[Last updated: 9/20/2017]
Saving money on heartburn / GERD meds
How to take omeprazole / Prilosec
Omeprazole should be taken with a glass of water on an
empty stomach (i.e., at least one hour after eating),
and you should not eat or drink anything except water
for at least 30 minutes after taking it. (For Zegerid,
you should wait at least 60 minutes after taking it.)
(I think it is generally acceptable to also take simple
antacids, like baking soda or calcium carbonate (TUMS),
within 30 minutes of taking omeprazole, though this site
disagrees.)
Generic omeprazole is usually packaged in capsules, like
prescription Prilosec and Nexium. However, Prilosec OTC
(and some generics) are packaged in caplets (elongated
tablets). While not identical, they are functionally
equivalent, when taken whole.
The main difference is this: You can open capsules to
split the dose, but you should not break the Prilosec OTC
caplet in half to split the dose, because the Prilosec
OTC caplet uses an enteric coating to delay dissolution
until the drug has passed into the small intestine, where
it will not be destroyed by stomach acid. If you break
the Prilosec OTC caplet the coating cannot work.
Most omeprazole capsules (except Zegerid) use an enteric
coating on the "tiny time pills" within the capsules.
Zegerid instead adds 1/3 teaspoon (1.1 gram) of baking
soda to the capsule, to neutralize stomach acid and
protect the omeprazole from acid degradation.
(Zegerid is also available as packets of powder for mixing
in water; each "20 mg" packet contains 20 mg of omeprazole
plus 1/2 teaspoon of baking soda.)
If you accidentally break an omeprazole caplet, instead of
discarding it you can take it with 1/3 to 1/2 teaspoon of
baking soda (and wait a full hour after taking it before
eating or drinking anything except water) -- unless you're
on a low sodium diet.
Click here for the full "prescribing information" for
prescription Prilosec, from the FDA. They also have some
supplemental information here.
The FDA prescribing information is a large document, but
the most important part is at the beginning: the list of
potential drug interactions and other special considerations.
Medications which should not be taken along with omeprazole
without first consulting a doctor include:
* warfarin, clopidogrel, atazanavir, nelfinavir, saquinavir,
cilostazol, tacrolimus, rifampin, St. John's Wort
* drugs for which gastric pH affects bioavailability (e.g.,
ketoconazole, iron salts, ampicillin esters, and digoxin)
* drugs metabolized by cytochrome P450 (e.g., diazepam,
phenytoin, cyclosporine, disulfiram, benzodiazepines)
* Combined inhibitors of CYP 2C19 and 3A4 (e.g. voriconazole)
** Many of those drugs can taken along with omeprazole, but
dosage adjustments for one or both drugs may be required.
** Additionally, people with hepatic impairment (liver
problems) should consult a doctor before taking omeprazole.
** Additionally, omeprazole can cause "false positive" test
results for neuroendocrine tumors.
Note: some omeprazole preparations contain "omeprazole" and
others contain "omeprazole magnesium" (the magnesium salt
of omeprazole). The difference is inconsequential.
What it costs, and where to get it cheapest
Prilosec OTC is available everywhere in the United States.
("OTC" stands for "Over The Counter," i.e., without a
prescription.) The best "regular" price I've found is
about $0.63 / 20 mg caplet, at Sam's Club. I've also seen
generic omeprazole on sale in stores like Walmart for as
little as $0.40 / 20 mg caplet (~$17 for a package of 42).
Prilosec / Omeprazole Magnesium is made by AstraZeneca
(innovator) as Prilosec / Losec, and under license by Procter
& Gamble (OTC version), and as part of a joint venture
with Astra, by Merck. Generic versions are apparently
made by Ranbaxy (as Romesec), Productos Farmaceuticos
Collins (as Alboz), KUDCo / Schwarz Pharma (as Nopramin, not
to be confused with Norpramin, which is an unrelated drug),
Mitsubishi Pharma (as Omeprazon), Valeant (as Nuclosina),
DrReddys (as Omez), SBL (as Merofex), Teva, Mylan, STADA
Arzneimittel, Kremers Urban, Omega Biotech (of India,
not Canada), Sandoz / Lek, Intas Pharmaceutical, Apotex,
Dexcel Pharma (as Omepradex & Zanprol), Santarus (as Zegerid),
UDL Labs, Cipla, Cadila (as Nogacid), and probably others.
