Omeprazole And Probiotics – Effects On Gut Flora

Probiotics often sold as a food supplement are friendly good bacteria that the microbiome and human body needs to function at it's best. Things like hot water, vinegar, stomach acid, antibiotics, alcohol, stress and more may kill off probiotic bacteria.

Because of this it's always wise to check if any medications you are taking will kill off your expensive probiotic supplement and make it useless. In this guide, I will looking at what the medical studies say happens when you take PPI's like Omeprazole with Probiotics.

What Is Omeprazole?


Omeprazole is a medicine often prescribed by Doctors around the world for conditions like Peptic Ulcers, GERD, Heart Burn, Acid Reflux, Erosive Esophagitis, Gastritis, Zollinger-Ellison Syndrome, and more. 

Omeprazole is most commonly sold under the brand names Prisolec & Losec is not a probiotic in any sort of way but interestingly may have effects on the digestive system like probiotics.

Check Out This Similar Article: Boric Acid Vs Probiotics

Omeprazole is able to reduce stomach acid by regulating proton pumps found in the stomach lining. It inhibits the final step of acid production and the effects of Omeprazole can start within 1 or 2 hours of ingestion.

Depending on where you live you may be able to get Omeprazole over the counter but for higher doses you may need a prescription from your Doctor. It's always best to talk with your doctor first incase you have side effects or the PPI doesn't work.

Can You Take Omeperazole And Probiotics Together?


Omeprazole 20mg

According to there are no interactions between Omeprazole and Probiotic formulas that contain Lactobacillus Acidophilus and Bifidobacterium Infantis.

This however is not 100% proof that there is no interactions as there are different probiotic strains out there and more studies may be needed. Probiotics may also help with GERD symptoms like heartburn so there could be interaction.

As mentioned previously Omeprazole's main role is to reduce stomach acid via proton pumps and because of this it could even benefit the effects of probiotic supplements.

For probiotic bacteria to reach deep enough into your microbiome it first has to get passed harmful stomach acid and not get killed. So the answer is yes, you can take both together at the same time and they could even compliment each other.

Does Omeprazole Effect Gut Flora?

The use of proton pump inhibitors has been studied on gut health at least twice and there were several concerning findings. It confirmed that taking PPI's may lead to gut dysbiosis which is an imbalance in gut bacteria.

This first study from Poland looked at the effects of Omeprazole treatment on gut microflora. It started by saying that PPI's may increase the risk of Clostridium difficile infections and that there was interactions between microflora & neutrophil function.

In the study of 50 patients, half were given 20mg of Omeprazole for twice per day for 4-weeks and another half were given a lower dose. Stool culture tests, lactulose hydrogen breath test and neutrophil function were monitored. 

The results were clear that those who took the 20mg dose of Omeprazole had a decreased diversity of microflora in the stool test results. Neutrophil & C. Difficile were unchanged but it's unclear why gut flora was changed.

This second study from Japan in 2018 also started by saying that problems associated PPI's have started to surface. This Japanese study gave 20 patients diagnosed with reflux esophagitis 8-weeks of PPI treatment.

The blood and stool test results showed that gut dysbiosis was caused by the PPI usage. The study is conflicting however because while there was a change in gut bacteria, the study says that Lactobacillus & Streptococcus bacteria were both increased and not decreased. My interpretation of that is while gut bacteria was altered it wasn't in a bad way. Clearly more studies are needed.

Is Omeprazole Bad For You?

Short-term usage of Omeprazole usually doesn't cause major problems but may cause side effects like headaches, nausea, vomitting, diarrhea, stomach pain, constipation and gas.

Probiotics may help with a lot of these symptoms if you take them together. The long-term side effects of Omeprazole sound a little bit more worrying. 

They include bone fractures, C. Diff infections, Gut Infections, Red tongue, Mouth Ulcers and Pins & needles. If you experience any side effects from Omeprazole discontinue use and consult with a Doctor asap.

What Not To Take With Omeprazole


Omeprazole Capsules

You should consult with your Doctor to check what medications may interact with how Omeprazole works. The following may effect how well Omeprazole works.

  • Diazepam
  • Clozapine
  • Oral Iron Supplements
  • Some Multi-vitamins
  • Indinavir
  • Atazanavirelfinavir
  • Clopidogrel
  • Posaconazole
  • Itraconazole

Probiotics are a food supplement and not a pharmacokinetics so they are not included. This is not a full list so you must consult with your doctor if you are taking any medications like IBgard for example. These medicines may effect how much acid is produced in your body.

Final Thoughts

This guide has proved that you can take both Omeprazole and Probiotic's together. Because PPI's can alter your gut bacteria it may be a good idea to take probiotic's along with your PPI's.

When PPI's reduce the amount of stomach acid it may even make it easier for the probiotic bacteria to survive the journey deep into your colon.

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