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Prilosec (omeprazole)

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Prilosec may cause vomiting in 1.5% to 3.2% of people. This symptom may occur with a history of zollinger-ellison syndrome.

This drug may also cause the following symptoms that are related to vomiting:


Medical Source Information
Yellow highlights indicate symptoms related to vomiting.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Other less serious side effects are more likely to occur, such as: stomach pain, gas; nausea, vomiting, diarrhea; or headache. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Gastrointestinal side effects have included diarrhea (3.0% to 3.7%), abdominal pain (2.4%), nausea (2.2% to 4%), vomiting (1.5% to 3.2%), constipation (1.1%), anorexia, irritable colon, flatulence, dry mouth, esophageal candidiasis, and persistent achlorhydria in a Zollinger-Ellison patient. Gastric polyps, hyperplasia of gastric enterochromaffin-like cells, and atrophic gastritis have been reported after long-term therapy. Campylobacter gastroenteritis has been identified in one case-control study. Rare cases of pancreatitis, some fatal, have been reported during the post marketing period.

Hepatic side effects have included elevations in serum transaminases, alkaline phosphatase, bilirubin, and rare cases of hepatitis and hepatic encephalopathy. Fatal fulminant hepatic failure attributed to omeprazole has also been reported.

A 62-year-old man with erosive esophagitis developed signs and symptoms of hepatic disease 17 days after the start of therapy with omeprazole 20 mg per day. Five days after presentation, the patient died from complications associated with fulminant hepatic failure. Autopsy findings included massive central zone necrosis and hemorrhage with proliferation of bile ducts.

Proton pump inhibitors may interfere with the detection of H. pylori by the urea breath test. Therefore, testing for H. pylori with the urea breath test is not recommended in patients who have received proton pump inhibitors in the preceding two weeks.

When omeprazole is given together with clopidogrel, the effectiveness of the clopidogrel is reduced. Patients at risk for heart attacks or strokes who use clopidogrel to prevent blood clots may not get the full effect of this medication if they are also taking omeprazole. Separating the dose of clopidogrel and omeprazole at different times of the day does not reduce this drug interaction.

Nervous system side effects have included headache, dizziness, somnolence, vertigo, hemifacial dysesthesia and numbness, paresthesias of the extremities, and a report of reversible gait ataxia.

Renal side effects have included elevations in serum creatinine, rare reports of interstitial nephritis, and renal failure.

Lab and Diagnostic Tests
If certain symptoms develop, ask your physician whether you need the following lab tests or other diagnostic tests (if you've not already had them):
  • Monitor blood tests
References
  1. Proton pump inhibitor-associated gastric polyps: A retrospective analysis of their frequency, and endoscopic, histologic, and ultrastructural characteristics. Choudhry U, Boyce HW, Coppola D Am J Clin Pathol 1998;110:615-21.
  2. Long-term treatment with omeprazole for refractory reflux esophagitis: efficacy and safety. Klinkenbergknol EC, Festen HPM, Jansen JBMJ, Lamers CBHW, Nelis F, Snel P, Luckers A, Dekkers CPM, Havu N, Meuwissen M Ann Intern Med 1994;121:161-7.
  3. Efficacy and safety of omeprazole in the long-term treatment of peptic ulcer and reflux oesophagitis resistant to ranitidine. Brunner GH, Lamberts R, Creutzfeldt W Digestion 1990;47:64-8;.
  4. Atrophic gastritis and helicobacter pylori infection in patients with reflux esophagitis treated with omeprazole or fundoplication. Kuipers EJ, Lundell L, Klinkenbergknol EC, Havu N, Festen HPM, Liedman B, Lamers CBHW, Jansen JBMJ, Dalenback J, Snel P, N Engl J Med 1996;334:1018-22.
  5. Gastric polyposis: onset during long-term therapy with omeprazole . Graham JR Med J Aust 1992;157:287-8.
  6. Omeprazole, hypergastrinemia, and gastric carcinoid tumors. Freston JW Ann Intern Med 1994;121:232-3.
  7. Development of sustained achlorhydria in a patient with the Zollinger- Ellison syndrome treated with omeprazole [published erratum appears in Gastroenterology 1992 Mar;102(3):1096]. Griffith JL, Cummings OW, Hirschowitz BI Gastroenterology 1991;101:242-6.
  8. Product Information. Prilosec (omeprazole). Anonymous Merck & Co, Inc, West Point, PA. PROD;
  9. Omeprazole and dry mouth. Teare JP, Spedding C, Whitehead MW, Greenfield SM, Challacombe SJ, Thompson RPH Scand J Gastroenterol 1995;30:216-8.
  10. Oesophageal candidiasis after omeprazole therapy. Larner AJ, Lendrum R Gut 1992;33:860-1.
  11. Omeprazole as a cause of oral candidiasis. Anderson PC Arch Dermatol 1995;131:965-6.
Multum version: 154.0 (Jun 16, 2010)
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