Omeprazole and Paltusotine: 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
Omeprazole
Paltusotine
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.
You're taking omeprazole (a common acid reducer, like Prilosec) along with paltusotine (Palsonify). Here's the key point: paltusotine needs an acidic stomach to dissolve and be absorbed well. Omeprazole lowers stomach acid, so less paltusotine may get into your body. That can make the paltusotine work less well for you.
This is based mostly on how the drugs behave rather than lots of patient studies, but the drop in absorption can be meaningful. Please don't change either medicine on your own. Your care team can manage this by adjusting your paltusotine dose or spacing things out, so talk with your pharmacist or doctor.
Effect: Reduced paltusotine exposure and possible loss of efficacy.
Mechanism: Paltusotine has pH-dependent aqueous solubility. Omeprazole (a PPI) raises gastric pH, reducing paltusotine dissolution and absorption. This is a PK (absorption) interaction, not enzymatic; neither agent's activation is impaired.
Magnitude: Paltusotine AUC decreased ~21% at 20 mg and ~42% at 60 mg. Evidence is theoretical/PK-based; onset unspecified.
- May require an increased paltusotine dose with concurrent PPI use.
- Avoid concomitant PPI use in patients already on paltusotine 60 mg.
- Monitor clinical/biochemical response (e.g., IGF-1) and individualize dosing.
What happens
Reduced paltusotine exposure and reduced efficacy of paltusotine
Interaction Deep Dive
Taking paltusotine together with proton pump inhibitors can lower paltusotine exposure and diminish its effectiveness, potentially necessitating a higher paltusotine dose. For patients already receiving paltusotine 60 mg, avoid using proton pump inhibitors at the same time. The aqueous solubility of paltusotine is pH-dependent. At the 20 mg dose level, paltusotine AUC fell by 21%, while at the 60 mg dose level it dropped by 42%1.
Why it happens (mechanism)
Changes in gastric pH
How to manage this interaction
Both drugs can be used together with planning, but your care team will tailor things so the paltusotine still works.
- Keep taking both as prescribed unless your prescriber tells you otherwise.
- Your paltusotine dose may need to be adjusted and individualized by your care team to account for the reduced absorption.
- If you are already on the 60 mg paltusotine dose, your team will typically avoid combining it with a PPI like omeprazole and consider other options.
- Your team may monitor your response more closely to confirm the paltusotine is working.
Ask your pharmacist or prescriber before starting, stopping, or changing either medicine.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) Paltusotine showed aqueous solubility that varied with pH. At the 20 mg dose level, paltusotine AUC fell by 21%, and at the 60 mg dose level it fell by 42% 1.
Common questions
Can I take Omeprazole and Paltusotine together?
Omeprazole lowers stomach acid, which can reduce how much paltusotine your body absorbs and how well it works. Don't change anything yourself; your care team can adjust the paltusotine dose or avoid combining them at the 60 mg dose. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Omeprazole and Paltusotine interaction?
It is rated major. Potentially serious — often needs a change or close 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 Paltusotine interaction managed?
Both drugs can be used together with planning, but your care team will tailor things so the paltusotine still works. Keep taking both as prescribed unless your prescriber tells you otherwise. Your paltusotine dose may need to be adjusted and individualized by your care team to account for the reduced absorption. If you are already on the 60 mg paltusotine dose, your team will typically avoid combi… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
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 Paltusotine 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 a safer alternative to one of these medications for me?
References (1)
- Product Information: PALSONIFY™ oral tablets, paltusotine oral tablets. Crinetics Pharmaceuticals, Inc (per FDA), San Diego, CA, 2025. DailyMed
Keep reading about Omeprazole
Keep reading about Paltusotine
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Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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