Heartburn is common during pregnancy and can become more noticeable as pregnancy progresses. Hormonal changes and the growing baby can both contribute to indigestion and acid reflux.
So, can you take omeprazole while pregnant? The short answer is that omeprazole can be used during pregnancy when it is clinically appropriate. It is the PPI with the most pregnancy safety information in the UK, which is why it is generally the preferred PPI when a PPI is needed. BUMPS states that there is no good evidence that omeprazole or other PPIs are linked to miscarriage, birth defects, stillbirth, preterm delivery or low birth weight.
That does not mean that every pregnant person with heartburn needs omeprazole. Treatment depends on how severe your symptoms are, what you have already tried and whether there could be another reason for your symptoms. This guide explains what the evidence shows, what it does not tell us, where omeprazole fits into treatment and when pregnancy related upper abdominal pain needs checking.
Key things to know
- Omeprazole may be used during pregnancy when a healthcare professional considers it appropriate, and it is the preferred PPI in UK pregnancy guidance because more safety information is available
- The old "pregnancy category" question comes from an American labelling system that has been retired. The FDA no longer uses the A, B, C, D and X system for current prescription medicine labelling, and it was not the UK system
- For pregnancy heartburn, lifestyle changes, antacids and alginates are generally considered before moving to other acid reducing medicines
- The decision to start, continue or change a medicine during pregnancy should be discussed with your GP, midwife, pharmacist or obstetric team
- Severe upper abdominal pain in pregnancy is not always heartburn and can sometimes need urgent assessment
Is Omeprazole Safe in Pregnancy?
UK prescribing information states that omeprazole can be used during pregnancy. BUMPS also describes omeprazole as the preferred PPI in pregnancy because there is more information about its safety than for the other PPIs.
The question gets typed in many ways: is omeprazole safe for pregnant women, can pregnant women take omeprazole for reflux, is omeprazole suitable for pregnancy heartburn, or simply omeprazole pregnancy. Underneath all of these searches are two different questions.
The first is whether exposure to omeprazole is associated with problems for the pregnancy. The available human evidence is reassuring and has not shown a clear increase in major pregnancy problems. The second is whether omeprazole is the right treatment for your symptoms. That depends on your symptoms, how often they happen and what you have already tried.
What the Evidence Shows
| Evidence | What it found |
|---|---|
| UKTIS and BUMPS information on PPIs | No good evidence that omeprazole or other PPIs increase the risk of miscarriage, birth defects, stillbirth, preterm delivery or low birth weight |
| Prospective epidemiological studies | More than 1,000 pregnancy outcomes exposed to omeprazole did not show evidence of adverse effects on pregnancy or the baby |
| Studies of first trimester exposure | Available research has not shown a clear increase in major birth defects following PPI exposure |
| Evidence across PPIs | Omeprazole has more pregnancy safety information than the other PPIs, which is one reason it is generally preferred |
The available studies are reassuring, but no study can prove that a medicine carries zero risk. Some studies also have limitations, such as differences in the health of people taking the medicine and the reasons they were prescribed it. This is why pregnancy medicine guidance looks at the whole body of evidence rather than relying on one study.
What the Evidence Does Not Settle
It is important to be honest about the limits of the evidence.
Research has looked at possible longer term outcomes in children exposed to acid reducing medicines during pregnancy, including possible links with conditions such as asthma or allergies. Associations in this type of research do not prove that the medicine caused the condition. Other factors can also influence the result, so more research may be needed before drawing firm conclusions.
There is also less pregnancy information for some of the other PPIs than there is for omeprazole. That does not mean those medicines are unsafe. It means the evidence base is smaller. BUMPS therefore identifies omeprazole as the preferred PPI in pregnancy when a PPI is needed.
Omeprazole Pregnancy Category: Why This Question Has No UK Answer
This is one of the most commonly searched parts of the topic, but the wording can be confusing.
Searches for omeprazole pregnancy category, omeprazole category in pregnancy, or omeprazole in pregnancy category are usually looking for a letter such as A, B, C, D or X. These letters came from an old US Food and Drug Administration system.
The FDA replaced the letter categories with the Pregnancy and Lactation Labeling Rule. The new system uses a more detailed description of the available evidence and potential risks rather than a single letter. The change began in 2015.
The UK does not use the old US pregnancy category system. UK medicine information describes pregnancy use in words and provides information about the available evidence.
For historical context, omeprazole was classified as Category C under the old US system. That historical letter should not be treated as a current safety rating. The FDA moved away from the categories because they could be misunderstood as a simple ranking of medicines from safe to unsafe.
So if you see a website saying that omeprazole is "Category C" and using that as its current pregnancy safety rating, remember that this is an old US classification, not a current UK recommendation.
Can I Take Omeprazole During Pregnancy?
If you are already taking omeprazole and have just found out that you are pregnant, speak to your GP, midwife or pharmacist before making changes to your treatment. Do not assume that you need to stop simply because you are pregnant. Current UK information is reassuring about omeprazole exposure during pregnancy.
If you are not taking omeprazole and are wondering whether you can start it for pregnancy heartburn, speak to a pharmacist, GP or midwife first. NHS guidance says pregnant people should check with a pharmacist or doctor before taking omeprazole.
The reason for checking is not simply the medicine itself. Your healthcare professional can look at how severe your symptoms are, what other medicines you take and whether your symptoms sound like ordinary pregnancy heartburn or something that needs further assessment.
