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calcium and ppi

PPIs reduce calcium carbonate absorption

What's happening

Calcium carbonate requires stomach acid to dissolve. Long-term PPI use is associated with reduced bone density and increased fracture risk, partly via impaired calcium absorption.

Recommendation

On PPIs, switch from calcium carbonate to calcium citrate — citrate does not require gastric acid for absorption.

Timing

Take calcium with meals regardless of PPI timing

Sources

  • — JAMA 2006
  • — PMID: 17190895

Frequently Asked Questions

Can I take calcium and ppi together?

PPIs reduce calcium carbonate absorption. On PPIs, switch from calcium carbonate to calcium citrate — citrate does not require gastric acid for absorption.

How should I time calcium and ppi?

Take calcium with meals regardless of PPI timing

Is this interaction dangerous?

This interaction is rated “Caution” by Formulate. Calcium carbonate requires stomach acid to dissolve. Long-term PPI use is associated with reduced bone density and increased fracture risk, partly via impaired calcium absorption.

Want to check your whole stack?

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Medical disclaimer. This page is for educational purposes only and does not replace advice from a qualified healthcare provider.