Based on NIH | Is it safe to eat nuts, such as almonds or peanuts, while taking omeprazole, or do they interact with the medication?

Eating nuts like almonds, peanuts, cashews, or walnuts is generally safe while taking omeprazole, and there is no evidence of a direct interaction between nuts and this medication. Omeprazole’s clinically relevant interactions are primarily with certain prescription drugs (for example, some HIV medicines, methotrexate, digoxin, and blood thinners) and with substances that affect stomach acidity or specific liver enzymes, rather than with common foods such as nuts. ^{[1] [2]}

What omeprazole interacts with

• Omeprazole lowers stomach acid and can change how certain medicines are absorbed if they need an acidic environment; examples include ketoconazole and some iron salts, while digoxin absorption can increase. ^[3]
• It can also affect drugs processed by the CYP2C19 enzyme (for example, clopidogrel and diazepam), and strong enzyme inducers like St. John’s wort or rifampin can reduce omeprazole levels. ^{[1] [4]}
• These well‑described interactions involve medications and certain supplements, not nuts or typical dietary proteins and fats. ^[1]

Food guidance with omeprazole

• Standard instructions are to take omeprazole before meals for best effect; antacids may be used if needed. There are no routine restrictions against nuts in official dosing instructions. ^[2]
• General heartburn tips sometimes suggest avoiding personal trigger foods such as fatty or fried items, chocolate, caffeine, alcohol, or certain acidic fruits if they worsen symptoms; this is about symptom control, not a medication interaction. ^[5]

Practical tips

• If high‑fat foods of any kind (including large portions of nuts or nut butters) tend to trigger your reflux symptoms, you might choose smaller portions or pair nuts with non‑fatty foods to see how you feel. This is individualized and not related to a drug–nut interaction.
• Keep taking omeprazole as directed (typically before a meal) and maintain a consistent routine to optimize acid control. ^[2]
• Always review your full medication and supplement list with your clinician or pharmacist, since clinically meaningful omeprazole interactions are medication‑specific. ^{[1] [2]}

Bottom line

• There is no known harmful interaction between omeprazole and nuts such as almonds or peanuts. ^[1]
• You can include nuts in your diet while on omeprazole, adjusting portions only if they personally aggravate reflux symptoms, not because of a medication interaction. ^{[5] [2]}