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Omeprazole
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==Adverse effects== Adverse effects occurring in at least 1% of people include:<ref>{{cite journal | vauthors = McTavish D, Buckley MM, Heel RC | title = Omeprazole. An updated review of its pharmacology and therapeutic use in acid-related disorders | journal = Drugs | volume = 42 | issue = 1 | pages = 138β170 | date = July 1991 | pmid = 1718683 | doi = 10.2165/00003495-199142010-00008 }}</ref>{{Failed verification|date=February 2023}} *Central nervous system: headache (7%), dizziness (2%) *Respiratory: [[upper respiratory tract infection]] (2%), cough (1%) *Gastrointestinal: abdominal pain (5%), diarrhea (4%), nausea (4%), vomiting (3%), flatulence (3%), acid regurgitation (2%), constipation (2%) *Neuromuscular and skeletal: back pain (1%), weakness (1%) *Dermatologic: rash (2%) Other concerns related to adverse effects are: *Recurrence of ''[[Clostridioides difficile infection|Clostridioides difficile]]'' associated diarrhea<ref>{{cite journal | vauthors = Abou Chakra CN, Pepin J, Sirard S, Valiquette L | title = Risk factors for recurrence, complications and mortality in Clostridium difficile infection: a systematic review | journal = PLOS ONE | volume = 9 | issue = 6 | pages = e98400 | date = 21 June 2014 | pmid = 24897375 | pmc = 4045753 | doi = 10.1371/journal.pone.0098400 | bibcode = 2014PLoSO...998400A | doi-access = free }}</ref> *[[osteoporosis#Fractures|Osteoporosis-related fractures]]<ref>{{cite journal | vauthors = Yang YX, Lewis JD, Epstein S, Metz DC | title = Long-term proton pump inhibitor therapy and risk of hip fracture | journal = JAMA | volume = 296 | issue = 24 | pages = 2947β2953 | date = December 2006 | pmid = 17190895 | doi = 10.1001/jama.296.24.2947 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Yu EW, Bauer SR, Bain PA, Bauer DC | title = Proton pump inhibitors and risk of fractures: a meta-analysis of 11 international studies | journal = The American Journal of Medicine | volume = 124 | issue = 6 | pages = 519β526 | date = June 2011 | pmid = 21605729 | pmc = 3101476 | doi = 10.1016/j.amjmed.2011.01.007 }}</ref> *[[Hypomagnesemia]]<ref>{{cite journal | vauthors = Hess MW, Hoenderop JG, Bindels RJ, Drenth JP | title = Systematic review: hypomagnesaemia induced by proton pump inhibition | journal = Alimentary Pharmacology & Therapeutics | volume = 36 | issue = 5 | pages = 405β413 | date = September 2012 | pmid = 22762246 | doi = 10.1111/j.1365-2036.2012.05201.x | s2cid = 9073390 | doi-access = free }}</ref> Concern has been expressed regarding [[vitamin B12|vitamin B<sub>12</sub>]]<ref>{{cite journal | vauthors = Neal K, Logan R | title = Potential gastrointestinal effects of long-term acid suppression with proton pump inhibitors | journal = Alimentary Pharmacology & Therapeutics | volume = 15 | issue = 7 | pages = 1085β1086 | date = July 2001 | pmid = 11421886 | doi = 10.1046/j.1365-2036.2001.0994a.x | s2cid = 39455836 | doi-access = free }}</ref> and [[iron]] [[malabsorption]],<ref>{{cite journal | vauthors = Sarzynski E, Puttarajappa C, Xie Y, Grover M, Laird-Fick H | title = Association between proton pump inhibitor use and anemia: a retrospective cohort study | journal = Digestive Diseases and Sciences | volume = 56 | issue = 8 | pages = 2349β2353 | date = August 2011 | pmid = 21318590 | doi = 10.1007/s10620-011-1589-y | s2cid = 33574008 }}</ref> but effects seem to be insignificant, especially when supplement therapy is provided.