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Prilosec (omeprazole)

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Prilosec may cause stomach polyps (benign growths).

Medical Source Information
Yellow highlights indicate symptoms related to stomach polyps.

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.

Gastric polyposis have been reported in three of eleven patients treated with long-term omeprazole therapy (20 to 40 mg daily). Hyperplastic and fundic gland polyps developed in the stomach of these patients. Neither dysplasia nor malignancy was present. The significance of these findings from a small case series is unknown. Controlled studies are needed to fully evaluate this effect. Ninety-one patients receiving long-term maintenance therapy for gastroesophageal reflux disease were followed for 5 years. Hyperplasia of gastric enterochromaffin-like cells was noted in 20% of patients and atrophic gastritis in 25%. Effects were more pronounced in patients with very high serum gastrin levels. The significance of these observed changes is unknown. No evidence of dysplasia, carcinoid, or other forms of neoplasia were noted.

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

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.
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.
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;.
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.
Gastric polyposis: onset during long-term therapy with omeprazole . Graham JR Med J Aust 1992;157:287-8.
Omeprazole, hypergastrinemia, and gastric carcinoid tumors. Freston JW Ann Intern Med 1994;121:232-3.
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.
Product Information. Prilosec (omeprazole). Anonymous Merck & Co, Inc, West Point, PA. PROD;
Omeprazole and dry mouth. Teare JP, Spedding C, Whitehead MW, Greenfield SM, Challacombe SJ, Thompson RPH Scand J Gastroenterol 1995;30:216-8.
Oesophageal candidiasis after omeprazole therapy. Larner AJ, Lendrum R Gut 1992;33:860-1.
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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