Altosec contains omeprazole, a proton pump inhibitor that reduces stomach acid. It is used for heartburn and acid reflux, for stomach and duodenal ulcers, and as part of treatment to clear Helicobacter pylori. It comes as 10 mg and 20 mg capsules and as an injection for hospital use.
What is Altosec?
Altosec is Schedule 4 in South Africa — prescription-only:
| Product | Contains |
|---|---|
| Altosec 10 mg | Omeprazole 10 mg capsule |
| Altosec 20 mg | Omeprazole 20 mg capsule |
| Altosec 40 mg/10 ml | Omeprazole 40 mg injection |
Omeprazole is one of the most widely used medicines in the world and is available under many names. Being dispensed one rather than another is ordinary generic substitution.
Omeprazole is a proton pump inhibitor (PPI). The cells lining the stomach have a “proton pump” that pushes acid into the stomach; omeprazole shuts that pump down, substantially and durably reducing acid production.
Two features follow, and both matter practically:
- It is not fast. A PPI takes a day or more to reach full effect, because it acts only on pumps that are currently active, and new pumps keep being made. It is not the right choice for immediate relief of one episode of heartburn — an antacid works in minutes; a PPI does not. Judging omeprazole on its first evening is judging it too early.
- It reduces acid rather than neutralising it. That is why it can heal ulcers and an inflamed oesophagus, where simply neutralising acid after the fact cannot.
Other PPIs used in South Africa include lansoprazole, esomeprazole and pantoprazole. They are closely related and often interchangeable, though they differ in drug interactions — omeprazole has more of these than pantoprazole, which matters for some people.
What is Altosec commonly used for?
- Gastro-oesophageal reflux disease (GORD) — persistent heartburn and acid rising into the throat.
- Healing reflux oesophagitis, where acid has inflamed or eroded the oesophageal lining.
- Stomach (gastric) and duodenal ulcers, both healing them and preventing recurrence.
- **Eradicating *Helicobacter pylori***, always combined with antibiotics — the PPI alone does not clear the bacterium.
- Protecting the stomach in people who must take an anti-inflammatory such as ibuprofen long term, or who have had an NSAID-related ulcer.
- Zollinger-Ellison syndrome, a rare condition of acid overproduction.
- Persistent indigestion (dyspepsia) that has been assessed.
Long-term use should be a considered decision, not a default. PPIs are effective and widely used, and many people genuinely need them indefinitely — but continuing one for years without review is common and worth questioning. Ask periodically whether it is still needed and at what dose.
How Altosec fits into this medicine category
| Group | Examples | What it does |
|---|---|---|
| Antacids | Calcium/magnesium salts, Citro-Soda | Neutralise acid already present; fast, brief |
| Alginates | Gaviscon-type products | Form a raft to block reflux |
| H2 blockers | Cimetidine, famotidine | Moderate acid reduction; faster onset than a PPI |
| Proton pump inhibitors | Omeprazole (Altosec), lansoprazole | Strongest and most sustained acid reduction |
| Antispasmodics | Hyoscine | Gut cramping, not acid |
| Anti-nausea | Metoclopramide | Nausea and gastric emptying |
For occasional heartburn after a heavy meal, an antacid is the sensible choice. For symptoms several times a week, or to heal damage, a PPI is the stronger tool. See the digestive and stomach medicines hub.
What to check before using Altosec
Take it before food, usually 30 to 60 minutes before the first meal of the day. PPIs act on active pumps, and a meal activates them — taken after eating, much of the effect is lost. This is one of the most common reasons a PPI seems not to work.
Swallow capsules whole; do not crush or chew them, as the coating protects the medicine from stomach acid.
Speak to a pharmacist or doctor first if you:
- Have liver disease, which may require a lower dose.
- Have osteoporosis or risk factors for it. Long-term PPI use is associated with a modest increase in fracture risk.
- Have low magnesium, or take a diuretic.
- Have lupus.
- Are pregnant or breastfeeding.
- Take clopidogrel. Omeprazole can reduce its antiplatelet effect — a clinically important interaction, and a common reason pantoprazole is preferred in people on clopidogrel after a stent.
- Take warfarin, phenytoin, methotrexate, digoxin, citalopram, an HIV medicine, or an antifungal such as ketoconazole or itraconazole. PPIs raise stomach pH, which changes how several medicines are absorbed.
- Are due to have an endoscopy or a test for H. pylori. A PPI can mask findings and produce a false negative — tell whoever arranges the test.
Do not self-treat indefinitely. If you need acid suppression continuously, the reason should be established.
Possible cautions and when to ask a pharmacist or doctor
Most people tolerate omeprazole well. Common effects are headache, diarrhoea or constipation, wind, nausea and abdominal pain.
See a doctor before starting, or promptly if these appear, because a PPI can mask rather than treat them:
- Difficulty or pain on swallowing, or food sticking.
- Unintended weight loss.
- Vomiting blood, or vomit like coffee grounds.
- Black, tarry stools.
- Persistent vomiting.
- A first episode of significant indigestion over the age of 55.
- Anaemia, or being told your iron is low.
Also seek advice for:
- Severe or watery diarrhoea, which can indicate a C. difficile infection — slightly more likely on PPIs.
- Muscle cramps, tremor, palpitations or unusual tiredness, which may indicate low magnesium with long-term use.
- A new rash, especially one worsened by sunlight.
- Swelling of the face or lips, or difficulty breathing.
- Reduced urine output, which can rarely reflect kidney inflammation.
- Numbness or tingling with tiredness — long-term PPI use can reduce vitamin B12 absorption.
Do not stop long-term treatment abruptly without advice. Acid production can rebound above its previous level for a period, which feels exactly like the original problem returning and often prompts people to restart unnecessarily. A doctor may taper it instead.
Chest pain is not always indigestion. Pain with breathlessness, sweating, or pain spreading to the arm or jaw needs emergency assessment, not an antacid.
Related medicine guides
Frequently asked questions
What is Altosec used for? Reducing stomach acid — for reflux and heartburn, healing oesophagitis, treating and preventing ulcers, and as part of H. pylori treatment. It contains omeprazole.
What is Altosec 20 mg used for? The standard adult strength for reflux, ulcer healing and H. pylori treatment.
What is Altosec 10 mg used for? The lower strength, often used for maintenance once symptoms are controlled.
How long does it take to work? Not immediately — it builds over a day or more. For instant relief of one episode, an antacid is more suitable.
Should I take it before or after food? Before, typically 30 to 60 minutes before the first meal. Taking it after eating markedly reduces how well it works.
Is Altosec the same as pantoprazole? Both are PPIs and work the same way, but they are different medicines and differ in interactions — pantoprazole is often preferred for people on clopidogrel.
Can I take it long term? Some people need to, under medical supervision. It is worth reviewing periodically whether it is still needed.
Can I stop suddenly? Ask first if you have taken it a while. Acid can rebound temporarily, and a doctor may prefer to reduce it gradually.