Lansoprazole is a “proton pump inhibitor” drug that blocks production of stomach acid. Lansoprazole is used to treat diseases in which stomach acid causes damage, including stomach and duodenal ulcers, esophagitis, and Zollinger-Ellison syndrome.
Folic acid is needed by the body to utilize vitamin B12. Antacids, including lansoprazole, inhibit folic acid absorption.1 People taking antacids are advised to supplement with folic acid.
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.2 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.
Omeprazole, a drug closely related to lansoprazole, has interfered with the absorption of vitamin B12 from food (though not supplements) in some,6 , 7 but not all, studies.8 , 9 This interaction has not yet been reported with lansoprazole. However, a fall in vitamin B12 status may result from decreased stomach acid caused by acid blocking drugs, including lansoprazole.10
Omeprazole was shown to reduce protein-bound vitamin B12 absorption and cranberry (Vaccinium macrocarpon) juice was shown to increase protein-bound vitamin B12 absorption in eight people treated with omeprazole (a drug closely related to lansoprazole).11 While this effect has not been studied with lansoprazole, people taking lansoprazole may choose to drink cranberry juice or other acidic liquids with vitamin B12-containing foods. Unlike vitamin B12 found in food, vitamin B12 found in supplements is not bound to peptides (pieces of protein). The absorption of B12 supplements therefore does not require acid and is unlikely to be improved by drinking cranberry juice.
1. Russell RM, Golner BB, Krasinski SD, et al. Effect of antacid and H2 receptor antagonists on the intestinal absorption of folic acid. J Lab Clin Med 1988;112:458-63.
2. Tang G, Serfaty-Lacronsniere C, Camilo ME, Russell RM. Gastric acidity influences the blood response to a beta-carotene dose in humans. Am J Clin Nutr 1996;64:622-6.
3. Regolisti G, Cabassi A, Parenti E, et al. Severe hypomagnesemia during long-term treatment with a proton pump inhibitor. Am J Kidney Dis 2010;56:168-74.
4. Gau JT, Yang YX, Chen R, Kao TC. Uses of proton pump inhibitors and hypomagnesemia. Pharmacoepidemiol Drug Saf 2012;21:553-9.
5. U.S. Food and Drug Administration. FDA Drug Safety Communication: Low magnesium levels can be associated with long-term use of Proton Pump Inhibitor drugs (PPIs). U.S. Food and Drug Administration Web site. Accessed at http://www.fda.gov/drugs/drugsafety/ucm245011.htm#Additional_Information_for_Patients on September 13, 2011
6. Marcuard SP, Albernaz L, Khazanie PG. Omeprazole therapy causes malabsorption of cyanocobalamin (Vitamin B12). Ann Intern Med 1994;120:211-5.
7. Termanini B, Gibril F, Sutliff VE, et al. Effect of long-term gastric acid suppressive therapy on serum vitamin B12 levels in patients with Zollinger-Ellison syndrome. Am J Med 1998;104:422-30.
8. Koop H, Bachem MG. Serum iron, ferritin, and vitamin B12 during prolonged omeprazole therapy. J Clin Gastroenterol 1992;14:288-92.
9. Schenk BE, Festen HP, Kuipers EJ, et al. Effect of short-and long-term treatment with omeprazole on the absorption and serum levels of cobalamin. Aliment Pharmacol Ther 1996;10:541-5.
10. Saltzman JR, Kemp JA, Golner BB, et al. Effect of hypochlorhydria due to omeprazole treatment or atrophic gastritis on protein-bound vitamin B12 absorption. J Am Coll Nutr 1994;13:584-91.
11. Saltzman JR, Kemp JA, Golner BB, et al. Effect of hypochlorhydria due to omeprazole treatment or atrophic gastritis on protein-bound vitamin B12 absorption. J Am Coll Nutr 1994;13:584-91.
Last Review: 04-29-2014
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