Can omeprazole cause anemia?
We report the first case of a serious short-term adverse reaction with the use of omeprazole: hemolytic anemia. The patient developed weakness, lethargy, and shortness of breath 2 days after starting therapy with omeprazole.
Does omeprazole interfere with iron?
When using ferrous sulfate and omeprazole, you should consult your doctor if you are iron deficient or have anemia. In addition to reducing stomach acid, omeprazole may also reduce iron absorption and make ferrous sulfate less effective in treating your condition by reducing stomach acid.
What are signs of severe anemia?
- Anemia is the most common blood disorder.
- Changes to your skin, nails or appetite may indicate anemia related to low iron.
- Symptoms of anemia can be related to many issues so context (and proper medical testing) is key.
What causes iron deficiency anemia might surprise you?
What causes iron-deficiency anemia?
- Blood loss. When you lose blood, you lose iron. ...
- Problems absorbing iron. Certain conditions or medicines can decrease your body’s ability to absorb iron and lead to iron-deficiency anemia.
- Other medical conditions. Kidney disease: People who have kidney disease do not make enough of a substance called erythropoietin.
Can omeprazole affect iron levels?
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].
Does omeprazole stop you absorbing iron?
Omeprazole and possibly all proton pump inhibitors decrease the absorption of oral iron supplementation. Iron-deficient patients taking proton pump inhibitors may have to be treated with high dose iron therapy for a longer duration or with intravenous iron therapy.
What drugs can cause iron deficiency anemia?
Drug-induced immune hemolytic anemiaCephalosporins (a class of antibiotics), most common cause.Dapsone.Levodopa.Levofloxacin.Methyldopa.Nitrofurantoin.Nonsteroidal anti-inflammatory drugs (NSAIDs)Penicillin and its derivatives.More items...•
Can proton pump inhibitors cause iron deficiency anemia?
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).
When should I take iron with omeprazole?
You should take ferrous sulfate on an empty stomach at least one hour before or two hours after a meal. Your doctor may be able to prescribe alternatives that do not interact, or you may need a dose adjustment or more frequent monitoring to safely use both medications.
Can acid reflux cause anemia?
Connection between GERD and anemia Research shows that GERD can sometimes cause esophagitis, which is inflammation of the esophagus. Some people with esophagitis may then develop gastrointestinal bleeding. This loss of blood may cause anemia and other conditions.
What are the most common causes of iron deficiency anemia?
Causes of iron deficiency anemia include:Blood loss. Blood contains iron within red blood cells. ... A lack of iron in your diet. Your body regularly gets iron from the foods you eat. ... An inability to absorb iron. Iron from food is absorbed into your bloodstream in your small intestine. ... Pregnancy.
What depletes the body of iron?
Common causes of iron deficiency include not getting enough iron in your diet, chronic blood loss, pregnancy and vigorous exercise. Some people become iron deficient if they are unable to absorb iron. Iron deficiency can be treated by adding iron-rich foods to the diet.
Why is my body not absorbing iron?
Malabsorption is when your body can't absorb iron from food, and is another possible cause of iron deficiency anaemia. This may happen if you have coeliac disease, a common digestive condition where a person has an adverse reaction to gluten, or surgery to remove all or part of your stomach (gastrectomy).
Can omeprazole cause low red blood count?
A number of drugs, such as omeprazole [23] and carbimazole [24], have been reported to cause iron deficiency and anemia.
Can antacids cause iron deficiency?
Iron deficiency anemia is often listed among potential adverse effects of gastric acid-suppressive medications, given that gastric acidity promotes intestinal absorption of nonheme iron. Additionally, the antacid calcium carbonate can inhibit iron absorption.
Does omeprazole have side effects?
Long-term side effects Taking omeprazole for more than a year may increase your chances of certain side effects, including: bone fractures. gut infections. vitamin B12 deficiency – symptoms include feeling very tired, a sore and red tongue, mouth ulcers and pins and needles.
Does omeprazole affect vitamin D absorption?
No interactions were found between omeprazole and Vitamin D3.
How do you take iron with PPI?
Antacids, dairy products, and agents that increase stomach pH will decrease iron absorption. Thus, patients should take oral iron 2 hours before or 4 hours after antacids (with the exception of PPIs and histamine type 2 receptor antagonists, as these agents have longer half-lives).
Does omeprazole cause B12 deficiency?
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.
What medications increase iron levels?
Ferrous sulfate is the mainstay treatment for treating patients with iron deficiency anemia. They should be continued for about 2 months after correction of the anemia and its etiologic cause in order to replenish body stores of iron.