<ref>{{cite journal | vauthors = McColl KE | title = Effect of proton pump inhibitors on vitamins and iron | journal = The American Journal of Gastroenterology | volume = 104 | issue = Suppl 2 | pages = S5βS9 | date = March 2009 | pmid = 19262546 | doi = 10.1038/ajg.2009.45 | s2cid = 31455416 }}</ref> Since their introduction, proton-pump inhibitors (PPIs, especially omeprazole) have also been associated with several cases of [[acute interstitial nephritis]],<ref>{{cite journal | vauthors = HΓ€rmark L, van der Wiel HE, de Groot MC, van Grootheest AC | title = Proton pump inhibitor-induced acute interstitial nephritis | journal = British Journal of Clinical Pharmacology | volume = 64 | issue = 6 | pages = 819β823 | date = December 2007 | pmid = 17635502 | pmc = 2198775 | doi = 10.1111/j.1365-2125.2007.02927.x }}</ref> an inflammation of the [[kidneys]] that often occurs as an adverse drug reaction. === Long-term use === Long-term use of PPIs is strongly associated with the development of benign [[polyp (medicine)|polyps]] from [[fundic glands]] (which is distinct from [[fundic gland polyposis]]); these polyps do not cause cancer and resolve when PPIs are discontinued. No association is seen between PPI use and cancer, but use of PPIs may mask gastric cancers or other serious gastric problems and physicians should be aware of this effect.<ref name="Corleto2014">{{cite journal | vauthors = Corleto VD, Festa S, Di Giulio E, Annibale B | title = Proton pump inhibitor therapy and potential long-term harm | journal = Current Opinion in Endocrinology, Diabetes, and Obesity | volume = 21 | issue = 1 | pages = 3β8 | date = February 2014 | pmid = 24310148 | doi = 10.1097/med.0000000000000031 | s2cid = 205791135 | hdl = 11573/618643 }}</ref> There is a possible association between long term use and [[dementia]] which requires further study to confirm.<ref>{{cite journal | vauthors = Eusebi LH, Rabitti S, Artesiani ML, Gelli D, Montagnani M, Zagari RM, Bazzoli F | title = Proton pump inhibitors: Risks of long-term use | journal = Journal of Gastroenterology and Hepatology | volume = 32 | issue = 7 | pages = 1295β1302 | date = July 2017 | pmid = 28092694 | doi = 10.1111/jgh.13737 | doi-access = free }}</ref> A review article in ''[[U.S. Pharmacist]]'' in 2013 states that long-term use of PPIs is associated with [[Hypocalcaemia|decreased calcium absorption]] (causing increased risk of [[osteoporosis]] and [[Bone fracture|fractures]]), [[Magnesium deficiency|decreased magnesium absorption]] (causing [[Electrolyte imbalance|electrolyte disturbances]]), and increased risk of certain infections such as ''[[C. difficile]]'' and [[community-acquired pneumonia]]. They hypothesize that this is due to decreased stomach acid production.<ref>{{cite journal | vauthors = O'Neill LW, Culpepper BL, Galdo JA |title=Long-Term Consequences of Chronic Proton Pump Inhibitor Use | journal = US Pharmacist | date = 2013 | volume = 38 | issue = 12 | pages = 38β42 |url= https://www.uspharmacist.com/article/longterm-consequences-of-chronic-proton-pump-inhibitor-use|access-date=28 December 2020 |archive-date=21 January 2021|archive-url=https://web.archive.org/web/20210121163435/https://www.uspharmacist.com/article/longterm-consequences-of-chronic-proton-pump-inhibitor-use|url-status=live}}</ref> ===Pregnancy and breastfeeding=== The safety of using omeprazole has not been established in pregnant or breastfeeding women.<ref name=Dav2015>{{cite book|title=Davis's Drug Guide for Nurses| vauthors = Vallerand AH, Sanoski CA, Deglin JH |publisher=F.A. Davis Company|year=2015|isbn=978-0-8036-4085-6|edition=14th|pages=924β925|oclc=881473728}}</ref> Epidemiological data do not show an increased risk of major birth defects after maternal use of omeprazole during [[pregnancy]].<ref>{{cite journal | vauthors = Pasternak B, Hviid A | title = Use of proton-pump inhibitors in early pregnancy and the risk of birth defects | journal = The New England Journal of Medicine | volume = 363 | issue = 22 | pages = 2114β2123 | date = November 2010 | pmid = 21105793 | doi = 10.1056/NEJMoa1002689 | s2cid = 10954538 | doi-access = free }}</ref>
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