Based on PubMed | Do avocados interact with omeprazole in a way that requires dosage caution or adjustment?

There is no known interaction between avocados and omeprazole that requires dose changes or special precautions for most people. Omeprazole’s absorption can be influenced by the presence of food in general (slower rate, and sometimes slightly lower exposure), but avocados themselves do not have a documented, clinically meaningful interaction with omeprazole. ^{[1] [2]}

What we know about omeprazole and food

• Omeprazole is designed to be absorbed best when the stomach is relatively empty. Taking enteric‑coated omeprazole before a meal leads to more reliable absorption, whereas taking it with food tends to slow absorption and may modestly reduce exposure. ^{[1] [2]}
• These food effects are not specific to any single food item; they are general meal effects seen with both immediate‑release and delayed‑release formulations. Studies show lower peak levels (Cmax) and sometimes reduced overall exposure (AUC) when omeprazole is taken with food, compared with fasting. ^{[2] [1]}
• Product labeling for delayed‑release omeprazole notes that certain soft foods used to sprinkle granules (like applesauce) can change the peak level for some capsule strengths, though the total exposure often remains similar; the recommendation remains to take it before meals for consistent effect. This guidance is about timing and formulation, not about avocados specifically. ^{[3] [4]}

Avocados and common drug‑interaction concerns

• Tyramine interactions are a concern with MAO inhibitor antidepressants, not with omeprazole. Only overripe avocados are mentioned in MAOI dietary cautions due to higher tyramine; this does not apply to omeprazole, which is not an MAOI. ^{[5] [6]}
• CYP3A4 or CYP2C19 food interactions are not established with avocados. Omeprazole is mainly metabolized by CYP2C19 and CYP3A4, but there is no evidence that avocados inhibit or induce these enzymes in a way that affects omeprazole dosing. ^{[7] [8]}

Practical guidance

• Timing: Take omeprazole 30–60 minutes before the first meal of the day for best acid suppression. This helps avoid the general “with food” reduction in rate and extent of absorption. ^{[1] [2]}
• Eating avocados: You can eat avocados as part of your usual diet without changing your omeprazole dose. There is no evidence that normal avocado intake alters the effect of omeprazole in a clinically important way. ^{[2] [1]}
• Special cases: If you take omeprazole sprinkled on soft food per capsule instructions, follow the exact directions for the specified foods (commonly applesauce) because different textures/acidity can change peak levels for some strengths, though overall exposure generally stays similar. ^{[3] [4]}

When to consider adjustments (not avocado‑related)

• Other medications can meaningfully interact with omeprazole (for example, clopidogrel, certain antifungals, some antiretrovirals, high‑dose methotrexate, and digoxin). These interactions are due to enzyme or transporter effects or gastric pH–dependent absorption and may warrant monitoring or therapy changes unrelated to avocado consumption. ^{[7] [8]}
• If heartburn control is inconsistent, ensure correct timing before meals and consistent day‑to‑day use before considering dose changes. Food timing has a larger effect than specific foods like avocados. ^{[1] [2]}

Bottom line

• Avocados do not have a specific, proven interaction with omeprazole that requires dosage caution or adjustment. The main consideration is to take omeprazole before meals for optimal and consistent absorption, regardless of whether your meal includes avocado. ^{[2] [1]}