Based on NIH | Can omeprazole cause numbness or tingling in the hands or feet, and what should I do if I notice this side effect?

Yes omeprazole can be associated with numbness or tingling (paresthesia) in the hands or feet, although this is uncommon. ^{[1] [2]} These sensations may occur as a direct neurological side effect listed in product labeling, and they can also result indirectly from low magnesium or low vitamin B12 levels that sometimes develop with longer-term proton pump inhibitor (PPI) use. ^{[1] [3]}

How omeprazole might cause tingling

• Direct nervous system effect: Paresthesia is included among reported nervous system side effects for omeprazole in official labeling. ^{[1] [2]}
• Low magnesium (hypomagnesemia): PPIs can reduce intestinal magnesium absorption after at least several months of therapy, which may lead to neurologic symptoms such as tingling, muscle cramps, tremors, or even more serious issues like seizures or abnormal heart rhythms. ^{[4] [5]}
• Low vitamin B12: Long-term acid suppression can, in some people, contribute to vitamin B12 deficiency, which may cause numbness or tingling in the arms and legs. ^{[6] [7]}

How common is this?

Paresthesia is considered an infrequent adverse effect, and clinically significant hypomagnesemia is described as rare, usually after at least 3 months (often after a year or more) of continuous PPI therapy. ^{[1] [4]} Most people taking omeprazole do not develop these problems, but they are important to recognize because they are reversible when addressed. ^{[4] [8]}

Warning signs to watch for

• New or worsening numbness, tingling, “pins and needles,” muscle cramps, tremors, or weakness may suggest a mineral deficiency. ^{[5] [4]}
• More urgent symptoms such as palpitations, dizziness, fainting, seizures, or spasms can indicate significant hypomagnesemia and need prompt medical care. ^{[4] [9]}

What to do if you notice tingling

1. Do not stop treatment abruptly without guidance if you are taking omeprazole for a diagnosed condition, but contact your clinician soon to discuss symptoms. Early evaluation helps distinguish medication effects from other causes like diabetes, nerve compression, or vitamin deficiencies. ^[4]
2. Ask about simple blood tests: serum magnesium, calcium, potassium, and vitamin B12 are reasonable first checks, especially if you have taken a PPI for 3 months or longer or use other drugs that lower magnesium (e.g., diuretics) or digoxin. ^{[4] [10]}
3. Consider medication adjustments with your clinician: Depending on results and your acid-related condition, options may include dose reduction, switching to an H2 blocker, adding on-demand rather than continuous therapy, or stopping the PPI if appropriate. Tingling related to hypomagnesemia often improves after magnesium repletion and discontinuation of the PPI. ^{[4] [11]}
4. Replace deficiencies when present: Magnesium supplementation is typically required for hypomagnesemia and is more effective when the PPI is discontinued; B12 deficiency can be treated with oral or injectable cobalamin. ^{[4] [6]}
5. Seek urgent care for red flags: Severe dizziness, fainting, chest fluttering, seizures, or tetany (muscle spasms) warrant emergency evaluation. ^[4]

Who is at higher risk?

• Long-term PPI users (≥3 months; risk often increases after a year). ^[4]
• People also taking diuretics or digoxin. ^[4]
• Older adults or those with malabsorption risks, which can heighten the chance of B12 deficiency. ^{[6] [4]}

Practical prevention tips

• Use the lowest effective dose for the shortest necessary time; periodically reassess the need for a daily PPI. ^[4]
• If prolonged therapy is expected, your clinician may consider checking magnesium before starting and then periodically, especially if you take diuretics or digoxin. ^{[4] [10]}
• Discuss lifestyle measures that can reduce reflux and possibly allow step-down therapy: weight optimization, avoiding late meals, limiting trigger foods, elevating the head of the bed, and moderating alcohol and tobacco. (General advice; no citation required)

Quick reference table

Issue	What it is	When it happens	Typical symptoms	What helps
Direct paresthesia side effect	Neurologic adverse effect listed in labeling	Any time, uncommon	Tingling, pins-and-needles	Assess medications; consider dose change or switch with clinician. [1] [2]
Hypomagnesemia from PPIs	Low magnesium due to reduced absorption	Usually ≥3 months (often longer)	Tingling, cramps, weakness, tremor, seizures, arrhythmias	Check magnesium; replace magnesium; often discontinue PPI; monitor electrolytes. [4] [5]
Vitamin B12 deficiency	Reduced B12 absorption with long-term acid suppression	Long-term use	Numbness/tingling, fatigue, pale skin, mood changes	Check B12; supplement; reassess need for chronic PPI. [6] [7]

Bottom line

• Numbness or tingling while taking omeprazole is uncommon but can occur as a direct side effect or due to low magnesium or B12 with longer use. ^{[1] [4]}
• These problems are usually reversible with timely evaluation, correction of deficiencies, and, when needed, changing or discontinuing the PPI. ^{[4] [11]}
• If you notice persistent tingling, it’s reasonable to contact your clinician, ask about checking magnesium and B12, and review whether your current PPI dose and duration are still necessary. ^[4]