Data provided by Applied Health
side effects, nutrient depletions, herbal interactions and health notes:
• Folic acid may be inhibited by taking this medication, causing a deficiency that could also create a deficiency of vitamin B12. Folic acid is required for the utilization of B12. The fall in vitamin B12 status may be the result of a decrease in stomach acid required for vitamin B12 absorption from food while taking this medication. Nutritional supplements containing these ingredients should be considered. Supplementation of 1,000 mcg of vitamin B12 per day is recommended to avoid depletion that can lead to anemia and high homocysteine blood levels.1
• Highly acidic juices, such as cranberry juice, may aid in the absorption of vitamin B12-containing foods while taking this medication.2
• This medication may affect the proper absorption of beta-carotene and iron. Consult your pharmacist regarding supplementation. Antacids may reduce the absorption of iron. To restore iron levels, eat more foods containing iron, such as fish, meat, poultry, and oysters. Individuals taking antacids may benefit from iron supplementation, if blood tests indicate an iron deficiency3
• Avoid alcohol with this drug.4
• Calcium - Antacids can deplete calcium levels, because stomach acid is necessary for calcium absorption. Adding calcium-rich sources, such as dark green veggies, fruits, dairy, and calcium supplementation can be added to avoid depletion.5
• Alginates - Using alginate, a thick gel derived from algae, can relieve symptoms and improve healing of heartburn. Alginate may work by blocking stomach acid from touching the esophagus. Two tablets containing 200 mg alginic acid may be supplemented with antacids.6
• This medication may interact with St. John's Wort to increase the risk of photosensitivity.7
• Black mustard, Cayenne, Devil's Claw, Goldenseal,and Horseradish, all increase gastric acid and could therefore theoretically interact with this medication.8
References1 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.
1 Marcuard SP, Albernaz L, Khazanie PG. Omeprazole therapy causes malabsorption of cyanocobalamin (Vitamin B12). Ann Intern Med 1994;120:211–5.
1 Bradford GS, Taylor CT: Omeprazole and vitamin B12 deficiency, Ann Pharmacother 1999 May;33(5):641-3.
1 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.
1 Koop H, Bachem MG. Serum iron, ferritin, and vitamin B12 during prolonged omeprazole therapy. J Clin Gastroenterol 1992;14:288-92.
1 Bellou A, Aimone-Gastin I, De Korwin JD, et al: Colbalamin deficiency with megaloblastic anemia in one patients under long-term omeprazole therapy, J Intern Med, 1996, 240(3): 161-4.
1 O’Neil-Cutting MA, Crosby WH. The effect of antacids on the absorption of simultaneously ingested iron. JAMA 1986;255:1468-70
2 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 (6):584-91.
2 Pronsky, Z Food Medication Interactions, 11th edition, 1999
3 Drug Interaction Facts, Tatro, D.S., Editor (St. Louis, MO, Facts and Comparisons, through July 1995)
3 Tang G, Serfaty-Lacronsniere C, Camilo ME, Russell RM. Gastric acidity influences the blood response to a beta-carotene dose in humans. Am J Clin Nutr 1996;64:622-26.
3 Koop H, Bachem MG. Serum iron, ferritin, and vitamin B12 during prolonged omeprazole therapy. J Clin Gastroenterol 1992;14:288-92.
3 Salom IL, Silvis SE, Doscherholmen A. Effect of cimetidine on the absorption of vitamin B12. Scand J Gastroenterol 1982;17:129-31
4 Pronsky, Z Food Medication Interactions, 11th edition, 1999
4 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
5 O'Connell MB, Madden DM, Murray AM, et al. Effects of proton pump inhibitors on calcium carbonate absorption in women: a randomized crossover trial. Am J Med 2005;118:778-81
6 McHardy G. A multicentric, randomized clinical trial of Gaviscon in reflux esophagitis. South Med J 1978;71(suppl 1):16-21
6 Graham DY, Lanza F, Dorsch ER. Symptomatic reflux esophagitis: A double-blind controlled comparison of antacids and alginate. Curr Ther Res 1977;22:653-8
7 Mirossay A, Mirossay L, Tothova, et al. Potentiation o fhypericin an dhypocrellin-induced phototoxicity by omeprazole. Phytomedicine 6(5): 311 - 317, 1999.
7 Seigers Cp, et al. Phototoxicity caused by hypericum. Nervehielkunde 12: 320 - 322, 1993.
8 PDR for Herbal Medicines, 2nd edition, Medical Economics Company, 2000
8 The Review of Natural Products, Clinisphere 2.0, Wolters Kluwer Company, 2000
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The information in Drug Watch is provided as a courtesy to NewsTarget readers by Applied Health Solutions in cooperation with Healthway Solutions. Although the information is presented with scientific references, we do not wish to imply that this represents a comprehensive list of considerations about any specific drug, herb or nutrient. Nor should this information be considered a substitute for the advice of your doctor, pharmacist, or other healthcare practitioner. Please read the disclaimer about the intentions and limitations of the information provided on these pages. It is important to tell your doctor and pharmacist about all other drugs and nutritional supplements that you are taking if they are recommending a new medication. Copyright © 2007 by Applied Health Solutions, Inc. All rights reserved.