The last U.S. omeprazole patent expired in 2001, and in
December, 2007 the first generic manufacturer, Dexcel Pharma,
and its marketing partner Perrigo, finally got FDA approval
to market generic omeprazole OTC caplets (as Omepradex?)
in the USA.
Omeprazole is manufactured in 10 mg, 20 mg & 40 mg dose sizes.
20 mg is by far the most common dose, but if you are buying
a generic product you should make sure that you are getting
the 20 mg dose, rather than the 10 mg dose.
I've found sources for generic omeprazole made by Collins,
Cadila, Ranbaxy, SBL, Omega Biotech (of India), Cipla, and Intas.
Cadila, Ranbaxy, Omega Biotech, Cipla and Intas are based in
India. Collins and SBL are Mexican companies. (I believe that
Ranbaxy is the manufacturer of many of the generic drugs that
WalMart sells with their $4/month prescription drug offerings -
which, unfortunately, do not include omeprazole.)
Cheapest sources (that I know of) for omeprazole:
Notes About Credit Cards
Payment by credit card is generally the safest way to buy
on-line. It might give you the option of disputing the
charge and getting your money back, if your order does not
arrive.
Note #1: That should always be true for American purchasers
buying from American sellers. But it's not always the case
for purchases from overseas.
Note #2: Credit card charges must be disputed within 60 days,
and you should allow 7 to 10 days for letter transit. See:
http://moneycentral.msn.com/content/Banking/creditcardsmarts/P79885.asp
eBay seems to have finally lifted their ban on generic
omeprazole sales, as of 3/12/2010. An eBay search finds
many vendors.
My most recent purchase of omeprazole for my own use was
Ranbaxy from eBay seller onlinegalazysuperstore. It is fine,
and the price was amazing, at under $25 for 600 capsules.
My 2nd-most-recent purchase of omeprazole for my own use was from
eBay seller store.health_beauty, in Sri Lanka. It took 42 days
to arrive in North Carolina, but the product was fine, and the
cost, including shipping, was just $30 for 400 capsules (7.5¢
per 20mg capsule).
My 3rd-most-recent purchase of omeprazole for my own use was
Nogacid brand omeprazole for ~$.10 per 20 mg dose from eBay
seller "health.planet" (since renamed to "designs.india").
(Thanks, Karl, for the tip!) It was shipped from India (in
very interesting but effective packaging). It works fine.
Note #1: the family who runs health.planet / designs.india are
now using eBay ID "real.phoenix" for selling omeprazole and
other over-the-counter medicines.
Note #2: They don't always list Nogacid on eBay; send them a
message if they don't have it listed when you look. I've bought
Nogacid omeprazole from them several times, the first time in
January 2011. They treated me very well.
(Note: I recommend that you only buy from eBay vendors
who have at least 98.5% positive feedback (or nearly that), and
many positive feedbacks for the sale of omeprazole.)
eBay used to permit the selling of generic omeprazole, but
then stopped allowing it. Before they changed their rules
I found a half-dozen vendors selling generic omeprazole there.
Update 2/16/2009: eBay seems to be permitting generic omeprazole
sales again. At least, an eBay search finds people selling it.
Update 3/9/2009: Oops, I spoke too soon. It appears that eBay
again has shut down their generic omeprazole sellers, even though
generic omeprazole is now for sale in every drug store and
WalMart in America. It makes no sense.
CanadaDrugPharmacy.com ("CDP") is where I bought my 4th-to-last
batch of omeprazole for my own use. A helpful correspondent
named Brad recommended them. He wrote:
"I buy my prescription meds at CanadaDrugPharmacy.com,
and now my omeprozole as well. They are higher priced but
will match a legitimate (Canadian) seller. I found pills
for $24/100 at Progressive RX, entered that information in
their blank and they matched it and gave an additional
small discount over the .24 as well. I have dealt with
CDP for years with no complaints."
