Digestive Enzymes vs. Omeprazole (Prilosec)

Digestive enzymes are proteins produced by the pancreas to break down the foods we eat. Oral digestive enzymes are used when the pancreas can’t produce enough. The main enzymes include proteases for proteins, lipases for fats, and amylases for carbohydrates. Pancreatic enzyme products (PEPs) are used for pancreatic diseases, cystic fibrosis, Shwachman-Diamond syndrome, chronic pancreatitis, pancreatic cancer, tumors, and when the pancreas is partially or fully removed. PEPs may also be used for gastrointestinal disorders like Celiac disease, Crohn’s disease, and poor digestion due to enzyme deficiencies.

Omeprazole (Prilosec) is a proton pump inhibitor (PPI) for ulcers, GERD, Zollinger-Ellison syndrome, duodenitis, erosive esophagitis, heartburn, and H. pylori infection. Other PPIs include lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), and esomeprazole (Nexium). PPIs treat conditions caused by stomach acid. Omeprazole blocks the acid-producing enzyme in the stomach, reducing acid production and promoting healing of the stomach and esophagus.

Side Effects of Digestive Enzymes and Omeprazole

Digestive Enzymes

In rare cases, allergic reactions can occur. Patients should seek emergency medical help if they experience difficulty breathing or talking, swelling of the mouth, face, lips, tongue, or throat, chest tightness, rash, hives, itching, red, swollen, blistered, or peeling skin, or wheezing. Other side effects include an increased risk of fibrosing colonopathy in the colon and should not be used by patients allergic to pork.

Omeprazole

The common side effects include nervousness, abnormal heartbeat, muscle pain, weakness, leg cramps, water retention, and sodium content should be considered for patients on a restricted diet. Prolonged use may increase the risk of Clostridium difficile infection, osteoporosis-related fractures, reduced vitamin B12 absorption, low magnesium levels, and heart attacks. Lowest effective doses and shortest treatment duration should be used.

Dosage of Digestive Enzymes and Omeprazole

Digestive Enzymes

Over-the-counter (OTC) digestive enzymes are used as dietary supplements and not FDA-approved for treating ailments. Prescription digestive enzymes come in different formulations and strengths, and are not considered bioequivalent by the FDA.

Omeprazole

For ulcers, GERD, erosive esophagitis, and H. pylori eradication, the recommended adult dose is 20-40 mg daily. Ulcer healing usually occurs within 4-8 weeks. H. pylori infections are treated for 10-28 days. Dosage adjustments are required for specific conditions.

Drug Interactions with Digestive Enzymes and Omeprazole

Digestive Enzymes

Antacids containing calcium or magnesium may reduce the effectiveness of oral digestive enzymes. Digestive enzymes may also reduce the effectiveness of alpha-glucosidase inhibitors, such as acarbose and miglitol, which are used to treat diabetes.

Omeprazole

Omeprazole may increase the concentrations of diazepam, warfarin, and phenytoin. It may affect the absorption of drugs like ketoconazole and digoxin. Omeprazole can increase blood levels of saquinavir and reduce levels of nelfinavir and atazanavir, used to treat HIV infections. It reduces the activity of clopidogrel and increases concentrations of cilostazol.

Safety of Digestive Enzymes and Omeprazole in Pregnancy and Breastfeeding

Digestive Enzymes

Oral digestive enzymes have not been adequately studied in pregnant women. Use during pregnancy should be considered only if benefits outweigh risks. Excretion into breast milk is minimal.

Omeprazole

The use of omeprazole in pregnancy has not been adequately evaluated. Breastfeeding should be avoided due to potential adverse effects on the infant.

Summary

Digestive enzymes and omeprazole are used to treat different gastrointestinal problems. Digestive enzymes help break down food and are used when the pancreas can’t produce enough. Omeprazole is a PPI that reduces stomach acid and treats ulcers, GERD, Zollinger-Ellison syndrome, and H. pylori infection.