What are the side effects of long term use of Omeprazole?

Omeprazole is a type of proton pump inhibitor or ‘PPI’. PPIs are a type of drug commonly prescribed to manage acid reflux or heartburn, as well as stomach ulcers. This is because their action decreases the production of stomach acid. However, long term use of omeprazole has been linked to some side effects and risks. It is important to be aware of these so that you can monitor your health and make informed decisions about your treatment. In this article we explore the frequently asked questions such as long term omeprazole use side effects.

How Omeprazole Works in the Body

Omeprazole is a type of drug called a ‘proton pump inhibitor’. As the name suggests, they target enzymes called proton pumps in the stomach lining that produce stomach acid. Thus, by inhibiting the proton pumps, omeprazole can decrease the amount of stomach acid made. This is important in conditions where gastric acid is causing irritation such as stomach ulcers, heartburn, indigestion, and acid reflux as it reduces symptoms and allows time for healing.

Common Short-Term Side Effects

Despite being a generally well tolerated drug, Omeprazole does come with some potential short-term side effects like most medications. These may include:

• Headaches – these often disappear after the first week
• Diarrhoea – make sure to stay hydrated if this happens
• Constipation – if this happens, you can try to increase your fibre intake
• Nausea or vomiting – taking omeprazole with food instead of on an empty stomach may help with this
• Abdominal pain – changing to smaller but more frequent meals might help

If these side effects do not get better or if they get worse, it is advised that you consult your doctor.

Long-Term Use of Omeprazole: Potential Risks

Some conditions may require you to be on Omeprazole long-term, in this case it is important to be aware of the potential risks of being on a proton pump inhibitor for a prolonged period of time. Let’s go over the long term use of omeprazole side effects:

Nutrient Deficiencies and Malabsorption

Magnesium deficiency: taking Omeprazole long-term can decrease magnesium levels which can present as irregular heartbeat and muscle weakness.

Vitamin B12 deficiency: While stomach acid can cause problems like heartburn and stomach ulcers, it is actually crucial to the absorption of Vitamin B12. Thus, long-term use of Omeprazole can lead to Vitamin B12 deficiency which includes symptoms of fatigue and potential neurological problems.

Increased Risk of Bone Fractures

Stomach acid is also important for the absorption of calcium. Thus long-term Omeprazole can mean you are not getting enough calcium which is important for maintaining bone density. If your bones are not dense enough, this means they are weaker and you are at a higher risk getting bone fractures. This is particularly dangerous for the elderly who are more likely to be taking higher doses of Omeprazole long-term as well as being at a higher risk of falls. Areas of the body that are particularly vulnerable include the hip, wrist, and spine. 

Gut Health and Microbiome Imbalance

The gut microbiome can be significantly affected by prolonged use of Omeprazole. The gastrointestinal environment is kept regulated by many mechanisms to maintain an optimal environment for functions such as nutrient absorption and digestion. However, omeprazole acts to reduce stomach acid and thus affects the natural, acidic stomach environment. The acidity actually helps to protect the body against certain harmful bacteria so losing the acidity may promote the growth of some bacteria and disrupt the balance of the gut microbiome. This can affect digestion and even immune system function.

Kidney Disease and Omeprazole Use

Long term use of omeprazole has been linked to a higher risk of kidney problems such as chronic kidney disease and acute interstitial nephritis (inflammation of kidneys). Thus if you are taking omeprazole long term it is important that your kidney health is being monitored by a medical professional. They can help weigh up the risks of long-term kidney problems against the benefits of omeprazole.

Cardiovascular Concerns

There is mixed evidence regarding the cardiovascular side effects from long term use of omeprazole. It is possible that because prolonged use of Omeprazole lowers magnesium levels in the body, there is an indirect link to cardiovascular problems. This is because insufficient magnesium in the body can be linked to cardiovascular problems such as your heart beating irregularly.

Who Should Be Cautious with Long-Term Use?

There are certain patient groups that need to be a bit more cautious if they are taking omeprazole long-term due to the side effects of long term use of omeprazole; they include:

• Elderly patients: they have an increased risk of weakened bones and nutrient deficiencies
• Patients with higher risk of infections: as Omeprazole reduces stomach acid, there is a higher risk of gastrointestinal infections
• Patients with a kidney condition: long-term use of Omeprazole can cause damage to the kidney

Alternatives and Safer Approaches

If you are worried about omeprazole long term side effects, there may be some alternatives you can consider however this will depend heavily on the type of condition the Omeprazole was meant to be treating. If you want to consider alternatives, please consult your doctor for advice. Here is a general overview of some examples of alternatives to Omeprazole:

• Other proton pump inhibitors e.g Lansoprazole (available at Meds for Less)
• Antacids e.g Calcium carbonate
• H2 receptor antagonists e.g Famotidine
• Lifestyle changes:
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• • Avoiding acidic or spicy foods in your diet
  • Keeping to a healthy weight
  • Eating smaller portions

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