Buying omeprazole over the counter for heartburn and acid reflux — use it for no more than 7 days; see a doctor immediately if you have trouble swallowing, vomit blood, or pass black stools

6. Buying omeprazole over the counter for heartburn and acid reflux — use it for no more than 7 days; see a doctor immediately if you have trouble swallowing, vomit blood, or pass black stools

Cost: No cost involved — just follow the dosage instructions on the package.

In plain terms: Since 2022, omeprazole enteric-coated tablets have been available over the counter without a prescription. However, the package instructions clearly state that you should only take it for up to 7 days, and avoid using it again within two months. If you experience trouble swallowing, pain in the throat, vomit blood, or pass black stools, do not take it on your own — these are potential signs of serious medical conditions. This medication can also mask symptoms of stomach cancer, potentially delaying an accurate diagnosis.

Benefit: In its Announcement No. 68 of 2022, the National Medical Products Administration reclassified omeprazole enteric-coated tablets from a prescription drug to an over-the-counter medication, and released a standard package insert for it. The approved indication listed in the insert is “short-term relief of heartburn and acid reflux caused by excess stomach acid”. The precautions section specifies that the drug must not be used for more than 7 days, and that patients should consult a physician or pharmacist if symptoms persist. It also states that the drug must not be taken again within two months, and that immediate medical attention is required if symptoms recur. Use is prohibited if a patient has trouble swallowing, throat pain, vomit blood, or passes black stools, as these are possible indicators of serious illness. For patients showing warning signs such as unexplained weight loss, repeated vomiting, trouble swallowing, vomit blood, or black stools, malignant tumors must be ruled out first, since treatment with this drug may conceal symptoms and delay diagnosis. Patients over 55 years old with new or changing symptoms should consult a doctor before use. People taking clopidogrel must avoid taking omeprazole at the same time.

Evidence grade: B

Sources: Announcement of the State Food and Drug Administration on the conversion of prescription drugs of Omeprazole Enteric-coated Tablets into over-the-counter drugs (No. 68, 2022) and Appendix 2 "Model Instructions for Over-the-Counter Drugs". <https://www.nmpa.gov.cn/yaopin/ypggtg/20220826171517123.html>

Notes: Clopidogrel is a blood-thinning medication commonly prescribed to patients who have had a stent implanted or a myocardial infarction. Omeprazole can reduce its effectiveness, so patients taking clopidogrel must consult a doctor first. The evidence grade is set to B because these requirements are stipulated in the official package insert, and no research has been conducted to quantify how many adverse events can be prevented by following these instructions. The benefit level is rated “moderate” because while this medication helps prevent delayed diagnosis of stomach bleeding or stomach cancer, most cases of heartburn and acid reflux are not severe.