Dear Dr. Roach: I have been diagnosed with acid reflex for 20 years, but have never been on any antacid medication until recently, when my doctor prescribed Prilosec. My concern is whether it safe for long-term use. Is there an ingredient in Prilosec that causes cancer? — A.M.
Answer: No medicine is completely safe, but omeprazole (Prilosec) has been safely used for decades by many people. Long-term risks include an increased propensity to bacterial pneumonia; gastrointestinal infections, such as C. diff; and poor absorption of vitamin B12 and calcium.
When this class of medications was first introduced, there was concern about an increase in a type of tumor called gastric carcinoid, based on laboratory animal studies. This has not been shown to be of concern in humans.
Some antacid medicines (such as ranitidine) have been contaminated by a carcinogen called NDMA. Omeprazole (Prilosec) has not been implicated by this contaminant.
Many people who have been on omeprazole and similar powerful anti-ulcer drugs for years or decades do just fine if they are slowly tapered off the drug. Some people really need them to keep their symptoms under control. I usually try to taper them off, but if a person needs them, it’s safe to continue them long-term.