At Brad's suggestion, I bought Cipla omeprazole capsules
from CDP, price-matched to ProgressiveRx (which was my
5th-to-last omeprazole purchase.) CDP treated me well, and
the omeprazole works fine. (Thanks, Brad!)
CDP's standard S&H seems to be $9.99. If you'd like me to
"refer" you so that you'll get a $35 discount on your first
order from them, send me an email.
ProgressiveRX.com sells Ranbaxy "Romesec" generic omeprazole
made by Cipla and Dr. Reddy's (both good companies) for about
$0.24 / 20 mg dose plus $5 shipping, drop-shipped from India.
I'm conservative, so their company name makes me a bit queasy,
but they have a good reputation, and when they used to sell
on eBay they had a near-perfect eBay feedback rating, and they
have a polished-looking web site.
I'm told that it typically takes 1.5 to 2 weeks to receive
your order. S&H is $5, or free for orders over $99.
(BTW, the note on their page saying, "Prescription products
must have a valid prescription emailed or faxed to
ProgressiveRx" does not apply to omeprazole, because
it is over-the-counter.)
Like CDP, they have a "referral deal" which gets you a $25
discount on your first order. If you'd like me to "refer"
you so that you'll get the discount, send me an email.
However, they might not honor the $25 discount offer for OTC
omeprazole.
Purplesale.com is an online store in India, operated by
Mr. Joy Mukherji. Circa 2008, he sold Ranbaxy omeprazole
through eBay as joymukherji200188jq. His eBay feedback rating
was perfect, but he closed his eBay store, and sometime around
early 2009 he and a partner opened the purplesale.com web store,
selling Omega Biotech omeprazole. Unfortunately, in early 2010,
because of reports of problems with customers receiving orders
from Mr. Mukherji's company, I recommended that omeprazole
users not buy from him. (I understand that he and his partner
had a falling out, and his online store subsequently closed.)
However, I've recently (2015) heard from him again, and he
told me that he has reopened his purplesale.com store. He
assured me that the ordering problems have long been solved, and
that his store is once again a reliable source for omeprazole.
If you buy from him, please email me and let me know how long
it took to receive your order, and whether you were satisfied.
PurpleOutlet.com is selling generic omeprazole made by
Intas and drop-shipped from India, for $.26/capsule, with free
shipping. Their web site is simple but professional-looking.
I've had no contact with them, but they registered their domain
name in February 2006, and they accept Visa & MC, so if
you buy with a credit card and don't get what you ordered you
might be able to file a dispute with your credit card bank to
get your money back.
Others
I used to use Collins "Alboz" omeprazole which I bought from two
sellers who I originally found on eBay. (Alboz worked fine for
me, and I liked that it comes in bottles instead of blister-packs.)
Both sellers have perfect 100% positive eBay feedback ratings,
both shipped from the USA, and both treated me well. Unfortunately,
neither is currently selling omeprazole.
1. Irene Diaz (email: Heartburncure at sbcglobal dot net) is
on eBay as Purplepenguin_2008. She sells sold Collins Alboz
omeprazole for under $.30 / 20 mg capsule.
2. Joe Cino & Ed Costa (email: hilojoe at hotmail dot com,
tel: 760-408-3535) are on eBay as joe_shoe. They sell sold
Collins Alboz omeprazole for about the same price as Irene.
(Irene and/or Joe & Ed might also have had "Merofex" generic
omeprazole from SBL Pharmaceuticals, but that's not what I
bought.)
2/17/2009 Update: Joe informed me that he is not currently
selling omeprazole.
4/26/2009 Update: Irene informed me that she is not currently
selling omeprazole, either.
7/16/2011 Update: eBay seller Greg Feazell ("bfeazell3han")
contacted me by email to tell me that he has Collins Alboz
omeprazole for sale, which he ships from his home in Texas.
