Iron oral (salts: sulfate, bisglycinate, fumarate, gluconate, polymaltose; heme iron polypeptide, lactoferrin) × Omeprazole
ModerateOral iron preparations; antianaemic agents×Proton pump inhibitors
Updated · Methodology
Mechanism
Non-heme iron needs an acid environment to convert from ferric to ferrous, the form the gut absorbs. NIH ODS states that proton pump inhibitors can potentially reduce iron absorption. The practical consequence: iron deficiency anaemia in someone taking omeprazole responds to oral treatment worse than expected.
Symptoms
Ferritin that rises little or not at all after 8–12 weeks of well-taken oral iron, with no bleeding to explain it.
Management
Take iron with vitamin C, which assists the conversion gastric acid no longer performs. Keep at least 2 hours between iron and the inhibitor. If ferritin is still flat at 12 weeks, reconsider the route: with documented malabsorption, intravenous iron achieves what oral cannot.
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Sources
- AEMPS: Ficha técnica Esomeprazol Cinfa 20 mg cápsulas gastrorresistentes EFG (2024)– AEMPS, CIMA, nº registro 82921, secciones 4.4 y 4.8
- NIH Office of Dietary Supplements: Iron – Health Professional Fact Sheet (2025)– NIH ODS, Iron, Interactions with Medications