Omeprazole
From £12.99
Omeprazole is commonly used to treat acid reflux, heartburn and gastro oesophageal reflux disease (GORD) in the UK. Depending on the condition being treated, adults may be prescribed doses such as 10mg, 20mg or 40mg. The right dose depends on why you are taking omeprazole, how severe your symptoms are and how you respond to treatment.
This guide explains the main omeprazole doses, including the difference between 20mg and 40mg. It also answers common questions, such as whether 40mg is considered a high dose and whether taking 40mg every other day is the same as taking 20mg every day.
Nothing here replaces individual clinical advice. Your prescriber will decide which dose is appropriate for your condition and circumstances.
What Dosage Forms Does Omeprazole Come In?
Omeprazole is available in the UK as capsules, tablets and liquid preparations. Some tablets can also be dispersed in water. The exact strengths and formulations available depend on the product.
Some omeprazole capsules contain small gastro resistant granules. These are designed to protect the medicine from stomach acid so that the active ingredient can be released after the medicine passes through the stomach.
The main omeprazole products stocked by EverydayMeds are:
- Omeprazole 20mg capsules
- Losec MUPS 20mg tablets, a branded formulation containing omeprazole magnesium
10mg and 40mg strengths are also available in the UK. For example, current UK product information lists Losec capsules and Losec MUPS tablets in 10mg, 20mg and 40mg strengths.
Omeprazole 20mg: A Common Adult Dose for Acid Related Conditions
20mg once daily is a commonly used adult dose for conditions such as symptomatic GORD and reflux oesophagitis. The exact dose and treatment length depend on the condition being treated. For example, UK product information lists 20mg once daily for symptomatic GORD and reflux oesophagitis.
Omeprazole is also used for stomach ulcers, prevention of some NSAID related ulcers and as part of treatment for H. pylori infection alongside antibiotics. The dose can differ depending on the condition.
Some people notice an improvement within a few days, although the response varies. Omeprazole reduces stomach acid, and its effect on acid secretion builds during the first few days of regular treatment. UK product information states that maximum acid suppression with once daily dosing is generally reached within about 4 days.
NHS guidance says that omeprazole can be taken with or without food. If you take it once a day, try to take it at the same time each morning. Swallow gastro resistant capsules or tablets whole with water and do not chew or crush them.
Some Losec MUPS tablets can be dispersed in water for people who have difficulty swallowing. Follow the instructions supplied with your specific product.
Omeprazole 40mg: When a Higher Dose Is Used
Is 40mg of omeprazole a high dose? It is higher than the usual 20mg daily dose used for many adults with GORD, but it is an established dose for several conditions. It is not automatically considered excessive or unsuitable simply because it is 40mg.
For example, UK product information recommends 40mg once daily for adults with severe reflux oesophagitis. It can also be used when some stomach ulcers have not healed adequately with a lower dose. The dose used for Zollinger Ellison syndrome is individually adjusted and can be higher than 40mg.
For GORD, a higher dose may be considered when symptoms are not adequately controlled with a standard dose. However, the decision depends on the diagnosis and the person's response to treatment. NICE and NHS guidance generally support using the lowest dose that controls symptoms once treatment is established.
Can I take 2 x 20mg omeprazole instead of 1 x 40mg? Two 20mg doses taken together provide a total of 40mg omeprazole, and this may be how a 40mg dose is supplied or prescribed. However, you should not increase your dose yourself. Follow the strength and dosing instructions given by your prescriber or pharmacist.
40mg is also used in some ulcer and H. pylori treatment regimens, but the exact dose and combination depend on the condition and treatment plan.
Omeprazole 20mg vs 40mg: What the Evidence Shows for Reflux Oesophagitis
The main difference between 20mg and 40mg is the amount of acid suppression produced. A higher dose generally produces greater acid suppression, but that does not mean that everyone with reflux will feel twice as much benefit from 40mg.