His price is $14.95 + $2.75 s&h = $17.70 for 120 capsules,
which is about $0.15 per 20mg capsule -- an excellent price
for a product shipped from the United States.
10/31/2015 Update: I've just become very belatedly aware of
a 2009 U.S. gov't press release alleging that Collins had
connections to narcotics traffickers, who supposedly used
Collins' pseudoephedrine to make methamphetamine. I never had
any problems with their omeprazole product, and Collins was
eventually removed from the U.S. government's "bad guy" list,
but the allegations are still disturbing.
Omeprazole is also sometimes sold on Amazon auctions
for $0.25-0.33 / capsule. One vendor I've seen there
is gizzy24 (Debbie Tye, email: dtye at cox dot net), whom
you can also contact via this link. However, because of
Amazon's 17% auction listing fee, you'll get an even better
price from her (as low as $.17 / capsule) if you shop at her
web site, datdiscounts.com. She sells generic omeprazole
made by Omega Biotech, of Ghaziabad, India (not to be
confused with the dubious Canadian "nutraceutical" outfit by
the same name). She stocks the smaller packages; the larger
ones are drop-shipped from India. However, in January 2009
I received an email from a dissatisfied customer of hers, and
her web site now says, "The site is temporarily down. We
hope to be back soon."
Another Amazon seller I've seen is AI-BNP Inc, which is
selling omeprazole for $0.33 / 20 mg dose. Their phone number
is 1-866-913-7866, but I know nothing else about them.
As of 8/08, generic Omeprazole by Teva is now for sale at
Walmart and Sam's Club, for $0.40 to $0.45/caplet (which is
slightly less than the price of Prilosec OTC). As of 3/09,
all drugstores & many grocery stores seem to have generic
omeprazole for sale, typically at about $.50/caplet.
Omeprazole is also sold on many other Internet web sites,
such as PurpleDiscount.com. PurpleDiscount apparently sells
generic omeprazole manufactured by Intas Pharmaceutical
of India, and the product is drop-shipped directly from India.
PurpleDiscount.com has been on the Web since October 2004.
That's a very good sign. They sell omeprazole in both capsule
and tablet forms (for aproximately the same price), which
is unusual. They have a toll-free 1-866 American phone
number, which is a plus. I have not purchased from them,
myself, but I personally know of someone I trust who was a
satisfied customer of PurpleDiscount.com, and I've recently
exchanged friendly emails with the owner, Mr. Dan Sherman.
I think purplediscount.com is a reliable vendor, though
getting packages from India is probably inherently less
reliable than getting them from Arizona or California.
As of 2/27/2009, the PurpleDiscount.com web site is down,
and Mr. Sherman has informed me by email that he is closing
his omeprazole business. (If you need to contact Mr. Sherman,
send me an email, as I have his email address and phone number.)
Unfortunately, I don't know how to determine which companies
are legitimate and reliable, and which are not. I guess I
could inquire with their local BBB & AG offices, but I've not
done that. The lack of an eBay-like "feedback system" makes
purchasing from such web sites less safe than purchasing from
an eBay vendor with an established >99% positive feedback
rating, in my opinion.
Aclepsa.com and Medstore International appear to be larger
companies, with many products. Aclepsa has been on the
Web since October 2005, and Medstore since October 2006.
Alcepsa drop-ships from India, and Medstore apparently
drop-ships from India, Singapore, Fiji and/or Canada. Both
companies have have toll-free 1-800 American phone numbers,
which is a plus. However, when I last checked the price of
omeprazole was about $.40 / 20 mg dose at Alcepsa, and about
$.45 / 20 mg dose + s&h at Medstore, which is similar to WalMart.
Warning: also, both companies also sell generic versions
of products which I believe are not legitimately available
in generic form in the USA, such as Nexium and Protonix.
What's more, Alcepsa's description of their "generic
Prilosec" product contains a glaring mistake: It says that
the drug's generic name is "pantoprazole," which is wrong.
Pantoprazole is Protonix, not Prilosec. So I worry about
their trustworthines.