How long does it take for omeprazole to work?
After oral administration of PPI, the onset of the antisecretory effect of omeprazole occurs within 1 h, with the maximum effect occurring within 2 h [10]. The inhibitory effect of omeprazole on acid secretion increases with repeated once-daily dosing, reaching a plateau after 4 days. Bastani et al. showed a significant rise in serum iron concentration of 164±32% µg/dL above baseline 2 h after oral ingestion, plateauing afterwards [11]. These studies suggested that a 5-day course of PPI treatment would be sufficient length of treatment and 3 h of serum iron-level monitoring would be sufficient to detect serum changes in iron levels following the ingestion of iron preparation.
What is the role of gastric acid in iron absorption?
Gastric acid plays an important role in the absorption of iron. Dietary iron can be divided into 2 types with respect to absorption: the heme type, derived from animal blood and muscle , which is well absorbed and comprises about 10%-30% of the normal Western diet, and the more common nonheme type, derived from plants (fruits, vegetables, grains, nuts), which requires an acidic gastric environment for absorption [1,2]. Although the heme component is absorbed independent of gastric pH, the nonheme part requires an acidic pH for absorption [3].
Does omeprazole affect iron absorption?
Since omeprazole’s effect was shown in iron-depletion or iron-overload states, it is plausible that omeprazole may have an effect on iron absorption only in abnormal iron metabolic states. Although short-term omeprazole therapy does not appear to affect iron absorption, since PPIs are increasingly being used for longer durations, further studies are warranted to evaluate their effects on long-term use.
Does omeprazole help with iron deficiency?
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]. Omeprazole inhibits iron absorption in rats that were fed an iron-deficient diet [12]. Another study showed that treatment of patients with hereditary hemochromatosis with PPIs led to significant reduction in the volume of blood removed annually [14]. In that report, postprandial iron absorption studies in 14 subjects with hemochromatosis demonstrated decreased absorption of nonheme iron from a test meal by approximately 50% after 7 days of PPI therapy. These studies suggest that PPIs may inhibit iron absorption in iron-depleted as well as iron-overloaded individuals.
Does gastric acid reduce iron?
It has been speculated that inhibition of gastric acid secretion may lead to reduction in iron and vitamin B12 absorption [7]. The development of iron malabsorption has been shown in a variety of hypo- or achlorhydric conditions. Heath and Patek observed that among patients with iron-deficiency anemia, the rate of the hemoglobin response to iron therapy was lower in those who had achlorhydria than in those without [8]. Goldberg et al., using radiolabeled iron, showed that patients with achlorhydria have diminished absorption of iron [9]. These data clearly demonstrate the importance of gastric acid secretion in iron absorption.
Is iron soluble in oxygen?
At physiologic pH and in the presence of oxygen, iron exists predominantly in the highly insoluble ferric Fe( III) form and therefore is poorly bioavailable [4]. Ingested ferrous ions are readily oxidized to ferric ions by dissolved oxygen [5]. Stomach acid is important in releasing iron from ligands in food and in solubilizing ferric iron by converting it to ferrous form [6].
Who published the Turkish Journal of Hematology?
Copyright© Turkish Journal of Hematology, Published by Galenos Publishing.
Does omeprazole cause anemia?
Hypochlorhydric states such as atrophic gastritis and partial gastrectomy have long been known to cause iron deficiency anemia. However, studies to date have failed to show a similar association with omeprazole, a proton pump inhibitor that also produces achlorhydria. These studies, however, have primarily involved nonanemic, iron-replete individuals. The effect of the drug has not been studied in patients with established iron deficiency, and to our knowledge the patients presented here are the first of their kind to be reported. Our observations support the probability that the profound hypochlorhydria induced by omeprazole may indeed impair the optimal absorption of orally administered iron in iron-deficient individuals, precluding them from obtaining therapeutically adequate amounts to establish the positive balance necessary for the resolution of anemia and the replenishment of stores. The possible explanations for this phenomenon are also discussed.
Does omeprazole cause iron deficiency?
Effect of omeprazole on oral iron replacement in patients with iron deficiency anemia. Hypochlorhydric states such as atrophic gastritis and partial gastrectomy have long been known to cause iron deficiency anemia. However, studies to date have failed to show a similar association with omeprazole, a proton pump inhibitor ...
What is Omeprazole?
Omeprazole has active ingredients of omeprazole. It is often used in gastroesophageal reflux disease. eHealthMe is studying from 329,747 Omeprazole users for its effectiveness, alternative drugs and more.
What is Iron Deficiency Anemia?
Iron deficiency anemia is found to be associated with 22 conditions by eHealthMe.
