Can I take Omeprazole and Sertraline together?

You can take omeprazole and sertraline together but with caution. Combining them can increase the risk of sertraline side effects and in rare cases, cause serotonin syndrome.

Why this happens

Sertraline is broken down in the liver by certain proteins (enzymes). Omeprazole can slow down these proteins, which means the sertraline stays in your body longer and reaches higher levels than intended. Additionally, both medicines can individually increase the risk of bleeding, so taking them together adds to this risk.

You may experiencing an interaction between omeprazole and sertraline if you notice symptoms such as:

• Feeling more anxious.

• Feeling shaky.

• Feeling generally unwell.

• High body temperature.

• Sweating.

• Confusion.

• If you notice any unusual bruising or bleeding.

If you notice you are feeling more anxious, shaky, or unwell after starting omeprazole, speak to your doctor. They may suggest a lower dose of sertraline or a different type of indigestion medicine (such as famotidine or lansoprazole) that is less likely to interfere.

Depression and anxiety disorders

You may experience an increase in suicidal thoughts or the urge to self-harm when first starting sertraline or changing the dose. This is more common in young adults under 25. Contact your doctor or go to hospital immediately if you notice any changes in your mood or behaviour.

Serotonin Syndrome

Sertraline can cause a life-threatening reaction if combined with other serotonergic drugs (such as St John's Wort, tramadol, or certain migraine medications). Seek immediate help if you experience extreme agitation, confusion, rapid heartbeat, or muscle twitching.

Increased bleeding risk

Taking these medicines together increases your risk of internal bleeding, particularly in the stomach. Omeprazole can mask the symptoms of a stomach ulcer, and sertraline affects how your blood clots. Seek urgent medical help if you vomit blood or pass black, tarry stools.

Low sodium (Hyponatraemia)

Sertraline can cause the level of sodium in your blood to drop dangerously low, especially in elderly patients. This can cause severe confusion, fits, or falls. Omeprazole can also contribute to low mineral levels if used long-term.

Severe diarrhoea

Contact your doctor immediately if you develop severe or persistent watery diarrhoea, as omeprazole can increase the risk of a serious bowel infection called Clostridium difficile.

Vitamin B12 deficiency

Long-term use of omeprazole can prevent your body from absorbing Vitamin B12 properly, which may lead to nerve damage or anaemia.

Lupus (SLE)

Seek medical advice if you develop a skin rash, especially in areas exposed to the sun, as omeprazole can trigger or worsen a rare autoimmune condition called Subacute Cutaneous Lupus Erythematosus.

Alcohol

It is best to avoid or strictly limit alcohol while taking sertraline. Combining alcohol with this medicine can increase the risk of side effects like drowsiness, dizziness, and impaired coordination. It may also worsen the symptoms of depression or anxiety.

It is best to avoid or strictly limit alcohol while taking omeprazole. Alcohol can increase the amount of acid your stomach produces, which may worsen your symptoms or make the medicine less effective. Additionally, both alcohol and omeprazole can irritate the stomach lining.

Grapefruit juice

You should avoid drinking large amounts of grapefruit juice while taking sertraline. Grapefruit can increase the levels of sertraline in your blood, which may increase the risk of side effects.

Caffeine (Coffee, Tea, Energy Drinks)

You may need to limit your caffeine intake. Sertraline can sometimes make you feel restless or anxious, and caffeine can worsen these feelings. Additionally, some people find that sertraline affects their sleep; caffeine can further disrupt your sleep patterns.

General Food Timing

Omeprazole works best if you take it 30 to 60 minutes before a meal, preferably breakfast. Taking it with food can slow down how quickly the medicine starts to work.

Taking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.

Disclaimer

This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.