitidine (Zantac),
- theophylline (Theo-Dur, Uniphyl, others), and
- all of the fluoroquinolone antibiotics, including ciprofloxacin (Cipro), norfloxacin (Noroxin), ofloxacin (Floxin), and lomefloxacin (Maxaquin).
All of these medications should be taken at least two hours prior to sucralfate.
It is possible, if not likely, that many other drugs will interact similarly with sucralfate. Therefore, it probably is prudent to take all medications at least 2 hours prior to sucralfate.
The absorption of certain drugs may be affected by stomach acidity. Therefore, omeprazole as well as other PPIs reduce the absorption and concentration in blood of ketoconazole (Nizoral) and increase the absorption and concentration in blood of digoxin (Lanoxin). This may reduce the effectiveness of ketoconazole or increase digoxin toxicity.
Through unknown mechanisms, omeprazole may increase blood levels of saquinavir and reduce blood levels of nelfinavir and atazanavir, drugs that are used for treating patients with infection caused by the human immunodeficiency virus (HIV). Accordingly, the dose of saquinavir may need to be reduced to avoid toxicity, and the doses of nelfinavir and atazanavir may need to be increased to maintain efficacy.
Clopidogrel (Plavix) is converted to its active form by enzymes in the liver. Omeprazole reduces the activity of these enzymes and potentially can reduce the activity of clopidogrel. Omeprazole should not be used with clopidogrel.
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Are Carafate and omeprazole safe to use while pregnant or breastfeeding?
Sucralfate itself is not teratogenic (causing congenital deformities) in animals, even in doses considerably higher than those used in humans. Although some animal data demonstrate concern for the effects of aluminum during pregnancy, all human data show no ill-effect on the fetus. Sucralfate is considered safe during pregnancy.
Use of omeprazole in pregnant women has not been adequately evaluated. Omeprazole should be used during pregnancy only if the benefits justify the unknown risks.
Omeprazole is excreted in breast milk and potentially could cause adverse effects in the infant.
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Heartburn is a burning sensation experienced from acid reflux (GERD). Symptoms of heartburn include chest pain, burning in the throat, difficulty swallowing, the feeling of food sticking in the throat, and a burning feeling in the chest. Causes of heartburn include dietary habits, lifestyle habits, and medical causes. Treatments for heartburn include lifestyle changes, OTC medication,prescription medication, and surgery.
GERD (Acid Reflux, Heartburn)
GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid contents of the stomach backs up into the esophagus. The symptoms of uncomplicated GERD are: heartburn, regurgitation, and nausea. Effective treatment is available for most patients with GERD.
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Heartburn vs. Acid Reflux (Differences and Similarities)
Heartburn and acid reflux are not the same thing. Heartburn is actually a symptom of acid reflux. Heartburn gets its name because it feels like a burning sensation around the heart. Another symptom that occurs with heartburn is a bitter or sour taste in the mouth, usually when you eat or lye down. Heartburn affects more than 60 million people in the US at least once a month. Acid reflux, or GERD, occurs when stomach acid backs up into the esophagus, which irritates it. Heartburn is just one symptom of acid reflux. Other symptoms of acid reflux include: Belching Nausea after eating A feeling of fullness during or after eating Abdominal bloating Upset stomach Belching Wheezing Reflux laryngitis A tightness in the throat Problems swallowing Indigestion In some people, vomiting Causes of acid reflux and heartburn include: Being obese Slouching (poor posture) Medications like calcium channel blockers, theophylline, nitrates, and antihistamines Foods and drinks like caffeine, citrus fruits and vegetables, alcohol, and chocolate Pregnancy Diabetes Increase in stomach acid Eating a heavy meal Eating before bed The treatment for heartburn and acid reflux is to treat the underlying cause, for example, GERD, with over-the-counter (OTC) medicine, prescription medicine, natural remedies, and lifestyle changes like a eating a healthy, less fatty, spicy diet, not eating big meals, not eating before bed, and getting regular exercise to improve your posture.Sometimes a heart attack can mimic heartburn and acid reflux because they feel very similar. If you have symptoms of chest pain, tightness in the chest, heartburn, acid reflux, jaw, tooth, or head pain; shortness of breath, nausea, vomiting, sweating, discomfort in the upper middle of the abdomen, arm or upper back pain, or the general feeling of being ill, go to the nearest Emergency Department immediately because these are the symptoms of a heart attack.REFERENCES:American College of Gastroenterology. "Acid Reflux." 2017.<http://patients.gi.org/topics/acid-reflux/> familydoctor.org. "Heartburn." Updated: Mar 2014.<https://familydoctor.org/condition/heartburn/> National Library of Medicine; PubMed Health. "Heartburn and GERD: Treatment options for GERD." Updated: Nov 18, 2015.<https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072436/>
Gastroesophageal Reflux Disease (GERD)
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Heartburn During Pregnancy
Heartburn during pregnancy is quite common. During pregnancy the lower esophageal sphincter muscle becomes weakened , which likely occurs due to the effect of the high levels of the hormones estrogen and progesterone during pregnancy. Fortunately, this resolves after pregnancy. Management of heartburn during pregnancy are generally involves lifestyle changes and avoiding foods that promote heartburn, for example, don't smoke, avoid tight clothing, eat small, frequent meals, chew gum, or sip liquids.
Heart Attack vs. Heartburn
Heartburn is a symptom of another disease or medical problem and can be described as a feeling of burning in the chest accompanied by symptoms of nausea, vomiting, or a sour taste or food stuck in the back of the throat. Heart attack occurs when an artery in the heart is completely blocked by a blood clot, which causes that portion of heart muscle to die. Heart attack also has symptoms of chest pain, nausea, and vomiting, however, other warning signs and symptoms of a heart attack are unusual weakness or fatigue, and persistent and/or increased severity of symptoms over a few minutes. Heart attack is a life threatening emergency. If you think you or someone you are with is having a heart attack, call 911 immediately for urgent medical treatment. It may save your life.
GERD (Acid Reflux) in Infants and Children
GERD (gastroesophageal reflux disease) is the upward movement of stomach content, including acid, into the esophagus and sometimes into or out of the mouth. Common symptoms of GERD in children include colic, feeding problems, poor growth, frequent vomiting or coughing, heartburn, regurgitation, recurrent wheezing, pneumonia, choking, or gagging. Treatment may involve elevating the child's bed, keeping the child upright after eating, limiting foods that seem to make the reflux worse, encouraging your child to exercise, and serving several small meals a day.
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