The health specialist is urging people to be mindful of the repercussions of long-term use
A doctor has issued a ‘you’ve been warned’ alert to anyone who takes a common type of medication. In the UK, omeprazole is a popular drug that works as a proton pump inhibitor (PPI). It is often used to manage problems such as acid reflux, heartburn, and stomach ulcers.
It was the first and most frequently prescribed PPI, with millions of NHS prescriptions given out each year. It is seen by many as an essential medication for numerous patients dealing with acid-related stomach problems.
The most recent data shows that in England, 73 million NHS prescriptions for all PPIs were given out during 2022-23, with omeprazole being one of the two most frequently prescribed drugs. With so many people taking omeprazole or being prescribed the drug, a doctor has issued a word of warning to anyone taking it.
Dr Ana Pérez Ballesta, who is a family doctor with a master’s degree in Emergency Medicine, says taking the medication for the sake of it can be doing more harm than good. She said: “If you take it unnecessarily, it can hinder the absorption of calcium, magnesium, and vitamin B12”
Omeprazole is one of the most prescribed medications in the UK and worldwide, but the doctor warns that she believes its use has spread beyond its intended use. She says many people use it as a “stomach protector” against heavy meals, alcohol, or the occasional intake of certain medications.
However, the health expert warns that this habit can cause side effects when continued for years without medical supervision. She says that omeprazole and other similar drugs, such as esomeprazole, pantoprazole, lansoprazole, and rabeprazole, belong to the group of proton pump inhibitors (PPIs).
“They reduce stomach acid and are useful, but not always,” she said. “They are indicated for reflux or esophagitis, gastric or duodenal ulcers, Helicobacter pylori eradication, and chronic treatment with anti-inflammatory drugs if there is a high risk of gastrointestinal bleeding.”
The problem arises when it’s taken as a preventative measure without a clear clinical cause. According to Dr Ballesta, “to avoid heartburn before a heavy meal or every time you’re prescribed an antibiotic or anti-inflammatory on a one-off basis” shouldn’t be a reason to consume it. In her words, this practice is widespread, even though the concept of “stomach protector” doesn’t really exist.
Prolonged, unnecessary use can have significant consequences. “If you take it for years without needing it, it can hinder the absorption of calcium, magnesium, iron, and vitamin B12, increasing the risk of osteoporosis, anaemia from various causes, and digestive infections,” the specialist warned.
She also noted that it has been linked to small intestinal bacterial overgrowth, also known as SIBO. Dr Ballesta emphasised that in her practice, she has seen numerous patients who had been taking omeprazole for more than a decade without a clear justification.
“In my practice, I have seen many people who have been taking it for 10 or 15 years without really knowing why, some of them already suffering from osteoporosis, anaemia that doesn’t respond to certain treatments, or digestive problems for which we can’t find another cause.”
Using omeprazole for a long time can raise the chances of developing some health problems, such as deficiencies in vitamins and minerals, broken bones, and kidney issues. Although omeprazole is usually safe for short-term use, the risks associated with long-term use are worrying, especially for older adults.
The drugs can increase the chances of contracting a serious bacterial infection called Clostridioides difficile (C. diff), which can cause severe diarrhoea. Numerous studies indicate a connection between omeprazole and long-term side effects, but these are observational.
This means they can show relationships without conclusively proving that the medication is the direct cause. It’s important to discuss with a doctor whether to keep using it long-term, as they can help evaluate the benefits compared to the possible risks based on your personal health requirements.
The doctor is reminding people who take omeprazole that while it is a useful and effective drug when properly prescribed, it should not be used routinely or preventively without a doctor’s recommendation. “Prolonged self-medication with this type of inhibitor can lead to complications that far outweigh the supposed benefits of taking it just in case,” she said.
Suddenly stopping omeprazole isn’t harmful, but it might lead to a serious and temporary return of acid reflux symptoms called “rebound acid hypersecretion.” It happens because the stomach starts making too much acid to make up for the medication’s effects, which can be even worse than the original symptoms. This rebound effect is a typical withdrawal symptom, especially if you’ve been on the medication for more than a few weeks. The positive side is that this usually doesn’t last long, and the symptoms can be controlled.
What does the NHS say?
A statement on the NHS website reads: “Do not take omeprazole for longer than two weeks if you bought it without a prescription.” It adds: “See a GP if your symptoms get worse or do not get better.”
The NHS also says that omeprazole usually comes as tablets, capsules and liquid that you swallow. Some tablets can be dissolved in water. How much to take and for how long depends on the type of omeprazole you’re taking and why you’re taking it.
It’s usually taken once or twice a day. Some people may only need to take it for a few days, others may need to take it for several weeks, months or years. Always check the packet or leaflet that comes with your medicine. Ask a pharmacist or doctor for advice if you’re not sure how to take it or if you have any problems taking it.
Like all medicines, omeprazole can cause side effects, but not everyone gets them. Common side effects of omeprazole include:
- a headache
- stomach pain
- feeling sick (nausea) or being sick (vomiting)
- constipation or diarrhoea
- farting more than usual
Omeprazole can sometimes cause serious side effects, but most of them are rare. Possible serious side effects of omeprazole include:
- having a very low level of vitamin B12, which can cause symptoms such as tiredness, dizziness, or muscle twitches or weakness
- weakened bones, which can break more easily if you have a fall or injury
- an allergic reaction (anaphylaxis), which can cause symptoms such as a swollen throat or tongue, a raised, itchy rash or difficulty breathing
- a type of lupus that can cause rashes (particularly on parts of the body exposed to the sun) and joint pain
The chance of getting serious side effects can be higher if you take omeprazole for a long time (a year or more).