Based on NIH | Do people taking omeprazole need to be cautious about the amount of broccoli or broccoli extract they consume, and is there any need to adjust the omeprazole dose?

People taking omeprazole generally do not need to avoid normal amounts of broccoli or typical broccoli-containing foods, and routine dose adjustments of omeprazole are not recommended based on broccoli intake alone. Omeprazole’s officially recognized interactions focus on other prescription medications and on pH‑dependent absorption effects, not on foods like broccoli or cruciferous vegetables. ^[1] Omeprazole can alter the absorption of certain drugs by raising stomach pH and can inhibit the enzyme CYP2C19, but food interactions with broccoli are not listed among clinically significant concerns in standard prescribing information. ^[1]

What we know about omeprazole interactions

• Omeprazole increases gastric pH, which can reduce absorption of medicines that need acid to dissolve (for example, certain antifungals and some cancer drugs). This is a drug–drug and pH effect, not a food issue. ^{[2] [1]}
• Omeprazole is a time‑dependent inhibitor of CYP2C19, which can raise levels of some CYP2C19‑substrate medicines; this is relevant when combining with drugs like clopidogrel or others with narrow therapeutic windows. Again, this is about medications, not vegetables. ^[1]

What we know about broccoli and sulforaphane

Broccoli and broccoli sprouts contain isothiocyanates such as sulforaphane, which can influence drug‑metabolizing enzymes in laboratory and animal studies. Reviews note that sulforaphane may inhibit or induce certain drug metabolism pathways and transporters, which in theory could affect how some drugs are processed. However, these effects are largely based on preclinical or mechanistic data, and clinical significance at dietary intake levels remains uncertain. ^[3]
In a rat study using kale (another crucifer), repeated intake appeared to inhibit several CYP enzymes and increased exposure to probe drugs, including a trend toward higher omeprazole levels; this suggests possible competition at CYP enzymes but was not a human study and used high doses. These animal findings do not directly translate into clinical guidance for people eating normal portions of cruciferous vegetables. ^[4]

Clinical guidance for broccoli with omeprazole

• There is no established, clinically confirmed interaction between eating broccoli and the efficacy or safety of omeprazole at usual dietary amounts. Major drug labels and clinical references do not advise avoiding broccoli or adjusting omeprazole because of cruciferous vegetables. ^[1]
• If you take high‑dose broccoli sprout or sulforaphane supplements, theoretical interactions with drug metabolism are possible based on mechanistic research; however, robust human data confirming a need to change omeprazole dosing are lacking. Any supplement use should be discussed with a clinician if you take multiple medications or have complex conditions. ^[3]

When dose adjustments might be considered

• Omeprazole dose adjustments are typically driven by symptom control (e.g., reflux persistence), treatment indication, duration limits, or interactions with specific medications (such as drugs affected by CYP2C19 or by gastric pH), not by usual dietary patterns. Broccoli intake does not appear among recognized reasons to change dosing. ^[1]
• If someone begins a high‑potency cruciferous supplement and notices unexpected changes like increased side effects from other medicines or altered acid‑control clinical evaluation is reasonable; any dose decision should be individualized and based on symptoms and, if needed, drug levels or alternative therapy selection. There is no standard recommendation to preemptively adjust omeprazole for broccoli products. ^{[1] [3]}

Practical tips

• Continue eating normal servings of broccoli and other cruciferous vegetables as part of a balanced diet; these are generally safe with omeprazole. No routine restrictions are necessary at food-level intake. ^[1]
• Be cautious with concentrated broccoli sprout/sulforaphane supplements if you take many medications, especially those with narrow therapeutic ranges, and consult your clinician or pharmacist. Evidence for a significant interaction with omeprazole specifically is limited, but prudence with supplements is sensible. ^[3]
• Monitor your symptom control: if heartburn or reflux worsens or improves markedly after starting any new supplement, discuss with your clinician rather than adjusting omeprazole on your own. Dose changes should be guided by clinical response and known drug interactions, not by typical vegetable intake. ^[1]

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Bottom line

• Broccoli in normal dietary amounts does not require caution with omeprazole, and there is no evidence‑based need to adjust the omeprazole dose because of broccoli. ^[1]
• Concentrated broccoli sprout/sulforaphane supplements have theoretical enzyme effects, but current human data are insufficient to recommend omeprazole dose changes; consult a clinician if using such supplements. ^[3]