Question - Can omeprazole cause iron deficiency anemia?

Answered by: Matthew Flores  |  Category: General  |  Last Updated: 24-06-2022  |  Views: 974  |  Total Questions: 14

Omeprazole is known to cause prolonged suppression of gastric acid secretion. Since acid plays an important role in the absorption of food iron (nonheme iron), this drug may lead to an iron deficiency state. Although the long-term use of PPIs is considered safe, there are several reported cases of iron deficiency anemia due to PPI use (2-4) and a community-based case control study reported that the risk of iron deficiency was increased among long-term PPI users (5). If you are iron-deficient or have anemia, you should talk to your doctor before using ferrous sulfate together with omeprazole. By reducing stomach acid, omeprazole may reduce the absorption of iron and make ferrous sulfate less effective in treating your condition. Previous human and animal studies suggested that omeprazole may inhibit iron absorption in iron-depleted states. Two adult patients with iron deficiency anemia from erosive gastritis had their anemia corrected only after discontinuation of omeprazole [13]. There are two types of anemia: one caused by iron deficiency, the other by vitamin B12 deficiency. While admittedly uncommon as a side effect of PPI use, these deficiencies can occur. The reason PPIs can induce anemia relates to how some nutrients are metabolized and absorbed.

https://www.chp.edu/our-services/transplant/liver/education/medications/ferrous-sulfate-feosol-slow-

Ferrous Sulfate Side Effects. Some people do experience stomach discomfort that ranges from heartburn to nausea and vomiting, but taking ferrous sulfate with food instead may help avoid or lessen it. Constipation or stools that are black or green also occur.

https://www.futurity.org/anemia-proton-pump-inhibitors-1888972-2/

New research finds an association between some popular heartburn treatments and iron deficiency. Heartburn is a symptom of gastroesophageal reflux, which hydrochloric acid rising into the throat causes. Iron deficiency is the most common cause of anemia, which affects about 2. 2 billion people globally.

https://www.peacehealth.org/medical-topics/id/hn-1266002

Omeprazole interferes with the absorption of vitamin B12 from food (though not from supplements) in some but not all studies. A true deficiency state, resulting in vitamin B12-deficiency anemia, has only been reported in one case.

http://www.irondisorders.org/iron-deficiency-anemia

Medication that inhibit iron absorption include antacids, proton pump inhibitors (to treat acid reflux) or calcium supplements.

https://www.medicinenet.com/is_zantac_more_effective_than_prilosec/ask.htm

Prilosec Prevacid, Aciphex are proton pump inhibitors (PPIs), drugs that are very effective in shutting down acid production by the stomach. Ranitidine (Zantac) is a H2 receptor blocker related to Tagamet, Pepcid and Axid, whereas Prilosec is a proton pump inhibitor (or PPI) related to Prevacid, Aciphex and Protonix.

https://intermountainhealthcare.org/ckr-ext/Dcmnt?ncid=520843231

– It usually takes 2 to 3 weeks of taking regular iron supplements before your symptoms start to improve. – You may need to keep taking iron for several months to build up your iron reserves and keep your anemia from returning. Take your pills for as long as your doctor recommends, even if your symptoms have improved.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5522969/

Some studies suggest that prolonged omeprazole use for at least 3 to 4 years is unlikely to cause iron and ferritin malabsorption, 6 whereas Sarzynski et al9 found that among adults on long-term PPI therapy, defined as >1 year, there was a significant decrease in hematologic indices from baseline.

https://www.practiceupdate.com/content/my-approach-to-tapering-off-a-proton-pump-inhibitor/36802

Before the quit date: Taper down the dose. For example, if someone is on 20 mg of omeprazole twice daily, I will reduce the dose to 20 mg a day for 10 days and then 20 mg every other day for 10 days before stopping.

https://www.nhs.uk/medicines/omeprazole/

Antacids, like calcium carbonate (Tums), sodium bicarbonate, Maalox and Milk of Magnesia, relieve indigestion and heartburn by neutralising the acid in your stomach. In general, PPIs like omeprazole are used first because they're better than H2 blockers at reducing stomach acid.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4167283/

The proton pump inhibitor omeprazole can alter the gut flora and immune responses, both of which can influence the course of experimental autoimmune encephalomyelitis (EAE), an animal model of MS.

https://sickle.bwh.harvard.edu/iron_absorption.html

Gastric acid lowers the pH in the proximal duodenum, enhancing the solubility and uptake of ferric iron (Table 1). Iron is readily transferred from these compounds into the mucosal lining cells. Conversely, iron absorption is inhibited by plant phytates and tannins.

https://www.drugs.com/drug-interactions/omeprazole-with-vitamin-c-1750-0-238-3823.html

No interactions were found between omeprazole and Vitamin C. This does not necessarily mean no interactions exist. Always consult your healthcare provider.

http://www.irondisorders.org/diet/

Calcium is found in foods such as milk, yogurt, cheese, sardines, canned salmon, tofu, broccoli, almonds, figs, turnip greens and rhubarb and is the only known substance to inhibit absorption of both non-heme and heme iron.

https://patient.info/digestive-health/indigestion-medication/h2-blockers

No one H2 blocker is thought to work any better than another. However, the newer group of medicines mentioned above - proton pump inhibitors - also reduce the amount of acid produced by the stomach. They include omeprazole, lansoprazole, pantoprazole, rabeprazole, and esomeprazole.