What are the differences between Prilosec and Zantac 360?
- Prilosec (omeprazole) and Zantac 360 (famotidine) are used for the treatment of conditions such as ulcers and gastroesophageal reflux disease (GERD) caused by stomach acid. Both drugs work in different ways to reduce stomach acid.
- Prilosec and Zantac 360 are both available over-the-counter (OTC).
- Prilosec is a proton pump inhibitor (PPI) that blocks the production of acid by the stomach. Zantac 360 works differently. It is an H2 (histamine-2) blocker that inhibits the action of histamine on the cells, thus reducing the production of acid by the stomach.
- Common side effects of Prilosec include diarrhea, headache, nausea, vomiting, rash, and dizziness.
- Zantac 360 currently has no known side effects.
What are Prilosec and Zantac 360?
Prilosec (omeprazole) is in a class of drugs called proton pump inhibitors (PPIs) that block the production of acid by the stomach. Other PPIs include lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), and esomeprazole (Nexium). Proton pump inhibitors are used for the treatment of conditions such as ulcers, gastroesophageal reflux disease (GERD) and the Zollinger-Ellison syndrome, which are all caused by stomach acid. Omeprazole, like other proton-pump inhibitors, blocks the enzyme in the wall of the stomach that produces acid so the production of acid is decreased, allowing the stomach and esophagus to heal.
Zantac 360 (famotidine) is in a class of drugs called H2 (histamine-2) blockers that blocks the production of acid by acid-producing cells in the stomach. Other H2 blockers include cimetidine (Tagamet HB), and famotidine (Pepcid AC). Histamine is a naturally occurring chemical that stimulates cells in the stomach (parietal cells) to produce acid. H2-blockers inhibit the action of histamine on the cells, thus reducing the production of acid by the stomach, which helps prevent and heal acid-induced inflammation and ulcers.
What are the side effects of Prilosec and Zantac 360?
Omeprazole like other PPIs is well-tolerated. The most common side effects are:
Other important side effects include:
- abnormal heartbeat,
- muscle pain,
- leg cramps, and water retention occur infrequently.
Each packet of Zegerid powder for oral suspension contains 460 mg of sodium and each capsule contains 304 mg of sodium. This should be taken into consideration for patients who need a sodium restricted diet.
Proton pump inhibitors may increase the risk of Clostridium difficile infection. High doses and long-term use (1 year or longer) may increase the risk of osteoporosis-related fractures of the hip, wrist, or spine. Prolonged use also reduces the absorption of vitamin B12 (cyanocobalamin).
Long-term use of PPIs has also been associated with low levels of magnesium (hypomagnesemia). Analysis of patients taking PPIs for long periods of time showed an increased risk of heart attacks.
Therefore, it is important to use the lowest doses and shortest duration of treatment necessary for the condition being treated.
There are no listed side effects of Zantac 360.
What is the dosage of Prilosec vs. Zantac 360?
- H. pylori infections are treated for 10-28 days.
- The usual dose for prevention of upper gastrointestinal bleeding in critically ill patients is 40 mg daily for 14 days.
- Prilosec OTC is used for treating heartburn for up to 2 weeks, and the usual dose is 20 mg daily.
- For the management of Zollinger-Ellison syndrome the starting dose for adults is 60 mg daily, and the dose is adjusted based on either the response of symptoms or the actual measurement of acid production. Doses greater than 80 mg should be divided. Doses up to 120 mg three times a day have been used in the treatment of Zollinger-Ellison syndrome.
- For maximal efficacy, omeprazole tablets should be taken before meals, swallowed whole and should not be crushed, chewed or opened.
Adults and children 12 years and over:
- to relieve symptoms, swallow 1 tablet with a glass of water. Do not chew.
- to prevent symptoms, swallow 1 tablet with a glass of water at any time from 15 to 60 minutes before eating food or drinking beverages that cause heartburn
- do not use more than 2 tablets in 24 hours
- children under 12 years: ask a doctor
Pancreatitis is inflammation of an organ in the abdomen called the pancreas.
What drugs interact with Prilosec and Zantac 360?
- The absorption of certain drugs may be affected by stomach acidity. Therefore, omeprazole as well as other PPIs reduce the absorption and concentration in blood of ketoconazole and increase the absorption and concentration in blood of digoxin (Lanoxin). This may reduce the effectiveness of ketoconazole or increase digoxin toxicity.
- Through unknown mechanisms, omeprazole may increase blood levels of saquinavir and reduce blood levels of nelfinavir and atazanavir, drugs that are used for treating patients with infection caused by the human immunodeficiency virus (HIV). Accordingly, the dose of saquinavir may need to be reduced to avoid toxicity, and the doses of nelfinavir and atazanavir may need to be increased to maintain efficacy.
- Clopidogrel (Plavix) is converted to its active form by enzymes in the liver. Omeprazole reduces the activity of these enzymes and potentially can reduce the activity of clopidogrel. Omeprazole should not be used with clopidogrel.
- Omeprazole increases the concentration of cilostazol. The dose of cilostazol should be reduced from 100 mg twice daily to 50 mg twice daily when given with omeprazole.
- Omeprazole may increase blood levels of methotrexate (Rheumatrex, Trexall) and tacrolimus (Prograf).
Zantac 360 (famotidine), like other drugs that reduce stomach acid, may interfere with the absorption of drugs that require acid for adequate absorption. Examples include iron salts (for example iron sulphate), itraconazole (Sporanox), and ketoconazole (Extina, Xolegel, Kuric).
Are Prilosec and Zantac 360 safe to use while pregnant or breastfeeding?
Omeprazole is excreted in breast milk and potentially could cause adverse effects in the infant.