Omeprazole and Risedronate: 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
Risedronate
Omeprazole
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.
What's going on: This warning is specifically about the delayed-release (enteric-coated) form of risedronate, brand name Atelvia. That tablet has a special coating meant to release the medicine at a certain point. Omeprazole reduces stomach acid, and that change in acid level can cause the coating to release risedronate faster, so more of it gets absorbed than intended.
The good news: This is a manageable situation, and it mainly applies to the Atelvia version, not necessarily other risedronate tablets. Please don't stop either medicine on your own. Just check with your pharmacist or doctor so they can confirm which risedronate product you take and pick the safest plan for you.
Mechanism: Omeprazole (PPI) raises gastric pH, which can trigger premature/faster release of enteric-coated delayed-release risedronate (Atelvia), increasing its bioavailability. Neither drug is a prodrug; this is a formulation-dependent PK interaction.
- Direction: Increased risedronate exposure.
- Magnitude: By analogy with esomeprazole studies, Cmax rose ~60% and AUC ~22%.
- Onset: Unspecified.
- Evidence: Theoretical (extrapolated from another PPI).
- Management: Concomitant use with the delayed-release product is not recommended per labeling. Confirm formulation; consider an alternative acid-suppression strategy or a different bisphosphonate formulation as directed by the care team.
What happens
Increased risedronate bioavailability
Interaction Deep Dive
Taking enteric-coated risedronate sodium (Atelvia(TM)) delayed-release tablets together with a proton pump inhibitor, for example omeprazole1, may raise the bioavailability of risedronate. When risedronate delayed-release tablets were studied for interaction with esomeprazole, another proton pump inhibitor, risedronate Cmax rose by 60% and AUC by 22%. Because of this potential rise in risedronate bioavailability, combining omeprazole with enteric-coated risedronate sodium (Atelvia(TM)) delayed-release tablets is not advised 2.
Why it happens (mechanism)
Increased stomach pH resulting in faster release of enteric-coated products
How to manage this interaction
What your care team may do:
- Confirm whether you take the delayed-release (Atelvia) form, since this concern is specific to that coated product.
- Because the label does not recommend using this coated form with a PPI like omeprazole, they may choose a different risedronate product or a different acid-reducing approach.
- Monitor and individualize your plan to keep your bone treatment safe and effective.
What you should do: Keep taking both as prescribed for now, and bring this up with your pharmacist or prescriber. Tell them the exact risedronate brand and form you use so they can tailor the right plan.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) In a phase 1, 2-period, crossover trial involving 60 healthy postmenopausal women, giving esomeprazole, a proton pump inhibitor similar to omeprazole, together with a delayed-release risedronate tablet led to higher risedronate AUC and Cmax. The women received a single 35 mg dose of delayed-release risedronate after breakfast following 6 days of treatment with delayed-release esomeprazole 40 mg. On day 6, esomeprazole 40 mg was given one hour before breakfast with 240 mL of water. The delayed-release risedronate 35 mg was given within 10 minutes of breakfast along with an additional 240 mL of water. Laboratory results showed increases of 60% in risedronate Cmax and 22% in risedronate AUC when esomeprazole was present 2.
Common questions
Can I take Omeprazole and Risedronate together?
Omeprazole can raise absorption of the delayed-release (Atelvia) form of risedronate, and using them together is not recommended; ask your pharmacist or doctor to confirm your product and adjust the plan. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Omeprazole and Risedronate 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 Risedronate interaction managed?
What your care team may do: Confirm whether you take the delayed-release (Atelvia) form, since this concern is specific to that coated product. Because the label does not recommend using this coated form with a PPI like omeprazole, they may choose a different risedronate product or a different acid-reducing approach. Monitor and individualize your plan to keep your bone treatment safe and effectiv… 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 Risedronate 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)
- Product Information: PRILOSEC(R) oral delayed-release capsules, omeprazole oral delayed-release capsules. AstraZeneca Pharmaceuticals LP (Per FDA), Wilmington, DE, 2011. DailyMed
- Product Information: Atelvia(R) oral delayed release tablets, risedronate sodium oral delayed release tablets. Warner Chilcott (US), LLC (per FDA), Rockaway, NJ, 2012. DailyMed
Keep reading about Risedronate
Keep reading about Omeprazole
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