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What are the differences between Prilosec and Zantac?
- Prilosec (omeprazole) and Zantac (ranitidine) are used for the treatment of conditions such as ulcers and gastroesophageal reflux disease (GERD) caused by stomach acid. Both drugs work in different ways to reduce stomach acid.
- Prilosec and Zantac are both available over-the-counter (OTC).
- Prilosec is a proton pump inhibitor (PPI) that blocks the production of acid by the stomach. Zantac works differently. It is an H2 (histamine-2) blocker that inhibits the action of histamine on the cells, thus reducing the production of acid by the stomach.
- Common side effects of Prilosec and Zantac that are similar include diarrhea, headache, nausea, and vomiting.
- Side effects of Prilosec that are different from Zantac include rash and dizziness.
- Side effects of Zantac that are different from Prilosec include constipation, fatigue, and insomnia.
What are Prilosec and Zantac?
Prilosec (omeprazole) is in a class of drugs called proton pump inhibitors (PPIs) that block the production of acid by the stomach. Other PPIs 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 so the production of acid is decreased, allowing the stomach and esophagus to heal.
Zantac (ranitidine) is in a class of drugs called H2 (histamine-2) blockers that blocks the production of acid by acid-producing cells in the stomach. Other H2 blockers include cimetidine (Tagamet), nizatidine (Axid), and famotidine (Pepcid). Histamine is a naturally occurring chemical that stimulates cells in the stomach (parietal cells) to produce acid. H2-blockers inhibit the action of histamine on the cells, thus reducing the production of acid by the stomach, which helps prevent and heal acid-induced inflammation and ulcers.
What are the side effects of Prilosec and Zantac?
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.
Minor side effects occur and these are:
Other important, but rare, side effects include:
What is the dosage of Prilosec vs. Zantac?
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 2 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.
Ranitidine may be taken with or without food.
- Usual oral doses for treating ulcers and GERD are 150 mg twice daily or 300 mg at bedtime. The maintenance dose is 150 mg daily.
- Erosive esophagitis is treated with 150 mg 4 times daily.
- Zollinger-Ellison syndrome may be treated with as much as 6 g daily.
- Heartburn is treated with 75 mg or 150 mg once or twice daily 30-60 minutes before consuming meals or beverages that cause heartburn.
Self-medication should not last longer than 2 weeks unless advised by a physician.
What drugs interact with Prilosec and Zantac?
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.
Ranitidine, like other drugs that reduce stomach acid, may interfere with the absorption of drugs that require acid for adequate absorption. Examples include iron salts (for example iron sulphate), itraconazole (Sporanox), and ketoconazole (Nizoral, Extina, Xolegel, Kuric).
Are Prilosec and Zantac safe to use while pregnant or breastfeeding?
Omeprazole is excreted in breast milk and potentially could cause adverse effects in the infant.
There are no adequate studies of ranitidine in pregnant women. Available evidence suggests that there is little risk when used during pregnancy.
Ranitidine is secreted into human breast milk and may pose a potential risk to the infant.
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Prilosec (omeprazole) and Zantac (ranitidine) are used for the treatment of conditions such as ulcers and gastroesophageal reflux disease (GERD) caused by stomach acid. Both drugs work in different ways to reduce stomach acid; one is a proton-pump inhibitor and the other is an H2 blocker.
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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.
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. The effect of heartburn medications on the fetus is unknown, so it is best to check with your OB/GYN if you feel you need medication to treat heartburn.
GERD and GER (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.
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.
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/>
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