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Some evidence indicates that other vitamins and minerals, such as folic acid and copper, require the presence of stomach acid for optimal absorption. Long-term use of H-2 blockers may therefore promote a deficiency of these nutrients. Individuals requiring long-term use of H-2 blockers may therefore benefit from a multiple vitamin/mineral supplement.
Stomach acid is needed for the vitamin B12 in food to be absorbed. H-2 blocker drugs reduce stomach acid and may therefore inhibit absorption of the vitamin B12 naturally present in food. However, the vitamin B12 found in supplements does not depend on stomach acid for absorption. Lab tests can determine vitamin B12 levels in people.
Omeprazole, a drug closely related to lansoprazole, taken for seven days led to a near-total loss of stomach acid in healthy people and interfered with the absorption of a single administration of 120 mg of beta-carotene. It is unknown whether repeated administration of beta-carotene would overcome this problem or if absorption of carotenoids from food would be impaired. Persons taking omeprazole and related acid-blocking drugs for long periods may want to have carotenoid blood levels checked, eat plenty of fruits and vegetables, and consider supplementing with carotenoids.
Stomach acid may increase absorption of iron from food. H-2 blocker drugs reduce stomach acid and are associated with decreased dietary iron absorption. The iron found in supplements is available to the body without the need for stomach acid. People with ulcers may be iron deficient due to blood loss. If iron deficiency is present, iron supplementation may be beneficial. Iron levels in the blood can be checked with lab tests.
In healthy people, a magnesium hydroxide/aluminum hydroxide antacid, taken with famotidine, decreased famotidine absorption by 20–25%. People can avoid this interaction by taking famotidine two hours before or after any aluminum/magnesium-containing antacids. Some magnesium supplements such as magnesium hydroxide are also antacids.
Last Review: 03-24-2015
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