What can I buy over-the-counter similar to omeprazole?

October 5, 2025 •

5 min read

Approximately 60 million Americans experience heartburn at least once a month, leading many to seek relief. When looking for a comparable over-the-counter option to omeprazole, a variety of medications and classes are available, each with a different mechanism of action and intended use.

Quick Summary

Several over-the-counter options, including other proton pump inhibitors, H2 blockers, and antacids, offer alternatives to omeprazole, with differences in onset, duration, and strength for managing heartburn and acid reflux symptoms.

Key Points

Other OTC PPIs: Over-the-counter options like esomeprazole (Nexium 24HR) and lansoprazole (Prevacid 24HR) are very similar to omeprazole, offering 24-hour relief from frequent heartburn.
H2 Blockers for Faster Relief: H2 blockers, such as famotidine (Pepcid AC), work faster than PPIs and provide up to 12 hours of relief for occasional or moderate heartburn.
Antacids for Immediate Relief: For instant, short-term relief, antacids like calcium carbonate (Tums) neutralize existing stomach acid.
Know the Difference: The key distinction lies in onset and duration of action: antacids are fastest but shortest, H2 blockers are intermediate, and PPIs are slowest but longest-acting.
Use OTCs as Directed: OTC PPIs are intended for 14-day courses, up to three times per year. Long-term, unsupervised use can have risks and warrants a doctor's visit.
Lifestyle Changes are Key: Modifying diet, maintaining a healthy weight, and avoiding trigger foods can significantly help manage acid reflux and reduce the need for medication.
Consult a Doctor for Chronic Symptoms: If you have frequent or severe heartburn, difficulty swallowing, or rely on OTC medication for prolonged periods, see a doctor to rule out more serious conditions.

Understanding Omeprazole and Its Function

Omeprazole, often sold as Prilosec OTC, belongs to a class of medications called proton pump inhibitors (PPIs). These drugs work by irreversibly blocking the proton pumps in the stomach lining, which are responsible for the final step of acid production. This mechanism provides a significant and long-lasting reduction in stomach acid. Because PPIs block acid production at its source, they are effective at healing damaged esophageal tissue from frequent heartburn associated with gastroesophageal reflux disease (GERD). However, PPIs are not intended for immediate relief, and it can take one to four days for their full effect to be felt.

Other Over-the-Counter Proton Pump Inhibitors (PPIs)

For those seeking an alternative to omeprazole, other OTC PPIs offer a similar long-acting treatment for frequent heartburn. These work in the same way as omeprazole, providing 24-hour relief from a single daily dose.

Esomeprazole (Nexium 24HR): Often cited as very similar to omeprazole, esomeprazole is another popular OTC PPI. Some research suggests it might have a slightly stronger acid-lowering effect, but for most people, the difference is not significant. It is intended for a 14-day course of treatment for frequent heartburn, like other OTC PPIs.
Lansoprazole (Prevacid 24HR): This is another effective OTC PPI for treating frequent heartburn. It provides a comparable level of acid suppression and is also taken once daily for a 14-day treatment period.
Omeprazole/Sodium Bicarbonate (Zegerid OTC): This product combines a PPI with an antacid. The sodium bicarbonate neutralizes stomach acid immediately, protecting the omeprazole and allowing it to work more quickly than omeprazole alone.

Histamine-2 (H2) Blockers

Histamine-2 (H2) blockers represent a different class of medication that also reduces stomach acid, but through a different pathway. Instead of blocking the acid pump directly, they block histamine receptors in the stomach lining that signal acid production.

Famotidine (Pepcid AC, Zantac 360): Famotidine is a widely available OTC H2 blocker. It works more quickly than a PPI, typically within one to three hours, and provides relief for up to 12 hours. It can be taken as needed for occasional heartburn or twice daily for more moderate, frequent symptoms.
Cimetidine (Tagamet HB): Cimetidine is another OTC H2 blocker that works similarly to famotidine by reducing acid production.
Nizatidine (Axid AR): Nizatidine is also available OTC and functions as an H2 blocker to reduce stomach acid.

It is important to note that the H2 blocker ranitidine (Zantac), which was once very popular, was recalled and is no longer available on the market due to safety concerns.

Antacids

Antacids are the oldest and fastest-acting form of heartburn relief. Unlike PPIs and H2 blockers, which reduce acid production, antacids neutralize existing stomach acid. They provide immediate, but short-lived, relief.