What Usually Comes Before Omeprazole
For heartburn during pregnancy, treatment generally starts with lifestyle measures. NICE recommends considering antacids or alginates for pregnancy heartburn. If these do not control the symptoms, a GP may consider another medicine.
| Step | What it involves | Why it may be considered |
|---|---|---|
| Lifestyle measures | Smaller meals, avoiding foods that trigger symptoms, avoiding eating close to bedtime and sitting upright after eating | May be enough for mild symptoms without medicine |
| Antacids and alginates | Medicines that neutralise stomach acid or help prevent acid from coming back up the gullet | Recommended by NICE as options for heartburn during pregnancy |
| Other acid reducing medicines | A healthcare professional may consider another medicine if symptoms continue | The choice depends on your symptoms, medical history and what you have already tried |
| Proton pump inhibitors | Omeprazole is the preferred PPI when a PPI is needed in pregnancy | More pregnancy safety information is available for omeprazole than for other PPIs |
NICE does not recommend routine use of PPIs for all pregnant women with heartburn. Instead, its guidance recommends considering antacids or alginates and then discussing further treatment if symptoms continue.
Omeprazole in Pregnancy, First Trimester
Searches about omeprazole in pregnancy during the first trimester often come from people who took the medicine before they knew they were pregnant.
The available evidence is reassuring. BUMPS states that there is no good evidence that omeprazole or other PPIs are linked to birth defects or several other major pregnancy complications. UK product information also reports data from more than 1,000 exposed pregnancy outcomes without evidence of adverse effects on pregnancy or the baby.
This does not mean that every pregnancy exposure is identical or that there is zero risk. If you have taken omeprazole during the first trimester, tell your GP, midwife or obstetric team. They can consider your individual circumstances and tell you whether any further follow up is needed.
This page does not provide dosing recommendations during pregnancy. If you have already been prescribed a dose, follow the instructions you were given rather than changing it yourself. If it is not controlling your symptoms, speak to your prescriber.
How Long Can I Take Omeprazole While Pregnant?
There is no single maximum number of days that applies to every pregnant person.
The appropriate treatment length depends on why you are taking omeprazole, how severe your symptoms are and how well they respond. Your treatment should be reviewed if symptoms continue or change.
If you are taking omeprazole for pregnancy related heartburn, do not increase the dose or continue treatment indefinitely without discussing it with your healthcare professional.
If your symptoms are occasional, an antacid or alginate may be more appropriate for short term relief. Omeprazole reduces stomach acid over a longer period and is not simply another version of an antacid. Your pharmacist or prescriber can help you choose the most suitable option.
Omeprazole Capsules in Pregnancy, and the Brand Name Question
Whether you search omeprazole capsule in pregnancy or omeprazole capsules in pregnancy, the pregnancy safety information relates to the active ingredient, omeprazole, rather than simply the shape of the medicine.
Omeprazole is available as capsules, tablets and liquid preparations. The exact instructions depend on the product. Some capsules and tablets are gastro resistant, which means they are designed to protect the medicine from stomach acid. Follow the instructions for your particular product and do not crush or chew a gastro resistant medicine unless the product information specifically says that you can.
Brand names can also cause confusion. Losec is a UK brand of omeprazole. Prilosec is a brand name used in the United States. Risek is a brand of omeprazole sold in some countries outside the UK.
The active ingredient may be the same, but medicines obtained outside the UK can have different formulations, strengths, packaging and regulatory arrangements. In pregnancy, it is sensible to check any medicine bought abroad with a pharmacist or doctor before taking it.
Breastfeeding After the Birth
Omeprazole can usually be taken while breastfeeding. NHS guidance says you can usually take it while breastfeeding, but recommends checking with a pharmacist or doctor first.
UK specialist pharmacy guidance states that omeprazole is a preferred PPI during breastfeeding because it passes into breast milk in very small amounts.
If you are taking omeprazole after birth and are worried about your baby, speak to your healthcare professional. Do not stop prescribed treatment without discussing it with them.
When Upper Abdominal Pain Is Not Heartburn
Heartburn is common in pregnancy, but not every burning or painful feeling in the upper abdomen is caused by reflux.
Severe pain in the upper abdomen, particularly under the ribs on the right hand side, can be a symptom of pre eclampsia. It can also occur with HELLP syndrome, a serious pregnancy complication. This is one reason severe or unusual upper abdominal pain should not simply be treated as heartburn.
Seek urgent medical advice if severe upper abdominal pain in the second half of pregnancy occurs with symptoms such as:
- A severe headache that does not go away
- Vision problems such as blurred vision or flashing lights
- Sudden swelling of the face, hands or feet
- Feeling very unwell or vomiting
- Pain that is severe, unusual for you or does not settle
Contact your maternity unit, maternity assessment unit or maternity triage service for urgent advice. If you cannot reach the appropriate maternity service and the situation is an emergency, seek emergency medical help.
Most pregnancy heartburn is not a sign of pre eclampsia. The important point is that severe or unusual symptoms should not automatically be assumed to be reflux.
Medical Disclaimer
This page provides general information about omeprazole and pregnancy. It is not personal medical advice, and it does not recommend a dose or a product for anyone.
Decisions about medicines during pregnancy should be discussed with your GP, midwife, pharmacist or obstetric team. Do not start, stop or change a prescribed medicine based only on what you read here.
If you have severe upper abdominal pain, a persistent severe headache, visual changes or sudden swelling during pregnancy, contact your maternity service urgently. Suspected side effects from medicines can be reported through the MHRA Yellow Card Scheme.
