Omeprazole and other proton pump inhibitors are metabolized by the cytochrome P450 system, primarily by isoenzyme CYP2C19, and may alter the metabolism of some other drugs metabolized by these enzymes. Omeprazole may prolong the elimination of diazepam, phenytoin, and warfarin. Omeprazole and other proton pump inhibitors can reduce the absorption of drugs such as ketoconazole, and possibly itraconazole, whose absorption is dependent on acid gastric pH.
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