For reflux oesophagitis, UK product information recommends 20mg once daily for many adults, while 40mg once daily is recommended for severe oesophagitis. Treatment duration can also vary depending on whether the oesophagus has healed.
This is why the dose should be based on the condition being treated rather than simply choosing the higher strength because it sounds stronger.
If symptoms remain troublesome despite treatment, a prescriber may review the diagnosis, how the medicine is being taken, the dose and whether another treatment approach is more suitable. NHS guidance also notes that a different type of medicine, such as an H2 receptor antagonist, may sometimes be considered when a PPI does not help.
Is 40mg Every Other Day the Same as 20mg Daily?
No. Taking 40mg every other day has not been established as clinically equivalent to taking 20mg every day for GORD.
Omeprazole is generally taken once or twice daily, depending on the condition and prescription. Regular dosing is used to maintain its acid reducing effect. UK product information describes once daily and, for some treatment plans, twice daily dosing, rather than a routine 40mg every other day schedule.
Taking 40mg on one day and nothing the next does not simply create the same treatment pattern as taking 20mg every day. If you are considering alternate day dosing because of side effects, cost, convenience or because your symptoms have improved, speak to your prescriber before changing the schedule.
There may be other suitable options, such as reducing the daily dose or using treatment only when symptoms occur in appropriate circumstances. The right approach depends on why you take omeprazole and how well your symptoms are controlled.
Omeprazole Dosage Range: A Quick Comparison
| Dose | Typical use | How it is taken |
|---|---|---|
| 10mg | A lower dose that may be used for some conditions or longer term management after symptoms are controlled | Usually once daily, as directed |
| 20mg | A common adult dose for GORD, reflux oesophagitis, some ulcers and other acid related conditions | Usually once daily, depending on the condition |
| 40mg | Used for conditions such as severe reflux oesophagitis, some ulcers and certain higher intensity treatment plans | Usually once daily, although some treatment plans use a different schedule |
The appropriate dose and treatment length vary between people. This table is a general guide rather than a substitute for a clinical assessment.
Branded vs Generic Omeprazole
EverydayMeds stocks generic omeprazole capsules and Losec MUPS. Both are omeprazole products, but they can differ in formulation and inactive ingredients.
Approved generic medicines are required to meet UK regulatory standards for quality and therapeutic performance. However, it is better not to assume that every branded and generic product is identical in appearance, formulation or excipients.
Losec MUPS is a gastro resistant tablet formulation containing omeprazole magnesium, while omeprazole capsules can contain gastro resistant granules. Some Losec MUPS tablets can be dispersed in water, which may be useful for people who have difficulty swallowing capsules.
The choice between products can depend on the prescribed strength, formulation, price and what is practical for you.
Alternative PPI Options
If omeprazole is not suitable for you, another proton pump inhibitor may sometimes be considered. Other PPIs used in the UK include lansoprazole, pantoprazole and rabeprazole. Esomeprazole is another medicine in the same group.
The reason for changing treatment can vary. It may be because of side effects, interactions with another medicine, an inadequate response or the need for a different formulation.
For some people with ongoing reflux symptoms, an H2 receptor antagonist such as famotidine may also be considered. This type of medicine works differently from a PPI.
How to Get Omeprazole Through EverydayMeds
Some strengths and pack sizes of omeprazole are available from pharmacies without a prescription, while other strengths, formulations and treatment plans require a prescription. NHS guidance states that most types of omeprazole are prescription only, and if you buy omeprazole without a prescription, you should not take it for longer than 2 weeks without speaking to a GP.
Through EverydayMeds, this means completing an online questionnaire about your symptoms and medical history. A UK registered prescriber can then review the information and decide whether treatment is appropriate and, if so, which strength may be suitable.
The aim is to make sure the choice between 20mg, 40mg or another treatment is based on your symptoms and medical history rather than simply choosing a higher dose yourself.
