Based on NIH | Can omeprazole cause a skin rash, how common is it, and what should I do if I develop one?

Omeprazole can cause skin rashes, though most are uncommon and usually mild; very rare but serious skin reactions have been reported and require immediate medical attention. ^{[1] [2]}

How omeprazole can cause rashes

• Omeprazole (a proton pump inhibitor, or PPI) has been linked to hypersensitivity (allergic) skin reactions ranging from simple maculopapular rashes (flat/red bumps) and hives to severe reactions like Stevens‑Johnson syndrome, toxic epidermal necrolysis, DRESS, and AGEP. ^{[3] [2]}
• The official prescribing information warns that PPIs, including omeprazole, can cause rare but severe skin reactions that may be life‑threatening and may involve blistering, peeling, or bleeding of the skin, including on the lips, eyes, mouth, nose, genitals, hands, or feet. ^{[1] [4]}
• These severe reactions can also include symptoms like fever, chills, body aches, shortness of breath, or enlarged lymph nodes, which suggest a systemic reaction requiring urgent care. ^{[4] [5]}

How common is a rash from omeprazole?

• Cutaneous (skin) adverse reactions to PPIs are generally uncommon, with estimated prevalence ranging from about 3 to 20 cases per 100,000 treated people in observational data. ^[6]
• Among reported PPI‑related skin reactions in one case‑control series, most were attributed to omeprazole, and the most frequent type was a maculopapular rash. ^[6]
• Overall, serious reactions like Stevens‑Johnson syndrome, toxic epidermal necrolysis, and DRESS are considered very rare, but their severity warrants strong precautions. ^{[3] [2]}

What to do if you develop a rash

• If you notice any signs of a severe skin reaction such as blistering, peeling, widespread painful rash, mucosal involvement (mouth, eyes, genitals), or systemic symptoms like fever or breathing difficulty stop omeprazole immediately and seek urgent medical care or emergency evaluation. ^{[2] [4]}
• The drug label advises discontinuing omeprazole at the first signs or symptoms of severe cutaneous adverse reactions or other signs of hypersensitivity and pursuing further evaluation. ^{[2] [7]}
• For a mild, limited rash without systemic symptoms, it would still be reasonable to stop omeprazole and contact your clinician promptly the same day to discuss next steps, as ongoing exposure can worsen drug eruptions. ^[2]
• Over‑the‑counter drug facts labeling also advises stopping use and seeking medical help right away if an allergic reaction (including rash) occurs. ^{[8] [9]}

Possible next steps and alternatives

• Your clinician may confirm the likely cause based on timing, appearance of the rash, and other medications, and may recommend symptomatic treatment (for example, non‑sedating antihistamines for itch), if appropriate. ^[10]
• If acid suppression is still needed, a different class such as an H2 blocker (e.g., famotidine) may be considered while avoiding PPIs until a full assessment is made. ^[10]
• In situations where a PPI is essential, allergy evaluation (including carefully selected skin testing and/or graded challenge under specialist supervision) may be discussed; cross‑reactivity between different PPIs is variable, and some individuals can tolerate an alternative PPI, though this should be assessed by an allergy specialist. ^{[10] [6]}

Key warning signs to watch for

• Blistering, peeling, or bleeding skin; involvement of eyes, mouth, nose, genitals, hands, or feet. These are red flags for severe reactions. ^{[1] [4]}
• Fever, chills, malaise, swollen lymph nodes, shortness of breath. These systemic symptoms with a rash need urgent care. ^{[4] [5]}
• Rapidly spreading rash or painful skin. Stop the medication and seek immediate evaluation. ^[2]

Quick reference table

Topic	What to know	What to do
Can omeprazole cause rash?	Yes; ranges from mild rashes to very rare but serious reactions (SJS/TEN, DRESS, AGEP). [3] [2]	Be alert to skin changes while taking omeprazole. [2]
How common?	Overall uncommon; estimated 3–20 per 100,000 treated for PPI‑related skin reactions; maculopapular rash most frequent. [6]	Discuss risks if you’ve had prior drug allergies. [6]
Mild rash (no systemic signs)	Often presents as itchy red bumps or hives. [6] [3]	Stop omeprazole and contact your clinician promptly for advice. [2]
Severe reaction signs	Blistering/peeling skin, mucosal involvement, fever, chills, body aches, breathing issues, enlarged lymph nodes. [1] [4]	Stop immediately and seek emergency care. [2] [4]
Future acid control	Alternatives or specialist‑guided evaluation may allow safe options; cross‑reactivity among PPIs can vary. [10] [6]	Ask about H2 blockers or allergy referral if a PPI is required. [10]

Bottom line

• Skin rashes from omeprazole do occur but are uncommon, and the most serious reactions are very rare; however, because they can be life‑threatening, any severe rash or systemic symptoms should prompt immediate discontinuation and urgent medical care. ^{[6] [2]}
• For mild rashes without systemic features, stopping the drug and contacting your clinician the same day is generally advisable to prevent worsening and to plan safe alternatives. ^{[2] [10]}