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Understand Why Omeprazole Is Being Withdrawn From Prescriptions and What Alternatives Are Already Indicated By Experts
For a long time, millions of Brazilians used omeprazole as a daily gastric protector, but experts have begun to warn about the hidden dangers of this habit.
Although it is a milestone in the treatment of reflux and gastritis, the medication now requires more caution from healthcare professionals.
Experts Highlight the Side Effects of Prolonged Use
Débora Poli, gastroenterologist at Hospital Sírio-Libanês, recommends avoiding continuous and unnecessary use of omeprazole.
She advises that patients should always undergo medical evaluation before continuing treatment.
Proton pump inhibitors (PPIs) — the group to which omeprazole belongs — reduce stomach acidity, but they also interfere with nutrient absorption.
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Raphael Brandão, oncologist and director of Clínica First, explains that many people start using it without a forecast for stopping and continue for years, without reassessments.
Karoline Soares Garcia, from Clínica Sartor and the Brazilian Federation of Gastroenterology, states that prolonged use of the medication impairs the absorption of iron, calcium, magnesium, and vitamin B12.
This nutritional deficit causes anemia, cramps, osteopenia, and fatigue, as well as facilitating intestinal infections from Clostridioides difficile and bacterial overgrowth in the small intestine (SIBO).
According to recent observational studies, continuous use may also increase the risk of kidney diseases and bone fractures.
In light of this, doctors recommend limiting the duration of use and always having professional oversight.
Omeprazole Remains Useful in Specific Conditions
Despite the warnings, the drug still plays a crucial role in the treatment of conditions such as gastroesophageal reflux, gastritis, ulcers, and Helicobacter pylori infection.
Débora Poli emphasizes that it continues to be effective and accessible, especially in short and well-directed treatments.
Patients with Barrett’s esophagus, eosinophilic esophagitis, or those using anti-inflammatory drugs for long periods may still need the medication.
Therefore, doctors analyze each case to decide whether it is worth maintaining or not the treatment with omeprazole.
Lighter and Safer Medications Now Replace Omeprazole in Mild Cases
For patients with mild or intermittent reflux, doctors recommend other less aggressive solutions.
Raphael Brandão suggests reducing the dose, using the medication on demand, or replacing it with H2 blockers, such as famotidine.
These medications act on histamine receptors and, although less potent, cause fewer adverse effects over time.
Another alternative is P-CABs (potassium blockers), such as vonoprazan, which has a faster and longer-lasting action.
On the other hand, the high cost and low availability still limit access to this new class of medications in Brazil.
Healthy Lifestyle Helps Reduce the Need for Medications
Doctors emphasize that adjusting one’s routine can prevent the need for medications, especially in milder cases.
Among the most recommended practices are:
- Gradually losing weight;
- Avoiding lying down after main meals;
- Reducing the consumption of ultraprocessed foods, alcohol, and chocolate;
- Maintaining a defined eating routine and slow chewing;
- Elevating the head of the bed during sleep.
These simple changes help control reflux and avoid self-medication.
Rational and Monitored Use of Omeprazole Is the Main Medical Recommendation
Karoline Soares Garcia clarifies that the current movement to reduce the use of omeprazole is not an opposition to the medication, but rather an attempt for rational use.
For her, omeprazole represents a significant advance in modern medicine, but, like any medication, it requires precise indication, limited duration of use, and constant medical supervision.
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