Digestive health · Proton pump inhibitor (PPI)

Omeprazole

Omeprazole is a proton pump inhibitor that reduces stomach acid production. Used for reflux, heartburn, and ulcer conditions.

OTCPregnancy: cautionKidney warningLiver warningAlcohol interactionPaediatric useSenior precaution
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Overview & typical uses

Omeprazole is a proton pump inhibitor that reduces stomach acid production. Used for reflux, heartburn, and ulcer conditions.

Primary uses

  • Frequent heartburn and acid reflux
  • Stomach and duodenal ulcer treatment (under medical supervision)
  • H. pylori infection eradication regimens (as part of combination therapy)
How it works

Irreversibly blocks the proton pumps in stomach lining cells, sharply reducing acid production.

Available forms & strengths
  • Capsule — 10 mg, 20 mg, 40 mg (Oral)
  • Tablet (delayed release) — 20 mg (Oral)
General precautions & contraindications

Do not use if

  • Known allergy to omeprazole or other PPIs
  • Concurrent use with rilpivirine (HIV medicine)

Pregnancy

Use with caution — discuss with clinician. Reassuring data at usual amounts; discuss with a clinician for regular use.

Breastfeeding

Use with caution — discuss with clinician. Small amounts pass into milk; usually considered acceptable.

Kidney considerations

  • No routine adjustment needed for typical use.

Liver considerations

  • Discuss with a clinician in severe liver disease.

Paediatric use

Under clinical supervision.

Older adults

Long-term high-dose use may slightly increase risk of fractures, B12 deficiency, or C. difficile — periodic review recommended.

Common side effects
  • Headache
  • Diarrhoea or constipation
  • Abdominal pain
  • Nausea
Serious warnings — seek help if these appear
  • Serious allergic reaction
  • Low magnesium (with prolonged use)
  • Bone fractures (long-term high-dose use)
  • Vitamin B12 deficiency (long-term use)
Drug interactions
Rilpivirine, atazanavirdanger

PPIs reduce absorption — avoid combination.

Clopidogrelwarning

May reduce clopidogrel's blood-thinning effect — discuss alternatives with a clinician.

Warfarincaution

May slightly enhance anticoagulant effect — monitor INR when starting or stopping.

Methotrexatecaution

May raise methotrexate levels at high doses.

Food & alcohol precautions
Food

Take before a meal (usually breakfast) for best effect.

Alcohol

  • No major interaction, but alcohol can worsen reflux symptoms.
Storage, missed dose & overdose

Storage

Store below 25 °C, out of reach of children.

If a dose is missed

Take when remembered unless the next dose is near — do not double up.

Overdose

Overdose can cause drowsiness, headache, sweating. Seek medical advice for large overdoses.

What to monitor

  • Long-term users benefit from periodic clinical review to check whether continued use is needed.
Frequently asked questions
When should I take omeprazole?

Usually 30 to 60 minutes before breakfast for best effect.

How quickly does omeprazole work?

Symptom relief may take a few days; full acid suppression develops over about a week.

Medical references
  • British National Formulary — OmeprazoleBNF (NICE)
  • FDA drug information — OmeprazoleU.S. Food & Drug Administration

Content last reviewed: 2025-01-01

Medical disclaimer

This information is for educational purposes only and should not replace professional medical advice. Please consult a licensed pharmacist or clinician for advice tailored to your personal circumstances.