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Prilosec OTC and Prilosec by prescription are the same medicine. The prescription is packaged in a different type of pill and comes in different strengths. But, the reason for the difference in marketing is a legal and medical one. People can't diagnose ulcers on their own. You need a doctor to do this and then if you have one your doctor could prescribe one of many medications. On the other hand, the FDA has approved Prilosec OTC for heartburn and has deemed that the layperson is able to diagnose and treat their own occasional heartburn with Prilosec OTC.    
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