Your guide to omeprazole alternatives

Chronic acid reflux from GERD can be painful, and it can lead to serious complications if you don’t receive treatment. Omeprazole is a medication that doctors often prescribe for the long-term management of acid reflux symptoms.

It belongs to a group of medications called proton-pump inhibitors (PPIs). These are medications that work by reducing the amount of acid your stomach produces. They are not instant relief medications and work over a longer period of time to reduce your symptoms.

Omeprazole typically comes as larger tablets, which some people may have difficulty swallowing.

Like all medications, taking omeprazole does come with some side effects. For example, you may experience diarrhea or drowsiness. While you may notice side effects from one PPI, it does not mean you will experience them from other PPIs.

There are different types of PPIs, so if you do not feel that omeprazole is right for you, there are plenty of alternatives for you to try.

Over-the-counter (OTC) and natural options are also available.

Other medications to try

Heartburn is the result of stomach acid rising into your esophagus. Most heartburn medications work by reducing the amount of acidity in your stomach or relaxing the muscles that push stomach acid up into your esophagus.

If you are experiencing side effects that will not go away, consider speaking with a healthcare professional about an alternative medication. Do not stop taking omeprazole unless a healthcare professional advises it.

Alternatives medications can include:

Other PPIs

If you are experiencing side effects from omeprazole (Prilosec), other PPIs may be more suitable for you. Omeprazole is one of the oldest PPIs available, and there are newer medications that may be better suited to your needs. These newer PPIs are also smaller tablets, making them easier to take.

Rabeprazole (Aciphex) and pantoprazole (Protonix) are two new PPIs. According to the International Foundation for Gastrointestinal Disorders (IFFGD), they have comparable effectiveness to omeprazole in suppressing stomach acid production, with some data even suggesting they’re slightly more effective.

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Prokinetics

PPIs are often the first-line medical treatment that a healthcare professional will recommend for GERD. However, if PPIs do not help relieve your symptoms, they may suggest a combination approach with prokinetic medications.

These are medications that help to increase the movement of the esophagus and stomach to strengthen your lower esophageal sphincter. This is the muscle that controls the movement of stomach contents into your esophagus.

This process encourages your stomach to empty faster, which helps reduce the symptoms of GERD. A research review from 2021 indicated that combination therapies of prokinetic medications and PPIs are more effective at reducing severe symptoms of GERD than PPI medications alone.

The types of prokinetics medications that a doctor may recommend include:

• metoclopramide (Reglan)
• bethanechol (Urecholine)
• cisapride (Prepulsid)
• domperidone (Motilium)

H2 Receptor Blockers

Prescription-strength H2 blockers are an alternative to PPIs like omeprazole. However, they are more suitable for short-term relief as their action only lasts for several hours. H2 blockers can provide relief to allow damage to your esophagus to heal.

H2 blockers may not be as effective as omeprazole, but only 1.5 percent of people taking them experience side effects significant enough to stop taking the drugs.

Some prescription-strength H2 blockers a doctor may prescribe include:

• famotidine (Pepsid)
• nizatidine (Axid)
• cimetidine (Tagamet)

OTC options

There are a wide variety of OTC GERD medications available for you to try. They are not as strong as prescription omeprazole, but they will be more affordable.

However, if you are experiencing regular heartburn, you will likely need something to help heal your esophagus, as long-term heartburn can damage it.

OTC medications to help relieve symptoms of GERD include:

• Antacids (Tums): These are some of the oldest available treatments for heartburn. Antacids are suitable for mild symptoms of GERD and work by neutralizing your stomach acid to prevent discomfort.

• Lansoprazole (Prevacid 24HR): OTC PPIs, such as lansoprazole, are available. These medications are low strength but are only suitable for use for up to 2 weeks at a time, 3 times per year. They can help treat frequent heartburn and may take 4 days to fully take effect.

• H2 blockers (Axid AR): These OTC H2 blockers work in the same way as the prescription versions, but like OTC PPIs, are lower strength. They work quickly but may only last several hours, so they may not be suitable if you have chronic GERD.

Natural remedies

If you do not wish to take medication for your GERD, there are plenty of natural alternatives to omeprazole that you can try. These include herbal remedies and lifestyle changes, such as:

• Managing your weight: If you have overweight, you may be more likely to experience heartburn or GERD. This is likely due to increased pressure on and around your abdominal area. Consider incorporating regular aerobic exercise into your daily routine.
• Quitting smoking if you smoke: Research indicates that almost 20 percent of smokers are likely to experience symptoms of GERD. Try to quit smoking — if you smoke — to help prevent your symptoms from worsening.
• Drinking chamomile tea: Research has shown that chamomile tea can help reduce inflammation. Try drinking some before meals and bedtime to relieve symptoms of heartburn. 
• Taking black garlic supplements: According to a 2023 review of research, black garlic supplements can help reduce irritation in your esophagus by lowering inflammation.
• Trying traditional herbal remedies: Research from 2020 suggests that certain traditional herbal remedies may have some benefit in treating GERD, either alone or alongside PPIs.

If you wish to try a herbal remedy for GERD, it is important to speak with a doctor before doing so. This is because certain herbal supplements can interact with certain medications.

More research is needed to say for certain whether any herbal remedies are effective in relieving GERD symptoms.

Getting medical advice

If you are taking omeprazole but you experience unpleasant side effects such as gastrointestinal problems or the medication is not working in the way you need it to, speak with a doctor.

They will be able to help find an alternative treatment that works best for you. It is important to not stop taking the medication unless a doctor instructs you to do so.

Summary

Omeprazole is a type of PPI medication that helps reduce the amount of acid in your stomach. It is an older PPI that some people experience unpleasant side effects from or simply may not notice that it helps their symptoms.

If omeprazole is not suitable for you, there are a variety of other prescription and OTC medications available for you to try. There are different options depending on the severity of your symptoms. These include other PPIs, prokinetics, and H2 blockers.

If you do not wish to take medications, there are lifestyle habits and herbal remedies you can try.

But remember, it is important to check with a doctor before starting a new routine or herbal supplement.

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