Protonpump Inhibitors

Generic and Trade Names:

Lansoprazole		Prevacid
Omeprazole		Prilosec

Description:

These drugs are used for the treatment of stomach or duodenalulcers. These agents work by suppressing gastric acid secretion by specific inhibition of the H + /K + ATPase enzyme system. The "enzyme system" is referred to as the "acid (proton) pump" within the gastric mucosa. They block the last step of acid production. (Facts and Comparisons 1999)

Nutritional Considerations:

Iron and vitamin B12 have been singled out (Bradford 1999), (Marcuard 1994)

Absorption of nutrients may be affected, notably:

Calcium, and zinc;
Together with vitamin: folic acid, vitamin B12 and vitamin D. (Bellou 1996)

Herbal Considerations

None at this time.

References

Bradford GS, Taylor CT: Omeprazole and vitamin B12 deficiency, Ann Pharmacother 1999 May;33(5):641-3

Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.

Bellou A, Aimone -Gastin I, De Korwin JD, et al: Colbalamin deficiency with megaloblastic anemia in one patients under long-term omeprazole therapy, J Intern Med, 1996, 240(3): 161-4

Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 1999.

Graedon J, Graedon T: The People's Guide to Deadly Drug Interactions, 1995. P 94

Koop H, Bachem MG. Serum iron, ferritin, and vitamin B12 during prolonged omeprazole therapy. J Clin Gastroenterol 1992;14:288-92.

Koop H, Bachem MG. Serum iron, ferritin, and vitamin B12 during prolonged omeprazole therapy. J Clin Gastroenterol 1992;14:288-92.

Marcuard SP, Albernaz L, Khazanie PG. Omeprazole therapy causes malabsorption of cyanocobalamin (Vitamin B12). Ann Intern Med 1994;120:211-15.

McKevoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.

PDR (Physicians Desk Reference). 49th Edition. Medical Economics Co. Montvale, NJ. 1995.

Pronsky, ZM: Food-Medication Interactions, 11th edition 1999

Saltzman JR, Kemp JA, Golner BB, et al: Effect of hypochlorhydria due to omeprazole treatment or atrophic gastritis on protein-bound vitamin B12 absorption, J Am Coll Nutr, 1994, 13 (6):584-91

Schenk BE, Festen HP, Kuipers EJ, et al. Effect of short-and long-term treatment with omeprazole on the absorption and serum levels of cobalamin. Aliment Pharmacol Ther 1996;10:541-45.

Skikne BS, Lynch SR, Cook JD: Role of gastric acid in food iron absorption, Gastroenterology, 1981, 81(6):1068-71

Sturniolo GC, Montino MC, Rossetto L, et al: Inhibition of gastric acid secretion reduces zinc absorption in man, J Am Coll Nutr, 1991, 10(4):372-5

Tatro, D.S. (Ed): Drug Interaction Facts. St. Louis, MO. 1995.

Termanini B, Gibril F, Sutliff VE, et al. Effect of long-term gastric acid suppressive therapy on serum vitamin B12 levels in patients with Zollinger-Ellison syndrome. Am J Med 1998;104:422-30.

United States Pharmocopeia Dispensing Information. 15th Edition. 1995.