Prilomed.com has been on the Web since February 2005.
That's a good sign. However, PriloMed.com is actually
the same folks as SlushConnection.com, a little Northern
California outfit that rents Margarita Machines to bars.
That does not inspire confidence. OTOH, I've heard from
a satisfied customer, and their product ("Ometab-20" from
Intas) is apparently good. (Web site is down 8/08.)
The ranitidine (or famotidine) alternative
For many people, there's an even cheaper alternative to
omeprazole. Generic ranitidine 75mg (equivalent to
Zantac 75) sells at Sam's Club for about $.02 / pill.
(Generic famotidine, which is equivalent to Pepcid, is
similar, and also less than a nickel per pill at Sam's
Club, and it works better than ranitidine for some people.)
One difference between omeprazole and ranitidine is that
omeprazole can be effective at one capsule per day.
Ranitidine is much shorter term in its effect. It has a
half-life of about 3 hours. Although it significantly
inhibits stomach acid for quite a bit longer than that,
you can't get by with just one per day. However, 75mg of
ranitidine every 8 hours is only about $.06 per day, and
for many people it is almost as effective as a daily
omeprazole (though obviously less convenient than taking
just one omeprazole dose when you get up in the morning).
Also, ranitidine (or famotidine) has the advantage that you
can take it with or without food. You need to fast for an
hour before taking omeprazole, and for at least a half-hour
afterward, but that is not necessary with ranitidine.
Silly labeling fictions
The approved labeling for both Zantac 75 / ranitidine and
Prilosec OTC / omeprazole contain silly polite fictions,
which everybody ignores.
The approved labeling for Ranitidine 75mg instructs that
it should be taken just twice per day (one 75 mg pill
"b.i.d." which means 2/day). But the reality is that it is
routinely taken 3 or 4 times per day (225mg or 300 mg/day).
In fact, the over-the-counter Zantac 150 is labeled for
two 150 mg doses per day, and for treatment of erosive
esophagitis Zantac 150 is given four times per day (one
150 mg pill "q.i.d." which means 4/day), a total of 600
mg/day.
Likewise, Prilosec OTC is labeled for use for up to 21
consecutive days, only. But the reality is that it is taken
continuously and indefinitely by almost everyone who uses it.
Note, though, that there is a potential downside to taking
omeprazole for an extended period of time. Your body may
develop a tolerance to omeprazole, making it less effective,
and resulting in "rebound hyperacidity" when you stop taking
the drug. The rebound effect should last only 3-5 days,
however.
Other similar drugs:
Omeprazole is in a class of drugs called "proton pump inhibitors,"
which include: omeprazole (Prilosec), esomeprazole (Nexium),
rabeprazole (Aciphex), lansoprazole (Prevacid), pantoprazole
(Protonix) & dexlansoprazole (Dexilant, nee Kapidex).
(The U.S. patent on pantoprazole expired on July 19, 2010,
and generic versions are appearing.)
Ranitidine is in an older class of drugs called "H2 blockers"
or "H2-receptor antagonists," which include ranitidine (Zantac),
cimetidine (Tagamet), famotidine (Pepcid) & nizatidine (Axid).
More medical notes, on other subjects
To find bargains on other generic medications, check these sites:
o GenericMedList.com (use the search feature!)
o Sam's Club Pharmacy
o Costco Pharmacy
o CanadaDrugPharmacy.com
Note: you needn't purchase a Costco or Sam's Club membership
to use their pharmacies -- they are open to everyone (I think
due to some sort of legal requirement). Also, note that even
though Walmart and Sam's Club are really the same company,
they have different generic drug lists.
Here's a web page similar in style to this one, but on a different
topic -- statins and other cholesterol-lowering drugs:
http://www.burtonsys.com/cholesterol.html
Here's a web page similar to this one, but about bisphosphonates
(drugs for osteoporosis / bone recalcification):
http://www.burtonsys.com/osteoporosis.html
Contact me
I can be reached by phone at home at 1-919-481-0098, or by email.
Dave Burton
Cary, NC
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