If you take omeprazole for acid reflux, you’re probably only worried about whether it’s keeping your heartburn under control.
But recent headlines have linked the medication to osteoporosis and bone fractures, especially in people who take it for years.
So how worried should you be?
“Omeprazole is a very effective treatment for reflux and ulcers,” says Daniel Mark Helburn, MD, a gastroenterologist with PACT Gastroenterology Center and Hartford HealthCare’s Digestive Health Institute. “When patients hear about long-term risks, it’s completely reasonable to want to understand what that means for them.”
Here’s what the research says about omeprazole, osteoporosis and whether you should be concerned.
Understanding omeprazole and osteoporosis
Omeprazole (Prilosec) belongs to a group of medications called proton pump inhibitors (PPIs). It works by lowering the amount of acid your stomach makes, which helps treat conditions like GERD, ulcers and inflammation in the esophagus.
Osteoporosis is a condition where bones become thinner and more fragile over time, increasing the risk of fractures, especially in the hip, spine and wrist.
“Osteoporosis is extremely common as we get older,” says Dr. Helburn. “So, when we look at medication risks, we have to separate what’s due to aging from what’s truly medication related.”
> Related: Why Omeprazole Isn’t Stopping Your Heartburn Anymore
Does omeprazole increase your risk of osteoporosis?
Some large studies found that people taking PPIs long-term appeared to have a slightly higher risk of fractures. That’s why the FDA added a warning about possible fracture risks with high-dose or long-term use.
But that doesn’t necessarily mean omeprazole is causing osteoporosis.
“These studies show an association, not proof of cause,” says Dr. Helburn. “Many patients taking PPIs are already at higher risk, which makes it harder to know what’s really driving that risk.”
And the research isn’t entirely consistent. Some studies show a small increase in fracture risk, while others show no meaningful change in bone density.
“Even in studies that show an increase, the absolute risk is small,” says Dr. Helburn. “For most patients, the benefits of treating reflux or preventing ulcers outweigh that potential risk.”
> Related: 6 Osteoporosis Risk Factors You Should Know
Why omeprazole might affect your bones
One possible explanation has to do with calcium.
Stomach acid helps your body absorb certain forms of calcium, so researchers have questioned whether reducing stomach acid over time could affect bone health.
“The mechanism makes sense biologically,” says Dr. Helburn. “But when we look at the data, the overall impact appears to be small.”
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Should you stop taking omeprazole
For many people, stopping omeprazole isn’t the right move, especially not without talking to their doctor.
“The medication plays an important role in controlling symptoms and preventing complications,” says Dr. Helburn. “Stopping abruptly can lead to rebound symptoms, and untreated reflux can cause its own problems.”
Instead, talk to your doctor about whether you still need the medication every day and if you’re taking the lowest effective dose.
> Related: Is It Safe to Take Heartburn Medication Long-Term?
How to protect your bone healt while taking omeprazole
If you’re worried about osteoporosis, there are steps you can take to keep your bones healthy, regardless of which medications you use:
- Get enough calcium, ideally through food.
- Keep your vitamin D levels in a healthy range.
- Do weight-bearing and strength exercises.
- Avoid smoking.
- Limit excess alcohol.
If you’re at higher risk, your doctor may recommend a bone density test based on standard screening guidelines, not just because you take a PPI.
> Related: What You Need to Know About Bone Density Scans
Talk to your doctor about long-term omeprazole use
Taking omeprazole for years doesn’t automatically mean you’re damaging your bones.
While some studies suggest a slightly higher fracture risk with long-term use, that doesn’t prove the medication causes osteoporosis.
“The key is thoughtful use,” says Dr. Helburn. “We don’t want patients afraid of a medication that may be protecting them from more serious complications. If you’re not sure whether you need it, let’s talk about it.”
