Omeprazole interactions can occur with a number of medications in part because this drug disrupts the balance of stomach acid and certain liver pathways. Doctors may recommend omeprazole to treat a patient with acid reflux, but must consider whether the patient is taking certain antibiotics, antiretroviral drugs, and diuretic medications, among others. Their concentrations in the body could rise or fall, causing complications for the patient.
The use of omeprazole should lower stomach acid, as this is the reason for taking the drug. Medications that rely on a particular stomach acid balance may enter the bloodstream more quickly or could fail to absorb. In addition, this drug disrupts one of the pathways the liver uses to metabolize medication, which can also cause skewed medication levels as drugs linger longer than expected in the system or are eliminated too quickly.
One particular area of concern is antiretroviral drugs used in the management of conditions like the human immunodeficiency virus, or HIV. Two known omeprazole interactions involve the drugs atazanavir and saquinavir, both of which can be rendered less effective. Atazanavir levels may drop low enough to contribute to the development of drug resistance, as HIV can evolve in response to the exposure. This could make the patient harder to treat in the future and also might endanger those later infected by the patient.
Certain anti-clotting agents, including warfarin and clopidogrel, have omeprazole interactions. Patients on these medications may experience problems like excessive bleeding because the drugs may become abnormally concentrated. Levels of tacrolimus, an immunosuppressive drug used to treat patients with organ transplants, can also become too high in patients taking omeprazole. These interactions can potentially cause serious health problems.
Ketoconazole, an antifungal, along with certain antibiotics, can also have omeprazole interactions. These medications may not be as effective as a result of the drug interaction. Levels of digoxin, a medication used to manage certain heart conditions, can also be altered by omeprazole. The interaction may cause a spike in the concentration of the heart medication, which could lead to complications.
Known omeprazole interactions can be a concern for doctors when they recommend this drug to patients. Patients should make sure their complete pharmaceutical history is available so the doctor can check for a potential problem. Pharmacists may also double check prescriptions to confirm that a drug is safe for the patient. If an interaction is a concern, an alternative medication may be available. In the event of a bad reaction to a drug not known to interact with omeprazole, it may be advisable to file a report with a drug database to alert regulators.
