Is it safe to take omeprazole during pregnancy?

Pregnancy can be an exciting time, but it’s not without an unpleasant side effect or two. Up to half of pregnant women experience gastroesophageal reflux disease (GERD), also known as indigestion or heartburn.

There are many medications and natural remedies for acid reflux. Prilosec (omeprazole) is a commonly used over-the-counter (OTC) heartburn medication. It’s a proton pump inhibitor drug (PPI), which means it reduces stomach acid production. PPIs are also used to treat ulcers.

Of course, not all drugs are safe for pregnant people. So, is it safe to take omeprazole during pregnancy? Research suggests that, in many cases, yes. But you could also try antacids, sleeping with your head elevated, and avoiding fatty or spicy foods.

Here is what you should know about taking omeprazole while pregnant—and alternative drugs or natural remedies for pregnancy-related acid reflux.

Can you take omeprazole while pregnant?

There are no definitive studies on the safety of omeprazole use during pregnancy. The Food and Drug Administration (FDA) does not offer any warning against using it to treat acid reflux during pregnancy. However, that does not mean it is risk-free, according to Staci McHale, MD, FACOG, a board-certified obstetrician and gynecologist at New Beginnings OB-GYN in Las Vegas.

There’s a reason OB-GYNs do not recommend the use of omeprazole in early pregnancy: Research shows that PPIs such as omeprazole, esomeprazole, pantoprazole, and rabeprazole can cross the placenta. This means that when a pregnant person takes omeprazole, the drug may pass through the boundary between their body and the developing fetus, potentially affecting the baby’s health. 

What are the risks of taking omeprazole while pregnant?

Though omeprazole can cross the placenta, research has not found that it causes harm to the developing fetus. In a 2010 Danish study of data from 840,968 live births, babies exposed to PPIs during the first trimester of pregnancy had no increased prevalence of major birth defects compared to those who were not exposed. 

A pregnant person taking omeprazole is still at risk of experiencing side effects. Common possible side effects of omeprazole include:

• Headache
• Abdominal pain or nausea
• Diarrhea
• Vomiting
• Flatulence
• Upper respiratory infection
• Constipation

These common side effects rarely present a serious health risk to a pregnant woman. However, diarrhea and vomiting can both contribute to dehydration. Dehydration during pregnancy can cause serious complications, including premature labor, low birth weight, and low breast milk production, according to the American Pregnancy Association. 

Ultimately, researchers say there is no risk to the baby if a mother takes omeprazole while pregnant—but your healthcare provider might not consider it safe for you to take omeprazole until the second trimester of pregnancy. 

It’s always best to check with your healthcare provider since any drug that crosses the placenta has the potential to affect fetal development. And even if your provider gives you the green light to take omeprazole, you should stop taking it and consult them if you start to experience serious side effects.

What can I take instead of omeprazole during pregnancy?

Every body and every pregnancy are different. Ultimately, it’s a good idea to ask your healthcare provider which heartburn or gastrointestinal treatment is best for you, says Blair Gingerich, Pharm.D., BCMTMS, a clinical care and retail pharmacist in northern Indiana. “Obstetricians are best suited for recommending over-the-counter medications for the specific needs of each patient,” she says.

Generally, safe acid reflux medications for pregnant women include antacids such as calcium carbonate (Tums) and OTC acid reducers such as H2 antagonists (famotidine or Pepcid), as well as prescription sucralfate.

Antacids are used to treat upset stomach, heartburn, and gas. While the use of PPIs like omeprazole reduces stomach acid production, antacids simply neutralize the acid in your stomach. This makes them the fastest-acting heartburn treatment. A meta-analysis of existing research suggests that your healthcare provider should set antacid use frequency since calcium may cross the placenta, and high levels of calcium may cause damage to the maternal kidneys.

H2 receptor antagonists, also called H2 blockers, are also a common heartburn treatment. Like PPIs, H2 blockers reduce stomach acid production, says Dr. Gingerich. H2 blockers work more quickly than PPIs, but PPIs provide longer-lasting relief. “[Omeprazole] is a much more complete acid block than H2 blockers,” Dr. Gingerich explains.

Sucralfate is a prescription medication that coats the lining of the stomach, creating a protective barrier against the acidic environment. When taken three times daily, it can reduce heartburn symptoms without causing adverse effects to the fetus.

Natural remedies for acid reflux during pregnancy

In addition to antacids and H2 antagonists, there are a number of natural remedies that expectant mothers can try to treat their acid reflux. They include:

• Try some ginger: This well-known herbal remedy for nausea and gastric distress is safe to eat while pregnant. 
• Change your eating schedule. Eating frequent small meals instead of two or three big ones may help prevent indigestion.
• Stay upright. Dr. McHale recommends sitting upright for three hours after eating and sleeping with your head elevated.
• Sip chamomile: Drinking chamomile tea before bedtime may help soothe the digestive tract and reduce GERD discomfort, according to Harvard Health. 
• Avoid trigger foods and beverages. Tomatoes, citrus, and fatty or fried foods can all contribute to acid reflux. Avoiding coffee, tea, citrus drinks, and carbonated beverages is also best. 

In other words, if your acid reflux is terrible while expecting, don’t despair. There are many pregnancy-safe treatments to try. Work with your provider to find a plan that works for you.