.
Omeprazole is a member of the proton pump inhibitor family of drugs, which blocks production of stomach acid. Omeprazole is used to treat diseases in which stomach acid causes damage, including gastric and duodenal ulcers, gastroesophageal reflux disease, erosive esophagitis, and Zollinger-Ellison syndrome.
Interactions with Dietary Supplements
Folic acid
Folic acid is needed by the body to utilize vitamin B12.
Antacids, including omeprazole, inhibit folic acid absorption.1 People taking
antacids are advised to supplement with folic acid.
Vitamin B12
Omeprazole interferes with the absorption of vitamin B12 from food (though not from
supplements) in some2 3 4 5 but not
all6 7 studies. A true deficiency state, resulting in vitamin
B12-deficiency anemia, has only been reported in one case.8 The fall in vitamin B12
status may result from the decrease in stomach acid required for vitamin B12 absorption from
food caused by the drug.9 This problem may possibly be averted by drinking acidic
juices when eating foods containing vitamin B12.10
However, all people taking omeprazole need to either supplement with vitamin B12 or have their vitamin B12 status checked on a yearly basis. Even relatively small amounts of vitamin B12 such as 10–50 mcg per day, are likely to protect against drug induced vitamin depletion.
Interactions with Herbs
Cranberry (Vaccinium
marocarpon)
People taking omeprazole may increase absorption of dietary vitamin B12 by drinking cranberry
juice or other acidic liquids with vitamin B12-containing foods.11
Summary of Interactions for Omeprazole
| Depletion or interference | Folic acid Vitamin B12* |
|---|---|
| Adverse interaction | None known |
| Side effect reduction/prevention | Cranberry* |
| Supportive interaction | None known |
| Reduced drug absorption/bioavailability | None known |
For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.
References:
1. Russell RM, Golner BB, Krasinski SD, et al. Effect of antacid and H2 receptor antagonists on the intestinal absorption of folic acid. J Lab Clin Med 1988;112:458–63.
2. Marcuard SP, Albernaz L, Khazanie PG. Omeprazole therapy causes malabsorption of cyanocobalamin (Vitamin B12). Ann Intern Med 1994;120:211–5.
3. Termanini B, Gibril F, Sutliff VE, et al. Effect of long-term gastric acid suppressive therapy on serum vitamin B12 levels in patients with Zollinger-Ellison syndrome. Am J Med 1998;104:422–30.
4. Koop H. Review article: metabolic consequences of long-term inhibition of acid secretion by omeprazole. Aliment Pharmacol Ther 1992;6:399–406 [review].
5. Bellou A, Aimone-Gastin I, De Korwin JD, et al. Cobalamin deficiency with megaloblastic anaemia in one patient under long-term omeprazole therapy. J Intern Med 1996;240:161–4.
6. Koop H, Bachem MG. Serum iron, ferritin, and vitamin B12 during prolonged omeprazole therapy. J Clin Gastroenterol 1992;14:288–92.
7. Schenk BE, Festen HP, Kuipers EJ, et al. Effect of short-and long-term treatment with omeprazole on the absorption and serum levels of cobalamin. Aliment Pharmacol Ther 1996;10:541–5.
8. Bellou A, Aimone-Gastin I, De Korwin JD, et al. Cobalamin deficiency with megaloblastic anaemia in one patient under long-term omeprazole therapy. J Intern Med 1996;240:161–4.
9. Saltzman JR, Kemp JA, Golner BB, et al. Effect of hypochlorhydria due to omeprazole treatment or atrophic gastritis on protein-bound vitamin B12 absorption. J Am Coll Nutr 1994;13:584–91.
10. Bradford GS, Taylor CT. Omeprazole and vitamin B12 deficiency. Ann Pharmacother 1999;33:641–3 [review].
11. Saltzman JR, Kemp JA, Golner BB, et al. Effect of hypochlorhydria due to omeprazole treatment or atrophic gastritis on protein-bound vitamin B12 absorption. J Am Coll Nutr 1994;13:584–91.
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The information presented in VitaminLore is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.