How to use the study?
You can discuss the study with your doctor, to ensure that all drug risks and benefits are fully discussed and understood.
Who created the Phase IV drug test?
It is created by eHealthMe based on reports from the FDA, and is updated regularly. To evaluate side effects or drug interactions, pharmaceutical companies and the FDA run phase IV clinical trials.
What does the polygonal line on a clinical course mean?
The clinical course. The polygonal line indicates the hemoglobin (Hb) level and the bars indicate the serum ferritin levels.
Does Zollinger Ellison syndrome affect iron?
No decrease in the body iron stores or iron deficiency was observed in patients with Zollinger-Ellison syndrome who received continuous omeprazole therapy for up to 12.5 years (8). On the contrary, in patients with hereditary hemochromatosis PPIs were shown to reduce the frequency of therapeutic phlebotomy and the absorption of dietary non-heme iron (9). However, these results cannot be applied to general PPI users.
Is PPI approved in Japan?
The long-term prescription of PPIs has been approved in Japan since as recently as in 2000. Accordingly, it is apparent that the number of long-term PPI users will increase and that the duration of PPI use will be extended. In addition, new PPIs with stronger gastric acid suppression are being developed and are becoming available. Thus, it is expected that the number of long-term PPI users with iron deficiency anemia will be increased in Japan and other countries worldwide in the near future. It is therefore necessary to limit long-term PPI use and to consider it in the differential diagnosis of iron deficiency anemia in long-term PPI users.
Can PPI cause iron deficiency?
A retrospective cohort study which reported a reduction in the levels of Hb, Ht, and MCV among individuals who took PPIs for more than one year suggests that iron deficiency would develop among long-term PPI users (10). A community-based case control study showed that the use of PPIs for a period of longer than two years was associated with iron deficiency; however, there was no consistent association between the use of PPIs for periods of more than two years and the development of iron deficiency (5). To the best of our knowledge, there have been four reported individual cases of iron deficiency anemia caused by PPI use; however, the entire GI tract, including the small intestine, was studied in only one of them (2-4). The present case is the second reported case in whom the entire GI tract was studied and GI blood loss was ruled out. The present case also revealed that very long-term PPI use, for as long as 25 years, can actually cause iron deficiency anemia after a long latency period. In the cohort and case control studies, the longest duration for which PPIs had been administered were more than one year (9) and longer than 10 years (5), respectively, and the duration of PPI administration was not specified in detail. All four reported cases developed iron deficiency anemia within three years after the start of PPI therapy (2-4). The present case clearly shows that iron deficiency anemia can develop in PPI users, even after 25 years of use. We hypothesize that the gastric acid-independent iron absorption of dietary heme iron and, possibly, the reduced secretion of gastric acid (which was still secreted) might have delayed the development of iron deficiency in the present case. This case also demonstrates that oral ferrous iron is effective in ameliorating iron deficiency without interrupting PPI use in such cases.
Is it safe to take PPIs for long term?
Proton pump inhibitors (PPIs) are the most potent medications currently available to reduce gastric acid secretion and are widely prescribed in the treatment of peptic ulcer disease and gastroesophageal reflux disease (GERD) (1). 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). However, the association between PPI use and iron deficiency anemia remains controversial and it is not yet known whether the extended use of PPIs is associated with iron deficiency anemia after a long latency period. We herein report the case of a patient who developed iron deficiency anemia after 25 years of continuous PPI use.
Do authors have conflict of interest?
The authors state that they have no Conflict of Interest (COI).
Is Internal Medicine a Creative Commons?
The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
What are the side effects of Prilosec?
Prilosec Side Effects: Anemia, B-12 Deficiency. Prilosec (omeprazole) belongs to the class of drugs known as proton pump inhibitors (PPIs), along with similar drugs such as Nexium, Prevacid, Dexilant, Aciphex, and Protonix. These drugs prevent the production of acid in the stomach lining to reduce symptoms of gastroesophageal reflux disease (GERD), ...
What are the symptoms of iron deficiency anemia?
Iron deficiency anemia may cause the following symptoms: If a person suffers from iron deficiency anemia, he or she could experience cognitive problems, heart problems, pregnancy complications, or even delayed growth and development in children.
How many people are affected by GERD?
These drugs prevent the production of acid in the stomach lining to reduce symptoms of gastroesophageal reflux disease (GERD), which affect as many as 4 in 10 Americans, according to a New York Times article.
What is the cause of anemia?
There are two forms of anemia: one is the result of insufficient iron in the blood, and the other results from low levels of the vitamin B-12.
