Prilosec and Pregnancy

Heartburn is one of the most common side effects of pregnancy. But how can you treat the condition safely when you're expecting? And if you already suffer from gastroesophageal reflux disease (GERD) before getting pregnant, you may be wondering if Prilosec and other medications are safe.

What is Prilosec?

Prilosec (omeprazole) is an acid pump inhibitor used mainly to treat severe heartburn by decreasing the amount of acid produced in the stomach. Prilosec is used to treat GERD and other conditions caused by excess stomach acid. However, it's not usually prescribed for the immediate relief of heartburn symptoms.

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Is Prilosec Safe During Pregnancy?

Prilosec is in a family of medications called proton pump inhibitors and it should be taken with caution during pregnancy. It has a category C rating. According to the U.S. Food and Drug Administration (FDA), this rating means that it is not known whether a particular medication will cause harm to an unborn baby if the medication is taken during pregnancy. This also means that, if possible, other alternative therapies should be tried.

A board-certified obstetrician and assistant professor at the New York University School of Medicine, Daniel Roshan, M.D., who specializes in high-risk fetal medicine, explains that while there are no known risks to the fetus, there are other medications that are safer for pregnant women. If you are taking Prilosec and find out that you are pregnant, you should consult your doctor immediately.

Dr. Roshan advises his pregnant patients against taking Prilosec in the first trimester since it is classed as a category C, but Dr. Roshan says women can take it in the second and third trimesters, if necessary.

Nursing mothers should avoid breastfeeding while taking Prilosec since omeprazole can pass into the breast milk and may harm your infant.

Heartburn and Pregnancy

Even if you do not normally experience heartburn, you may find that during your pregnancy you have it as early as the first trimester. This occurs for a variety of reasons.

"Heartburn is certainly not a stranger to the pregnant woman," says Michele Hakakha, , M.D., a Los Angeles-based board-certified obstetrician and gynecologist. "It is triggered by the high levels of progesterone causing relaxation of the muscular sphincter between the stomach and the esophagus."

Changes in digestion can also lead to increased instances of heartburn during pregnancy. "Food sits in the stomach for longer periods of time and as the uterus enlarges, it puts mechanical pressure on the stomach," Dr. Hakakha says. "All of these things lead to stomach acid creeping its way up the esophagus to cause heartburn."

There are many remedies to help ease the symptoms of pregnancy heartburn, from changing your diet to trying out a new sleeping position. Dr. Hakakha recommends eating small, frequent meals instead of three large meals each day, as well as cutting certain foods from your diet, such as citrus fruits, spicy foods, tomatoes and tomato sauces, caffeine, and chocolate, all of which can make heartburn worse. Dr. Roshan also suggests elevating the head of the bed, drinking a lot of water, and avoiding tight clothing.

Alternatives to Prilosec During Pregnancy

Because Prilosec has a category C rating, doctors typically recommend alternative medications for pregnant women. Safe alternatives for treating pregnancy heartburn include over-the-counter Tums or Mylanta, and prescription medications including H2 blockers (Tagamet, Zantac, and Pepcid) and other proton pump inhibitors (like Prevacid, Aciphex, and Nexium), which have a category B rating, which indicates that they're routinely and safely used during pregnancy.