Based on NIH | Does taking ginger or ginger supplements increase the risk of side effects or interactions when used with omeprazole?

Short answer

Based on available evidence, ginger (as food or typical over‑the‑counter supplements) does not have a known direct, clinically proven interaction with omeprazole, and most people can use them together without problems. ^[1] However, ginger can affect blood clotting and may increase bleeding risk when combined with blood thinners or NSAIDs, and omeprazole changes stomach acidity and the absorption of certain medications; these broader effects may matter depending on your full medication list and health status. ^{[2] [3] [4]}

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How omeprazole interacts with other substances

• Omeprazole lowers stomach acid, which can reduce or increase the absorption of certain drugs (for example, it can decrease absorption of ketoconazole or iron and increase digoxin). ^[4] It also interacts with medicines metabolized by liver enzymes and transporters (notably CYP2C19 and P‑gp), with well‑documented interactions involving clopidogrel, methotrexate, certain antivirals, antifungals, and some antibiotics. ^[5] Labels advise discussing all vitamins and herbal supplements because some herbs (e.g., St. John’s wort) can alter omeprazole levels or effects. ^{[1] [6]}

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What is known about ginger

• Ginger is widely used for nausea and digestive comfort, and is generally well tolerated, but it can inhibit platelet aggregation and has case reports of increased bleeding, particularly when combined with anticoagulants or antiplatelet drugs. ^{[2] [7]} It is commonly advised to stop ginger supplements two weeks before surgery and avoid them in bleeding disorders. ^{[3] [8]} Ginger may also have additive effects with NSAIDs on bleeding risk. ^[9]

• Laboratory work suggests ginger extracts can inhibit certain liver enzymes, including CYP2C19, in vitro; however, clinical relevance to typical oral doses remains unclear and conflicting modeling suggests variable risk across CYPs, with higher concern for CYP3A4/2C9 than for CYP2C19 in real‑world use. ^{[10] [11]}

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Ginger with omeprazole: interaction assessment

• There is no established clinical interaction where ginger reliably increases omeprazole side effects or alters its efficacy. ^[1] Comprehensive reviews of omeprazole drug–drug interactions highlight many prescription agents and some herbs (like St. John’s wort), but do not list ginger as a confirmed interaction. ^[5]

• Theoretical considerations:

  • If ginger were to meaningfully inhibit CYP2C19 in vivo, omeprazole levels could rise, but human data are lacking and modeling suggests low risk for CYP2C19 at typical intake. ^{[10] [11]}
  • Omeprazole’s acid suppression may modestly alter absorption of some compounds, but ginger’s active constituents are generally absorbed across a range of pH, and no clinical evidence shows reduced or increased ginger effects with PPIs. ^{[5] [4]}

• Practical takeaway: In people not taking blood thinners or NSAIDs, and without bleeding disorders, combining standard doses of ginger (food or common supplements) with omeprazole appears acceptable. ^{[2] [9]} If you use anticoagulants, antiplatelets, or routine NSAIDs, the bleeding risk from ginger not omeprazole becomes the primary concern. ^{[2] [7]}

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Safety tips if you take both

• Keep ginger doses moderate (e.g., typical supplement range) and monitor for unusual bruising, nosebleeds, or black stools; stop and seek care if these occur. ^{[2] [7]}
• Review all medications: if you take warfarin, direct oral anticoagulants (e.g., apixaban, rivaroxaban, dabigatran), clopidogrel, or daily NSAIDs, consider avoiding ginger supplements and discuss with your clinician. ^{[2] [9]}
• Inform your clinician and pharmacist about all herbs and supplements; omeprazole labeling specifically advises this because herbal products can change drug effects. ^{[1] [6]}
• Time of dosing generally does not need adjustment for ginger relative to omeprazole, since no absorption interaction is proven; take omeprazole 30–60 minutes before meals as directed, and ginger as needed for nausea or digestive support. ^[5]

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Who should be more cautious

• People with bleeding disorders or upcoming surgery should avoid ginger supplements due to bleeding risk, regardless of omeprazole use. ^{[3] [8]}
• Individuals on complex regimens with known omeprazole interactions (e.g., clopidogrel, certain antivirals or antifungals) should minimize additional variables like new supplements until medications are reviewed. ^[5] Labels also specifically call out St. John’s wort and rifampin because they can reduce omeprazole’s effect; while ginger is not listed, the general caution applies. ^{[1] [6]}

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Bottom line

• Current evidence does not show a direct, clinically confirmed interaction between ginger and omeprazole. ^[1] Most users can take both without increased side effects from omeprazole. ^[5] The main risk to consider is ginger’s potential to increase bleeding when combined with blood thinners or NSAIDs; this is independent of omeprazole but important for overall safety. ^{[2] [9]} If you have a bleeding risk, are on anticoagulants/antiplatelets, or plan surgery, avoid ginger supplements and speak with your clinician. ^{[3] [7]}