Long-term users of omeprazole for acid reflux are being urged to watch for signs of low magnesium, a side effect that can cause fatigue, confusion, and dizziness. The warning comes from Raj Patel, known as the Straight-Talking Pharmacist on TikTok, where he has over 100,000 followers.
What is omeprazole and why is it used?
Omeprazole belongs to a class of drugs called proton pump inhibitors (PPIs), which work by reducing the amount of acid the stomach produces. It is commonly prescribed for heartburn and acid reflux, with some patients taking it for months or years.
In a video on long-term use, Mr Patel said: "Long term omeprazole use can lead to a drop in magnesium levels. This isn't just a minor issue, it can make you feel tired, confused and dizzy."
What the guidance says
UK medicines guidance supports this caution, noting that low magnesium has been documented in some people taking PPIs for three months or longer, though most reported cases occurred after a year of treatment. The Medicines and Healthcare products Regulatory Agency (MHRA) states symptoms can emerge gradually and may be missed.
Additional signs include muscle twitches, tremors, and an irregular heartbeat, according to the regulator. Mr Patel described these symptoms as "even more concerning".
Other potential risks
The pharmacist also highlighted vitamin B12 deficiency, which can be linked to prolonged use of acid-reducing medications. He explained: "Vitamin B12 deficiency is another silent attacker, creeping in with symptoms like extreme fatigue, a sore and red tongue, mouth ulcers and that unsettling feeling of pins and needles."
Other possible issues from extended PPI use include gut infections and a higher risk of bone fractures, especially in people with existing risk factors such as osteoporosis. Evidence on long-term risks varies, and reports suggesting a possible link between PPIs and stomach cancer do not prove the medicine causes the condition.
People taking omeprazole are advised not to panic or stop their medication without consulting a doctor, as it may be necessary to manage their condition. Anyone using it long term who experiences worrying symptoms should contact their GP, who can assess treatment and decide whether tests, including a blood test for magnesium, are needed.
