Does Omeprazole Cause Hair Loss?
In our latest question and answer, the pharmacist discusses whether or not omeprazole is associated with hair loss (alopecia).
I am a healthy almost 91-year-old lady who has been prescribed to take 50mg Losartan once a day and I also take a 20mg Omeprazole once a day when needed. I have been doing this for about 3 yrs and my hair started falling out about 2 yrs ago on a daily basis. Do either of these drugs cause hair loss or possibly together?
Sep 12, 2022- Hair loss with omeprazole is rare, occurring in less than 1% of people taking the drug, but it has been reported and is listed as a possible side effect. If hair loss does occur from omeprazole, it is generally reversible after stopping the medication, though regrowth can take several months to become visible. Hair loss from omeprazole typically begins around three months after starting the drug rather than years later, so you should discuss with your doctor whether omeprazole is the actual cause of your hair loss.
Answer
Thanks for your question! I will focus on omeprazole in this answer since losartan has not been associated with hair loss.
Omeprazole, a PPI (proton pump inhibitor) used to treat a variety of stomach-acid-related conditions, has been associated with hair loss, but only rarely.
Most research indicates that less than 1% of individuals taking omeprazole will experience hair loss.
The good news is that if hair loss does occur while taking the drug, it tends to be reversible, but regrowth can take a few months.
Omeprazole-Induced Hair Loss
As stated, hair loss (also known as drug-induced alopecia) with omeprazole is rare but has been reported.
The FDA-approved prescribing information for the drug does list it as a side effect that has been reported during the 'post-marketing' experience, but not during clinical trials for the drug.
Post-marketing experience side effects are those which are reported after the drug has been approved and made available on the market.
Gathering information about the effects of a drug after it has been on the market is important, but needs to be evaluated cautiously since information (e.g. side effects) is voluntarily reported and it can be difficult to definitively associate reported effects with a particular drug.
Nevertheless, several research studies have also reported omeprazole as a potential causative agent in drug-induced hair loss.
One such study, published in the New England Journal of Medicine, lists omeprazole (among many others), as a potential culprit (as shown in the below image):
Source: N Engl J Med 2007; 357:1620-1630
You'll notice in the above image that there are two different types of drug-induced hair loss listed:
- Telogen effluvium
- Anagen effluvium
Anagen effluvium refers to the loss of hair in the anagen phase of the hair growth cycle.
Chemotherapy drugs often cause this type of hair loss. It typically happens very quickly after the offending drug is started (within 1-2 weeks) and can be quite severe since, at any given time, around 90% of your hair is actively growing (in the anagen phase).
Individuals experiencing anagen effluvium hair loss lose most of their hair, including eyebrows, other facial hair, and hair on the scalp.
Telogen effluvium refers to hair loss caused by a shifting of hair growth from the anagen phase (i.e. growing) of the hair growth cycle to the telogen phase (i.e. rest phase).
Unlike anagen effluvium hair loss, which occurs very quickly, telogen effluvium hair loss is delayed and generally begins around 3 months after the causative factor is initiated.
Causative factors include major stresses (e.g. surgery, nutritional deficiency) and medications. Omeprazole is associated with this type of hair loss.
Even though this type of hair loss is delayed, when it does occur, it can be substantial. Many studies report that it can result in losing between 100-300 hairs per day and over 70% hair loss in total.
Is It Reversible?
Yes, hair loss associated with omeprazole is generally reversible.
Telogen effluvium hair loss, in general, has been reported to be reversible once the drug is discontinued.
After discontinuation, hair re-growth generally resumes about two to three months after the trigger has been removed but you likely won't visibly see hair growth until much longer.
One study reports that it can take up to 4 to 6 months.
"Regrowth is not visible for 4 to 6 months. If the trigger is identified and removed, recovery can be expected to be complete."
Do All Proton Pump Inhibitors Cause Hair Loss?
Like omeprazole, most proton pump inhibitors list 'alopecia' or hair loss, as a rare, but possible, side effect. In addition to omeprazole, this includes:
- Prevacid (lansoprazole)
- Protonix (pantoprazole)
- Aciphex (rabeprazole)
- Nexium (esomeprazole)
Final Words
Be sure to speak with your doctor regarding the hair loss you have been seeing.
As discussed in this answer, omeprazole may be contributing to it, but the fact that you say you have been taking it for years and it is only now occurring isn't common.
If omeprazole does cause hair loss in someone, it generally would start just a few months after initiating the drug.
Your doctor will be your best resource to get to the bottom of your issue.
The other drug you mention in your question, losartan, has not been associated with hair loss.
References & sources
- Omeprazole Prescribing Information — AccessFDA
- Hair Loss in Women — New England Journal of Medicine
- Drug reactions affecting hair: diagnosis — PubMed
- Diffuse hair loss: its triggers and management — PubMed
Glossary — Terms in This Answer
- PPI (proton pump inhibitor)
- A type of medication that reduces stomach acid by blocking acid-producing cells in the stomach lining.
- Alopecia
- The medical term for hair loss.
- Post-marketing
- Refers to the period after a drug has been approved by the FDA and is available for patients to use.
- Telogen effluvium
- A type of hair loss where hairs prematurely shift from the growing phase to the resting phase of the hair growth cycle.
- Anagen effluvium
- A type of hair loss that occurs when hair is actively growing and stops abruptly, often caused by chemotherapy drugs.
- Anagen phase
- The active growing stage of the hair growth cycle.
- Telogen phase
- The resting stage of the hair growth cycle before a hair sheds.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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