Based on NIH | Is it safe to take omeprazole every day if I eat fish or take fish oil supplements daily?

Taking omeprazole daily is generally considered compatible with eating fish and with typical daily fish oil (omega‑3) supplements, and there is no well‑documented direct interaction between omeprazole and fish oil supplements. Official product information for omeprazole highlights interactions with certain prescription drugs (for example, some antibiotics, clopidogrel, methotrexate, St. John’s wort, rifampin, and certain HIV medicines), but it does not list fish oil as a known interaction. ^{[1] [2]} In other words, most people can use standard doses of fish oil while taking omeprazole without a specific interaction risk. ^{[3] [4]}

What omeprazole interacts with

• Medications of concern: Product labeling advises special caution with drugs such as clarithromycin/amoxicillin combinations, clopidogrel, methotrexate, St. John’s wort, rifampin, and certain antivirals, because omeprazole can change how these drugs work. ^{[1] [2]}
• Supplements/herbals: The label advises discussing vitamins and herbal supplements with your clinician, but does not name fish oil as a problem item. This implies that fish oil is not a commonly recognized interaction with omeprazole. ^{[3] [5]}

Fish oil safety in general

• Typical doses are usually safe: When taken as recommended, fish oil supplements are generally considered safe, though they can cause mild side effects like fishy aftertaste, heartburn, nausea, or diarrhea. At high doses, fish oil may increase bleeding risk. ^{[6] [6]}

Long‑term omeprazole use: what to know

• Overall safety: Proton pump inhibitors (PPIs) such as omeprazole are widely used and have a strong safety record when taken for appropriate reasons, though long‑term use should be reviewed periodically. Serious adverse events are rare, and long‑term omeprazole has generally been well tolerated in studies. ^{[7] [8]}
• Potential long‑term considerations: Extended PPI use has been linked in some studies to issues such as low magnesium, vitamin B12 and iron absorption changes, fundic gland polyps (often benign), and a small increase in some infections; many of these associations are debated and may depend on individual risk. Clinicians often recommend using the lowest effective dose and reassessing the need for ongoing daily therapy. ^{[9] [10]}

Practical guidance if you take both

• Standard fish oil with omeprazole is typically acceptable: There is no established direct interaction between omeprazole and omega‑3 supplements. If you are taking high‑dose fish oil (for example, well above typical OTC amounts) or blood‑thinning medications, speak with your clinician due to fish oil’s potential bleeding effect. ^[6]
• Watch for stomach symptoms: Both fish oil and omeprazole can affect the digestive tract in different ways; fish oil may cause heartburn or indigestion in some people. If heartburn worsens after starting fish oil, try taking fish oil with meals, dividing the dose, using enteric‑coated capsules, or adjusting timing. ^[6]
• Medication check‑in: Make sure any other medicines you take do not have known issues with omeprazole as outlined above. If you take clopidogrel, certain antivirals, methotrexate, rifampin, or St. John’s wort, review this with your clinician or pharmacist. ^{[1] [2]}

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Quick reference table

Topic	Key point	Why it matters
Direct interaction: omeprazole + fish oil	No established interaction	Omeprazole labeling lists many drugs of concern but not fish oil. [1] [2]
Fish oil side effects	Fishy taste, heartburn, nausea, diarrhea; bleeding risk at high doses	Helps interpret new symptoms and plan dosing. [6]
Omeprazole long‑term safety	Generally safe when indicated; rare serious events	Supports continued use with periodic reassessment. [7] [8]
Nutrient absorption with PPIs	Possible effects on vitamin B12, iron, magnesium over long periods	May prompt occasional lab checks in long‑term users. [9] [10]
Key drug interactions with omeprazole	Clopidogrel, certain antibiotics, methotrexate, rifampin, St. John’s wort, some antivirals	Ensures safe co‑prescribing. [1] [2]

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Bottom line

• For most people, taking daily omeprazole alongside eating fish or using standard‑dose fish oil supplements is considered safe, with no specific interaction identified. ^{[1] [2]}
• Focus on the basics: use fish oil within recommended doses to minimize bleeding risk and stomach upset, and periodically review the need for daily omeprazole with your clinician, especially if you have been on it long term. ^{[6] [9]}

If you’d like, I can help you review your exact fish oil dose and other medications to spot any personalized risks.