Calcium Carbonate (Tums, Rolaids): These are common antacids that neutralize stomach acid. They can also supplement calcium intake but may cause constipation if overused.
Aluminum Hydroxide and Magnesium Hydroxide (Mylanta, Maalox): Often combined, this type of antacid works by neutralizing stomach acid. The magnesium can have a laxative effect, while the aluminum can be constipating, so the combination helps balance these side effects.
Sodium Bicarbonate (Alka-Seltzer): This provides fast relief by neutralizing stomach acid, though its high sodium content can be a concern for some individuals.

Comparison of OTC Heartburn Medications


Feature	PPIs (e.g., Omeprazole)	H2 Blockers (e.g., Famotidine)	Antacids (e.g., Tums)
Mechanism	Blocks final step of acid production	Reduces acid production by blocking histamine	Neutralizes existing stomach acid
Onset of Action	1-4 days for full effect	1-3 hours	Immediately
Duration of Relief	Up to 24 hours (once daily dose)	Up to 12 hours	1-3 hours
Best For	Frequent heartburn (≥2 days/week)	Occasional to moderate heartburn	Quick, short-term relief of occasional heartburn
Availability	OTC and Prescription	OTC and Prescription	OTC
Healing Action	Allows esophagus to heal	May allow healing over time	No healing effect
Long-Term Use	Not recommended without doctor supervision	Not recommended without doctor supervision	Short-term use is best

Lifestyle and Dietary Changes

Managing heartburn and acid reflux isn't just about medication; lifestyle changes play a significant role. These changes can often reduce the need for medication or improve its effectiveness.

Dietary Modifications: Identify and avoid trigger foods, such as fatty or fried foods, spicy dishes, chocolate, mint, and acidic beverages like coffee and soda.
Maintain a Healthy Weight: Excess weight can put pressure on the stomach and the lower esophageal sphincter, increasing the likelihood of reflux.
Avoid Lying Down After Eating: Wait at least three hours after a meal before lying down or going to bed.
Elevate the Head of Your Bed: Raising the head of your bed by six to eight inches can help gravity keep stomach acid down during the night.
Eat Smaller, More Frequent Meals: Large meals can increase pressure on the stomach. Eating smaller portions more frequently throughout the day can help.
Stop Smoking: Nicotine can weaken the lower esophageal sphincter, allowing acid to escape.

When to See a Doctor

While OTC medications are effective for many people, they are not a substitute for professional medical advice, especially for chronic or severe symptoms. You should see a doctor if you experience any of the following:

Your symptoms occur more than twice a week and OTC treatments aren't helping.
You've used OTC treatments for more than 14 days without relief.
You experience alarming symptoms like difficulty or pain swallowing, unexplained weight loss, or persistent nausea or vomiting.
You have chest pain, which could be a sign of a more serious condition and requires immediate medical attention.

Conclusion

For those wondering what can I buy over-the-counter similar to omeprazole, the choice depends on your symptoms. For frequent heartburn that requires long-term prevention, other OTC PPIs like esomeprazole (Nexium 24HR) and lansoprazole (Prevacid 24HR) are the closest options. For quicker, shorter-lasting relief for occasional heartburn, H2 blockers such as famotidine (Pepcid AC) are a solid choice. For immediate, but very temporary, relief, antacids like Tums are effective. It's essential to understand the differences in how these medications work and to consult a healthcare professional for chronic or severe issues. Additionally, incorporating lifestyle changes can significantly improve management of your symptoms.

Mayo Clinic is a trusted source for medical information on gastroesophageal reflux disease.

Frequently Asked Questions

Antacids, such as Tums or Rolaids (calcium carbonate), provide the fastest relief by neutralizing existing stomach acid almost immediately.

Over-the-counter proton pump inhibitors (PPIs) like omeprazole (Prilosec OTC), esomeprazole (Nexium 24HR), and lansoprazole (Prevacid 24HR) provide the longest-lasting relief, with effects lasting up to 24 hours.

It is generally not recommended to take a PPI and H2 blocker simultaneously, as they have different mechanisms. Consult a healthcare provider before combining these medications.

No, ranitidine (Zantac) was removed from the market by the FDA in 2020 due to potential safety concerns and is no longer available.

Take an antacid for immediate relief of occasional heartburn. Use an H2 blocker for less potent but longer-lasting relief for occasional to moderate symptoms, especially if you anticipate heartburn (e.g., before a triggering meal).

You should choose a PPI if you experience frequent heartburn (two or more days a week) that is not adequately controlled with H2 blockers, as PPIs are more powerful and intended for chronic conditions.

Prolonged use of OTC PPIs, without a doctor's supervision, has been associated with potential adverse effects, including vitamin malabsorption (B12, calcium), infections, and kidney disease. Always follow the label's directions and consult a doctor if your symptoms persist.