Many interactions — the most well-known is warfarin.
Also, clopidogrel (Plavix), digoxin,.
Pneumonia
Complications of prolonged use are many including community-acquired pneumonia (aspiration pneumonitis too?)
- Clostridium difficile
- Hypomagnesemia
- Hip fracture, wrist fracture, spine fracture (decreased bone mineral density (BMD))
- Vitamin B12 deficiency
- Iron deficiency anemia
- Gastric carcinoma
- Community-acquired pneumonia — risk increases with PPI dosage, H2 blocker also conferred risk, but less than PPI
Drug interactions
- Decreased absorption — iron salts, vitamin B12, itraconazole, cefpodoxime, griseofulvin, ketoconazole
- Increased absorption — digoxin, nifedipine
- Increased specific to omeprazole (CYP450) — diazepam, phenytoin, warfarin, carbamazepine, methotrexate
- Lowered efficacy specific to omeprazole — clopidogrel
- Decreased specific to lansoprazole (Prevacid) — Theophylline (Theo-Dur)
Most potent agents appear to be — esomeprazole (Nexium), rabeprazole.
Source/credit: family physician notebook
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