[Last updated: 3/12/2010]
Saving money on heartburn / GERD meds
How to take omeprazole / Prilosec
Omeprazole should be taken with a glass of water at least
one hour after eating, and you should not eat or drink
anything except water (and/or antacids) for at least 30
minutes after taking it. (For Zegerid, you should wait
at least 60 minutes after taking it.)
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 must 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.
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 / 20mg caplet, at Sam's Club. I've also seen
generic omeprazole on sale in stores like Walmart for as
little as $0.40 / 20mg 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, 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 10mg, 20mg & 40mg dose sizes.
20mg is by far the most common dose, but if you are buying
a generic product you should make sure that you are getting
the 20mg dose, rather than the 10mg dose.
I've found sources for generic omeprazole made by Collins,
Ranbaxy, SBL, Omega Biotech (of India), and Intas. Ranbaxy,
Omega Biotech, 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 do
not, unfortunately, include 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.
Update 3/12/2010: At last, eBay seems to have lifted their ban
on generic omeprazole sales. Several vendors are selling it,
some for as little as $.23 / 20mg dose.
I currently use Collins "Alboz," which I've bought from two
sellers who I originally found on eBay. Both have perfect 100%
positive eBay feedback ratings, both ship shipped from the USA,
and both treated me well:
1. Irene Diaz (email: Heartburncure at sbcglobal dot net) is
on eBay as Purplepenguin_2008. She sells sold Collins "Alboz"
omeprazole for under $.30 / 20mg 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: I recently emailed both Irene and Joe, to
confirm that the information here is up-to-date. Unfortunately,
Joe replied that he is not currently selling omeprazole.
4/26/2009 Update: Unfortunately, I've just heard from Irene,
and she is no longer selling omeprazole, either.
Another eBay seller of Ranbaxy "Romesec" omeprazole was eBay
vendor joymukherji200188jq. His (yes "his," not "her") eBay
feedback rating was perfect, but his eBay store is now closed.
I've never bought omeprazole from him, but I recently (4/2009)
got an email from him saying that he still sells generic
omeprazole (now made by Omega Biotech instead of Ranbaxy),
and he now has a web site at www.purplesale.com. His email
address is joymukherji2001 at yahoo dot com, and you can
probably also contact him via this link. At last notice,
he was selling 200 capsules for $38.40, shipping included
($0.19 / capsule), drop-shipped from India. I've heard
from several of his satisfied customers, but recently I've
also heard from several dissatisfied customers; apparently
there have been problems with the drop shipments from India.
Unfortunately, the continuing reports
of severe problems dealing with Mr. Mukherji, and not just
with the drop shipment process from India, have led me to
conclude that he is no longer a viable source of omeprazole.
Do not buy from him.
Note that credit card charges must be disputed within 60 days,
and you should allow a week or 10 days for letter transit. See:
http://moneycentral.msn.com/content/Banking/creditcardsmarts/P79885.asp
ProgressiveRX sells Ranbaxy "Romesec" generic omeprazole made
by Cipla and Dr. Reddy's (both good companies) for about
$0.24 / 20mg 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.
A helpful correspondent recently told me:
"I buy my prescription meds at CanadaDrugPharmacy.com,
and now my omeprozole as well. They are higher priced
but will match a legitimate 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."
(Thanks, Brad!)
Their standard S&H seems to be $9.99.
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
can presumably file a dispute with your credit card bank to
get your money back.
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 / 20mg 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 / 20mg dose at Alcepsa, and about
$.45 / 20mg 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 150mg 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.
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). (Note that the U.S. patent on pantoprazole isn't
due to expire until July 19, 2010, but two manufacturers
are apparently marketing generic versions anyhow, and
challenging the pantoprazole patent in court.)
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
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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