Omeprazole – Information for Older Adults
Plain-language information about omeprazole in older adults. This page is for older Canadians and their caregivers. It does not replace advice from your own health-care provider.
Omeprazole
Proton Pump Inhibitor (PPI) – Stomach Acid Reducer
1. What is omeprazole used for?
Omeprazole is a proton pump inhibitor (PPI) – a type of medication that reduces the amount of acid your stomach makes. It is one of the most commonly used medications in Canada.
Omeprazole is commonly used to:
- Treat heartburn and acid reflux (GERD) – when stomach acid flows back into the esophagus
- Heal stomach ulcers – sores in the lining of the stomach
- Heal duodenal ulcers – sores in the first part of the small intestine
- Protect the stomach – in people taking medications that can irritate the stomach (like certain pain medicines)
- Treat H. pylori infection – used with antibiotics to kill bacteria that cause ulcers
- Treat Zollinger-Ellison syndrome – a rare condition causing too much stomach acid
Good to know
PPIs like omeprazole are very effective at reducing stomach acid. They have helped millions of people find relief from heartburn and allowed ulcers to heal. However, they work best when used for the right reasons and for the right amount of time.
2. How does omeprazole usually help?
Omeprazole works by blocking the "proton pump" – a tiny mechanism in the stomach lining that produces acid:
Shuts down the acid-producing pumps in your stomach
Less acid means less burning sensation when acid refluxes
With less acid, ulcers and irritated tissue can heal
Helps prevent damage from irritating medications
How quickly does it work?
Omeprazole may take 1–4 days to reach its full effect. It's not meant for immediate relief like antacids (such as Tums). If you need quick relief, ask your provider what you can take while waiting for omeprazole to work.
3. Why omeprazole needs extra care in older adults
While omeprazole is generally safe for short-term use, using PPIs for a long time (especially months or years) may be linked to some concerns in older adults:
- Lower magnesium levels – can cause muscle cramps, weakness, or irregular heartbeat
- Lower vitamin B12 levels – can cause tiredness, weakness, or memory problems over time
- Increased risk of certain infections – like C. difficile diarrhea (a serious bowel infection)
- Possible increased fracture risk – if used at high doses for long periods
- Possible kidney effects – rarely, long-term use may affect kidney function
Because of this, health-care providers often:
Important perspective
For many people, omeprazole is genuinely needed and the benefits outweigh the risks. Don't stop taking it without talking to your provider first. The goal is to make sure you're taking it for a good reason and at the right dose.
4. How omeprazole is usually taken
Important
Follow your provider's instructions. Omeprazole works best when taken correctly – timing matters for this medication.
In general:
Most people take it once a day, often in the morning
Take 30–60 minutes before eating (usually before breakfast) for best effect
Don't crush or chew capsules/tablets unless your provider says it's okay
Take with a glass of water
Why before meals?
The acid-producing pumps in your stomach are most active when you eat. Taking omeprazole before a meal means it's ready to block those pumps when they "wake up" for digestion. This timing helps it work better.
If you miss a dose
Take it as soon as you remember, unless it's almost time for your next dose. Don't take two doses at once. If you frequently forget, try setting a daily reminder.
Stopping omeprazole
If you've been taking omeprazole for a long time, don't stop suddenly without talking to your provider. Sometimes symptoms can temporarily get worse ("rebound acid") when you stop. Your provider may suggest reducing the dose gradually.
5. Possible side effects older adults may notice
Many people tolerate omeprazole very well. When side effects do occur, common ones include:
Usually mild and may improve over time
Upset stomach or feeling queasy
Changes in bowel habits
Bloating, gas, or mild abdominal pain
Usually well tolerated
Most people take omeprazole without any problems. Side effects are usually mild and often improve as your body adjusts to the medication.
Tell your provider right away if:
- Severe or watery diarrhea that doesn't stop – could be a sign of C. difficile infection
- Muscle cramps, spasms, or weakness – could be a sign of low magnesium
- Signs of allergic reaction – rash, itching, swelling of face/throat, difficulty breathing
- Unusual tiredness or weakness that doesn't improve
- Joint pain – especially in the wrists, elbows, or knees (rare)
6. When to be extra careful with omeprazole
Talk to your health-care provider if you have:
Important drug interactions
Omeprazole can interact with several medications. Always tell your provider about all medications you take, including:
- Clopidogrel (Plavix) – omeprazole may make it less effective; your provider may choose a different PPI
- Warfarin – may increase bleeding risk; monitoring may be needed
- Methotrexate – levels may increase
- Some HIV medications
- Some anti-seizure medications (like phenytoin)
- Certain antifungal medications (like ketoconazole) – need acid to be absorbed
Similar medications
Other PPIs include pantoprazole (Pantoloc), esomeprazole (Nexium), lansoprazole (Prevacid), and rabeprazole (Pariet). They work similarly. If you have problems with one, your provider might try another.
7. Habits and lifestyle that may help
While omeprazole is helpful, lifestyle changes can also reduce heartburn and acid reflux. These may help you need less medication over time:
Large meals increase pressure on the stomach and can worsen reflux
Avoid eating within 2–3 hours of lying down or bedtime
Raising it 6–8 inches can help prevent nighttime reflux (use blocks, not just pillows)
Extra weight around the middle increases pressure on the stomach
Smoking weakens the valve between stomach and esophagus
Tight belts and waistbands can increase pressure on your stomach
Foods that may trigger heartburn
Common triggers include spicy foods, citrus, tomatoes, chocolate, coffee, alcohol, fatty or fried foods, and peppermint. Triggers vary by person – notice what bothers you and try to avoid those foods.
Can I stop omeprazole?
For some people, lifestyle changes allow them to reduce or stop omeprazole. Talk to your provider before making changes. They may suggest trying a lower dose or taking it only when needed ("on-demand" use) instead of every day.
8. When to call your doctor, nurse practitioner, or pharmacist
(Non-urgent)
Contact your health-care provider or pharmacist if:
- You've been taking omeprazole for longer than a few weeks and haven't discussed this with your provider
- You still have frequent heartburn or stomach pain despite taking omeprazole as directed
- Your symptoms have changed or gotten worse
- You have ongoing diarrhea or stomach upset while on omeprazole
- You have muscle cramps, weakness, or spasms
- You're feeling unusually tired or weak
- You want to try reducing or stopping omeprazole
- You have questions about using omeprazole with other medications
- You're not sure if you still need to take it
9. When to call 911 or go to the emergency department
Call 911 immediately if:
- Chest pain or pressure that does not go away – could be heart attack (not just heartburn)
- Black, tarry stools – could be bleeding in the stomach
- Vomit that looks like coffee grounds or contains blood – could be bleeding
- Trouble swallowing that is new or getting worse
- Severe abdominal pain
- Signs of severe allergic reaction – swelling of face, lips, tongue, or throat; difficulty breathing
If possible, do not drive yourself. Ask someone to call for you or call an ambulance.
Heartburn vs. heart attack
Heartburn and heart attacks can feel similar. If your chest discomfort is different from your usual heartburn, comes with shortness of breath, sweating, or pain spreading to your arm, jaw, or back – assume it could be your heart and call 911. It's better to be safe.
10. Questions to ask your doctor or nurse practitioner
You can print these questions and bring them to your next appointment: