Does omeprazole (Prilosec) increase blood pressure?

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Last updated: March 22, 2025View editorial policy

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From the Guidelines

Omeprazole does not typically increase blood pressure. It is a proton pump inhibitor (PPI) that reduces stomach acid production and is commonly used to treat conditions like acid reflux, heartburn, and ulcers. The standard dosage ranges from 20-40 mg once daily, usually taken before breakfast. While omeprazole is generally well-tolerated, it can occasionally cause side effects such as headache, nausea, or diarrhea, but hypertension is not a common side effect.

Some studies have suggested that long-term use (over a year) of PPIs like omeprazole may be associated with other health concerns such as vitamin B12 deficiency or increased risk of bone fractures, but not with elevated blood pressure 1. If you're taking omeprazole and experiencing high blood pressure, it's more likely due to other factors. However, it's essential to discuss any concerns about medication side effects with your healthcare provider, especially if you notice changes in your blood pressure after starting omeprazole.

The provided evidence does not support a direct link between omeprazole and increased blood pressure. Studies have focused on the interaction between PPIs, including omeprazole, and antiplatelet therapy, particularly clopidogrel, rather than the effect of omeprazole on blood pressure 1. Therefore, based on the most recent and highest quality evidence, there is no conclusive evidence to suggest that omeprazole increases blood pressure.

Key points to consider:

  • Omeprazole is a PPI used to treat acid reflux, heartburn, and ulcers.
  • The standard dosage is 20-40 mg once daily.
  • Common side effects include headache, nausea, and diarrhea, but not hypertension.
  • Long-term use may be associated with other health concerns, but not elevated blood pressure.
  • If experiencing high blood pressure while taking omeprazole, it's likely due to other factors, and you should discuss concerns with your healthcare provider.

From the FDA Drug Label

The following adverse reactions have been identified during post-approval use of omeprazole. ... Cardiovascular: ... elevated blood pressure, ...

Omeprazole (Prilosec) may increase blood pressure as it has been reported as an adverse reaction in the post-approval use of the drug 2.

From the Research

Omeprazole and Blood Pressure

  • The relationship between omeprazole and hypertension is complex, with some studies suggesting a possible causal link 3.
  • A study analyzing data from the World Health Organization's global database found 1043 cases of hypertension related to omeprazole, with 65.0% reported as 'serious' and 10.6% as 'fatal' 3.
  • In some cases, hypertension resolved after withdrawal of omeprazole and recurred after re-introduction, suggesting a possible causal relationship 3.

Effects of Omeprazole on Blood Pressure

  • One study found that omeprazole therapy reduced blood pressure in patients with gastroesophageal reflux disease (GERD) and hypertension, suggesting a potential beneficial effect on blood pressure 4.
  • However, the study also noted that GERD may provoke high blood pressure episodes, and that antiacid therapy, including omeprazole, may help control blood pressure in these patients 4.

Comparison with Other Studies

  • Other studies have focused on the effects of different antihypertensive drugs on vascular health, rather than the specific relationship between omeprazole and blood pressure 5, 6.
  • These studies suggest that certain classes of antihypertensive drugs, such as angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers, may have beneficial effects on vascular health and blood pressure 5, 6.
  • However, the relevance of these findings to the specific question of whether omeprazole increases blood pressure is unclear, as omeprazole is a proton pump inhibitor rather than an antihypertensive drug 7.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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