From the Guidelines
Omeprazole can cause several negative effects with both short and long-term use, including increased risk of vitamin B12, magnesium, and calcium deficiencies, kidney disease, dementia, and certain infections, and it is recommended to use the lowest effective dose for the shortest duration necessary, typically not exceeding 8 weeks without medical supervision, as supported by recent studies 1.
Adverse Effects of Omeprazole
The adverse effects of omeprazole can be categorized into short-term and long-term effects. Common short-term side effects include:
- Headache
- Nausea
- Diarrhea
- Stomach pain
- Flatulence These side effects typically resolve as the body adjusts to the medication.
Long-term Effects
More concerning are the potential long-term effects of omeprazole, which include:
- Increased risk of vitamin B12, magnesium, and calcium deficiencies that can lead to anemia, muscle weakness, and bone fractures
- Increased risk of kidney disease
- Increased risk of dementia
- Increased risk of certain infections like Clostridium difficile and pneumonia due to reduced stomach acid allowing bacterial overgrowth Omeprazole can also interact with other medications, reducing their effectiveness.
Recommendations
When stopping omeprazole after long-term use, acid rebound can occur, where stomach acid production temporarily increases above normal levels. To minimize the risks associated with omeprazole, it is recommended to use the lowest effective dose for the shortest duration necessary, typically not exceeding 8 weeks without medical supervision, as supported by recent studies 1. It is also essential to discuss any concerns about side effects with a healthcare provider.
Interactions with Other Medications
Omeprazole can interact with other medications, such as clopidogrel, and reduce their effectiveness. The FDA advises that healthcare providers avoid the use of clopidogrel in patients with impaired CYP2C19 function due to known genetic variation or due to drugs that inhibit CYP2C19 activity, such as omeprazole 1. Consideration may be given to the use of H2 antagonists as an alternative to PPIs in the setting of dual-antiplatelet therapy.
From the FDA Drug Label
Omeprazole delayed-release capsules can cause serious side effects, including: • A type of kidney problem (tubulointerstitial nephritis). • Diarrhea. • Bone fractures. • Certain types of lupus erythematosus.
The adverse effects of Omeprazole (Proton Pump Inhibitor) include:
- Kidney problems: A type of kidney problem called tubulointerstitial nephritis
- Diarrhea: Increased risk of getting severe diarrhea, which may be caused by an infection (Clostridium difficile) in the intestines
- Bone fractures: Increased risk of fractures of the hip, wrist, or spine with long-term use
- Lupus erythematosus: Certain types of lupus erythematosus or worsening of existing lupus 2
From the Research
Adverse Effects of Omeprazole
The adverse effects of omeprazole are reported in several studies, including:
- Gastrointestinal complaints such as nausea and diarrhea 3
- Elevation of serum aspartate aminotransferase and alanine aminotransferase concentrations 3
- Diarrhea, headache, dizziness, flatulence, abdominal pain, and constipation 4
Common Adverse Effects
Some common adverse effects associated with omeprazole therapy include:
- Gastrointestinal symptoms such as nausea and diarrhea
- Laboratory abnormalities such as elevation of serum aspartate aminotransferase and alanine aminotransferase concentrations
Comparison with Other Treatments
Omeprazole is compared with other treatments in terms of adverse effects, including: