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This medication comes with several important safety warnings and precautions. Please carefully review the following information and consult your healthcare provider if you have any questions or concerns.

• Masked Symptoms of Serious Illness: Persistent heartburn may indicate a more serious condition such as stomach cancer. If your heartburn worsens or returns after using omeprazole (Prilosec), or if you experience poor appetite, unexplained weight loss, or weakness, promptly contact your healthcare provider for further evaluation.

• Acute Kidney Issues: Some individuals taking proton pump inhibitors (PPIs) like omeprazole (Prilosec) have experienced sudden kidney problems, which can occur at any time during treatment. Seek medical advice if you notice changes in urination frequency, nausea, weakness, fever, rash, or joint pain, as these could be signs of kidney issues.

• Severe Infectious Diarrhea: PPIs, including omeprazole (Prilosec), may increase the risk of contracting Clostridioides difficile (C. diff) infections, leading to severe diarrhea. The risk is heightened for individuals over 65, those recently hospitalized or in nursing homes, or those with weakened immune systems. To mitigate this risk, use the lowest effective dose for the shortest duration necessary. Contact your healthcare provider immediately if you experience severe or watery diarrhea, fever, abdominal pain, loss of appetite, or nausea.

• Bone Fractures: Use of omeprazole (Prilosec) may elevate the risk of fractures in the hip, wrist, or spine, particularly with high doses or prolonged use exceeding one year. If you have a history of fractures or osteoporosis, discuss your risk with your prescriber before starting the medication.

• Serious Skin Reactions: Rarely, PPIs can cause severe skin reactions like Stevens-Johnson syndrome or toxic epidermal necrolysis. Symptoms can include fever, body aches, rash, skin peeling, painful blisters, and facial swelling. Seek urgent medical attention if these symptoms occur.

• Lupus: Use of PPIs such as omeprazole (Prilosec) may trigger new or worsening lupus symptoms, including joint pain or rash. These symptoms can develop at any point during treatment but typically improve within one to three months after discontinuing the medication. If lupus symptoms arise, stop taking omeprazole and consult your healthcare provider.

• Vitamin B12 and Magnesium Deficiency: Long-term use of omeprazole (Prilosec) can lead to decreased levels of vitamin B12 and magnesium, especially if combined with other medications that lower magnesium levels. If you've been on this medication for over three years or exhibit symptoms of deficiency (e.g., dizziness, muscle weakness, pale skin, fatigue, tingling in limbs), consult your prescriber.

• Drug Interactions: Certain medications can alter the body's processing of omeprazole (Prilosec), impacting its effectiveness and side effect profile. For instance, St. John's wort and rifampin can reduce omeprazole levels. Avoid these while taking omeprazole.

• Interference with Lab Tests: Omeprazole (Prilosec) may affect the results of specific tumor markers. Inform your healthcare provider or radiologist about your current medications before undergoing lab tests. You may need to temporarily discontinue omeprazole two weeks before such tests.

Contraindications:

• Allergy: Avoid use if you have a known allergy to PPIs.
• Concurrent Medications: Do not use if you are taking Edurant (rilpivirine) or medications containing rilpivirine (e.g., Complera).

Common side effects:

• Headaches
• Abdominal pain
• Nausea
• Diarrhea
• Vomiting
• Passing gas

Less common but important to monitor:

• Respiratory system issues
• Fever
• Ear infections

Serious side effects:

• Acid reflux
• Constipation
• Dizziness
• Back pain
• Cough
• Upper respiratory infections
• Rash
• Overall feeling of weakness
• Low magnesium levels
• Signs of lupus
• Kidney problems
• Bacterial intestinal condition caused by C. difficile
• Persistent diarrhea
• Blood or mucus in stool
• Significant change in urinary habits
• Vitamin B-12 deficiency
• Severe allergic reactions (fever, swollen lymph nodes, rash, trouble breathing)

Interactions with high risk of serious adverse effects and should be avoided:

• Rilpivirine
• Esomeprazole

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Clopidogrel
• Mavacamten
• Methotrexate
• Rifampin
• St John's wort
• Atazanavir
• Erlotinib
• Levoketoconazole
• Nelfinavir
• Pazopanib
• Sparsentan
• Itraconazole
• Ketoconazole
• Posaconazole
• Abametapir
• Acalabrutinib
• Amphetamine
• Benzphetamine
• Bosutinib
• Capecitabine
• Cilostazol
• Citalopram
• Clorazepate
• Conivaptan
• Dacomitinib
• Dasabuvir
• Dasatinib
• Delavirdine
• Dextroamphetamine
• Elagolix
• Escitalopram
• EslicarbazepineAcetate
• Fosnetupitant
• Gefitinib
• Indinavir
• Ledipasvir
• Lisdexamfetamine
• MycophenolateMofetil
• Neratinib
• Netupitant
• Nilotinib
• Octreotide
• Ombitasvir
• Paritaprevir
• Pexidartinib
• Ritonavir
• Saquinavir
• Secretin Human
• Selpercatinib
• Sunitinib
• Tacrolimus
• Velpatasvir
• Vismodegib
• Voriconazole

Interactions with low risk that usually do not require a change in therapy:

• Armodafinil
• Carbamazepine
• Digoxin
• Disulfiram
• Fluconazole
• Ginkgo Biloba
• Iron
• Levothyroxine
• Raltegravir
• Tipranavir
• Triazolam
• Warfarin