Table 6.

Mechanisms of adverse effects of omeprazole, which may be associated with prevention and/or risk of genomic instability.

Dose/concentration	Study	Study model	Mechanisms of action	Prevention/risk for genetic material	References
10 and 20 mg/kg	Clinical	—	Proton pump and histamine receptors, hyperplasia, gastric atrophy, carcinoid tumors	Apoptosis, tumor induction	[125]
—	Clinical	Human (n = 113)	Characterization of H. pylori associated with gastritis, therapeutic complications	Not reported	[126]
—	Clinical	Meta-analysis review	Hypomagnesemia	Not reported	[42, 43]
5, 10, 20, and 40 mg/kg	Clinical	Human (n = 764)	Adverse effects: diarrhea, nausea, constipation, immune deficiencies	Immunological changes	[127]
5 and 40 mg/kg	Clinical	Human (n = 170) (review)	Induction of fractures, vitamin B12 deficiency, and diarrhea	Apoptosis	[120]
20 mg/kg	Clinical	Patients with gastric disorders, case studies	Induction of allergies, respiratory infection, hepatotoxicity, electrochemical changes, hypo- and hyperglycemia, diarrhea	Apoptosis	[121]
20 and 40 mg/kg	Clinical	Case study	Deficiency of vitamin B12, anemia	Not identified	[128]
20 mg/kg	Clinical	Case study	Induction of gastroesophageal reflux	Metastases, hyperplasias, polyp	[129]
—	Several	Several	Intestinal nephritis, hepatitis, polyps, metaplasia, pneumonia	Cancer	[130]
—	Clinical	Human (n = 298)	Adverse effects on cysts and polyps	Lung cancer and pancreatic cancer	[131]
0.83–1.6 mg/kg	In vivo	Cats	Heartburn, hypergastrinemia, hypersecretions	Oxidative stress	[109]