Picture this: You’re standing in the drug store with heartburn, trying to decide which antacid pill to buy. This burning pain in your chest started hours ago, and it’s worse when you bend over, lie down, or eat. With so many different heartburn medications to choose from, you can’t tell which one will give you the most relief. Should you pick something cheaper, like Tagamet (generic: cimetidine), Zantac (generic: ranitidine) or Pepcid (generic: famotidine)? Which works faster: Pepto-Bismol, or TUMS? Since your pain’s persistent, you choose the most powerful option: Prilosec (generic: omeprazole), which is a PPI (proton pump inhibitor).
If you’ve never seen a doctor to treat your acid reflux, Prilosec OTC may seem like the safest bet. PPIs are fast, effective, and feature brands like Nexium you’ve seen for years in television commercials or glossy magazine ads. But without a doctor’s prescription, PPIs can present extreme — and potentially irreversible — side effects and complications. That’s why every single PPI available without a prescription warns you not to take it for more than 14 days. If you have frequent heartburn, we’ll compare potential side effects for two popular OTC (over-the-counter) heartburn medications: Prilosec and Zantac.
Prilosec vs. Zantac: Comparing Side Effects
Prilosec OTC, one of the most popular heartburn and acid reflux medications available on the market today, is a PPI. PPIs virtually halt the cells in your stomach’s lining from producing almost any gastric acid. This helps prevent your stomach from forming any peptic ulcers, assists in healing, and controls acid-reflux symptoms from severe heartburn. But unfortunately, PPIs tend to do their job a little too well.
“Dip into any physiology textbook,” says Harvard Health Publications’ website, “and you’ll find that stomach acid serves several constructive purposes.” Stomach acid helps digest your food, and it also provides a built-in barrier against bacterial infections. Eliminating most stomach acid means that your body cannot absorb many important nutrients from the food you eat during digestion. Scientists believe this could explain some of the more extreme side effects seen from long-term or frequent Prilosec use.
Commonly Reported Prilosec OTC Side Effects with Short-term Use
The most commonly reported Prilosec OTC short-term side effects include:
- Abdominal pain
Potentially Serious Health Complications from Taking Prilosec Longer Than 14 Days
Recent medical studies offer proof that you shouldn’t take PPIs long-term unless you’re prescribed them for a medically diagnosed ailment. If you take Prilosec daily or several times per month for years, you may develop the following side effects:
Prilosec Complication #1: Acute Renal Disease
A 2013 study observed 184,480 acid reflux patients living in the Midwest. Among these test subjects, 854 cases reported at least two claims for an acute renal disease diagnosis. Researchers found that patients receiving a renal disease diagnosis were twice as likely to have taken PPIs in the past.
Prilosec Complication #2: Chronic Clostridium Difficile Infections
C-diff is a bacterial infection that, if left untreated, can cause chronic, life-threatening diarrhea. Individuals who swallow C-diff bacteria in their food normally fight off infection through sufficient gastric acid production in their stomachs. But since PPIs make the stomach significantly leszans acidic, Prilosec patients are prone to experiencing serial C-diff infections. This increased risk is especially worrisome for older or immunocompromised Prilosec patients.
Prilosec Complication #3: Pneumonia
Similar to C-diff, the acid in your stomach kills incoming bacteria and viruses. Pneumonia occurs more frequently with PPI use because the acid does not destroy the viruses that cause it.
Prilosec Complication #4: Increased Risk of Bone Fractures
Your body absorbs calcium during digestion, but PPIs interfere with that process, leading to brittle, easily broken bones. In fact, the FDA released a warning about the possible increased risk of fracture for those who use a PPI.
Prilosec Complication #5: Dementia
A February 2016 JAMA Neurology study observed 70,000 adults aged 75 and up who had no dementia signs before enrollment. Researchers discovered subjects prescribed a PPI for at least 18 months had a 44% increased chance of developing dementia symptoms.
Other serious Prilosec side effects recently noted by medical researchers include:
- Heart attacks
- Vitamin D and B-12 deficiencies
- “Silent” kidney damage, which may lead to end-stage renal disease (ESRD) and death
UPDATE: FDA Orders Permanent Zantac Recall Due to Cancer Risk
In April 2020, the FDA issued a permanent Zantac recall after it discovered a cancer-causing substance called NDMA. Over time, the FDA says, the NDMA’s potency grew stronger in normal Zantac storage conditions. So if you happen to have any bottles of Zantac lying around the house, throw them out! The longer it sits around, the more likely you are to get cancer if you take those pills.
The safest H2 blocker to take now for severe heartburn is Maximum Strength Pepcid AC (20mg) twice per day.
What Victims Can Do
If you or a loved one develop cancer after taking tainted Zantac, you may qualify for a cash settlement. Once you’ve submitted your information, an experienced mass tort lawyer will call to discuss your case and potential compensation options.
Mandy Voisin is a freelance writer, blogger, and author of Girls of the Ocean and Star of Deliverance. As an accomplished content marketing consultant, mom of four and doctor's wife, Mandy has written hundreds of articles about dangerous drugs and medical devices, medical issues that impact disabled Americans, veterans' healthcare and workers' compensation issues since 2016.