Omeprazole and other proton pump inhibitors are metabolized by the cytochromes P450 system primarily by isoenzyme CYP2C19, and may alter the metabolism of some 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 with voriconazole, the plasma concentration of both drugs may be increased and a reduced dose of Omeprazole is recommended.
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