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Alternatives to Prilosec OTC

Prilosec was introduced in 1998 as a prescription medication for frequent heartburn that was due to acid reflux disease. In 2003, the Food and Drug Administration, or FDA, approved the 20mg capsule to be sold over the counter as Prilosec OTC. There are a number of alternatives to Prilosec OTC, sold both with and without prescription.

  1. Definition

    • Prilosec was the first of the proton pump inhibitors, or PPIs, developed to help prevent damage to the esophagus from chronic reflux. PPIs were also shown to heal ulcers and gastritis. They work by suppressing the production of acid in the digestive tract by blocking the enzyme that produces it. While the mechanism of proton pump inhibitors may differ slightly, they are made to provide the same results.

    Prescription Medications

    • With a physician's prescription, there are four other PPIs that can be used as alternatives to Prilosec OTC. They are: Prevacid (lansoprazole); Aciphex (rabeprazole); Protonix (pantoprazole); and Nexium (esomeprazole). All of the proton pump inhibitors are available in more than one strength, and Prevacid is also available as Prevacid SoluTab, which dissolves under the tongue.

    OTC Options

    • Prilosec OTC is the only proton pump inhibitor that is available without a prescription, but there are similar medications over the counter. Antacids such as Tums, Rolaids provide quick, but temporary, relief for heartburn. H-2 receptor blockers like Pepcid and Zantac can be taken prior to eating and provide longer relief. Unlike PPIs, though, antacids and H-2 receptors will not heal ulcers or other damage to the digestive system if that is the reason for the heartburn.

    Generic

    • The main ingredient of Prilosec is the generic omeprazole. Omeprazole is available with a prescription in the same 20mg dose as Prilosec OTC as well as the stronger 40 mg strength. The cost may be about the same, though most insurance will cover prescription medications but not those sold over the counter ones. Protonix is also available as a generic, pantoprazole, by prescription. H-2 receptors come in generic formulas.

    Consideration

    • Prilosec OTC is the lowest strength available as a proton pump inhibitor, but it should still be used under the direction of a health professional. If your symptoms do not improve after two weeks of taking Prilosec OTC, consult a physician as you may need a prescription strength medication. One option available since 2009 is Zegerid, a rapid release version of the omeprazole in Prilosec.

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