Omeprazole and Kratom: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 2, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Kratom
No brand names on recordOmeprazole
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Here's what's going on. Kratom can slow down a liver enzyme called CYP3A, which is one of the ways your body breaks down omeprazole (Prilosec). If that enzyme works slower, more omeprazole can build up in your body than usual. This is more likely with higher kratom doses or if you use kratom regularly.
In practice, this could mean a bit more of omeprazole's usual effects or side effects, like headache or stomach upset. The good news is this is very manageable. Let your pharmacist or doctor know you use kratom so your care team can keep an eye on how you're doing and adjust things if needed.
Mechanism: Kratom is a probable CYP3A inhibitor. Omeprazole is partly metabolized by CYP3A4 (also CYP2C19), so concurrent kratom may reduce omeprazole clearance and increase its systemic exposure (AUC/Cmax).
- Direction: Increased omeprazole exposure (increases_drug_effect).
- Magnitude: Not quantified; dose- and duration-dependent (higher/chronic kratom = greater effect).
- Onset: Unspecified.
- Evidence: Probable.
Management: Neither agent is narrow-therapeutic-index, so risk is modest. Monitor for exacerbated omeprazole effects/adverse events; dose may be individualized by the care team. Document kratom use, which patients often omit.
What happens
Increased CYP3A substrate exposure
Interaction Deep Dive
Taking kratom (a CYP3A inhibitor) together with a CYP3A substrate can raise the exposure of that substrate, particularly when kratom is used at higher doses or over the long term1. Careful monitoring is advised2.
Why it happens (mechanism)
Inhibition of CYP3A-mediated metabolism by kratom
How to manage this interaction
What your care team may do:
- Monitor you more closely for stronger omeprazole effects or side effects, especially if you use kratom often or in larger amounts.
- Individualize and adjust your omeprazole dose if needed.
What you can do:
- Keep taking both exactly as prescribed unless your prescriber tells you otherwise.
- Tell your pharmacist or doctor that you use kratom, and how much and how often, so they can factor it in.
- Report any new or worsening symptoms.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) An open-label crossover study in healthy adults (N=12) assessed intake of a single low dose of kratom tea (2 g) alongside oral midazolam (a CYP3A probe substrate; 2.5 mg) and oral dextromethorphan (a CYP2D6 probe substrate; 30 mg). Kratom produced a modest rise in midazolam geometric mean AUC (1.39; 90% CI, 1.23 to 1.57) and Cmax (1.5; 90% CI, 1.32 to 1.7); no change in dextromethorphan AUC or Cmax was seen. The half life of midazolam was not significantly changed with concurrent kratom use, which points to inhibition of first-pass metabolism, mainly intestinal CYP3A. The participants (median age, 30 years) had prior kratom exposure and agreed to refrain from concomitant medications and botanical or other natural products (including kratom) for the duration of the study 1.
Common questions
Can I take Omeprazole and Kratom together?
Kratom may slow how you break down omeprazole, raising its levels somewhat, more so with heavy or regular kratom use. Tell your care team about your kratom use so they can monitor you and adjust the dose if needed. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Omeprazole and Kratom interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Omeprazole and Kratom interaction managed?
What your care team may do: Monitor you more closely for stronger omeprazole effects or side effects, especially if you use kratom often or in larger amounts. Individualize and adjust your omeprazole dose if needed. What you can do: Keep taking both exactly as prescribed unless your prescriber tells you otherwise. Tell your pharmacist or doctor that you use kratom, and how much and how often, so t… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Omeprazole or Kratom need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there anything you'd monitor while I'm on both?
References (2)
- Tanna RS, Nguyen JT, Hadi DL, et al: Clinical assessment of the drug interaction potential of the psychotropic natural product kratom. Clin Pharmacol Ther 2023; 113(6):1315-1325. PubMed
- Dhoble LR, Gour A, McCurdy CR, et al: Evaluating the drug interactions in kratom usage: clinical application. Expert Opin Drug Metab Toxicol 2025; 21(8):949-959. PubMed
Keep reading about Kratom
Keep reading about Omeprazole
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