Prilosec with antibiotics: interactions and safety
Antibiotic courses are common, short-term and often combined with chronic medications such as Prilosec (Omeprazole). Most antibiotics do not interfere meaningfully with Omeprazole at 10mg, 20mg, 40mg, but a few classes do, and a small number of combinations are best avoided.
Common antibiotic interactions
Macrolides (clarithromycin, erythromycin) and certain antifungals can inhibit hepatic metabolism (CYP3A4) and raise plasma levels of many medications including some Gastrointestinal Medications agents. Rifampicin has the opposite effect, accelerating metabolism. Most penicillins, cephalosporins, fluoroquinolones and tetracyclines have no clinically meaningful interaction with Omeprazole at 10mg, 20mg, 40mg.
Practical guidance
According to the prescribing information for Omeprazole, an antibiotic course should be reviewed by the prescriber or pharmacist for known interactions before Prilosec is co-administered. Adjusted 10mg, 20mg, 40mg dosing or temporary substitution is sometimes preferred for the duration of the antibiotic course.
Frequently asked questions
Can I take Prilosec during an antibiotic course? ▾
For most common antibiotics, yes. A few classes — notably macrolides and azole antifungals — alter how Omeprazole is metabolised and may need a temporary 10mg, 20mg, 40mg adjustment. The prescribing pharmacist should review any new antibiotic against the existing Prilosec regimen.
Will antibiotics make Prilosec stop working? ▾
Most antibiotics do not affect Prilosec efficacy. Rifampicin and a few others can lower Omeprazole levels and reduce effect; in those cases the prescriber may adjust the dose during and shortly after the antibiotic course.
More on Prilosec
- With alcoholPrilosec and alcohol — is it safe to drink?
- With foodShould Prilosec be taken with food?
- Side effectsPrilosec side effects: common, rare and warning signs
- Dosage guidePrilosec dosage guide: how much to take and when
- OnsetHow fast does Prilosec start working?
- DurationHow long does Prilosec last?
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