Nutrient depletion·Iron·Reviewed June 9, 2026
What depletes iron?
8 medications in the NutriStack database are documented to lower Iron with ongoing use. The pattern spans 4 drug classes. Another 5 bind iron in the gut when taken at the same time, which is a timing problem rather than true depletion. Depletion builds slowly and is easy to miss; the table below shows how each medication drives it and which biomarker to check. Never start a replacement supplement without your prescriber's input.
Iron depletion at a glance.
A quick, data-grounded summary. The per-medication table is below.
8 medications in the NutriStack database are documented to lower Iron with ongoing use. The pattern spans 4 drug classes. Another 5 bind iron in the gut when taken at the same time, which is a timing problem rather than true depletion. Depletion builds slowly and is easy to miss; the table below shows how each medication drives it and which biomarker to check. Never start a replacement supplement without your prescriber's input.
What is documented to lower iron.
Worst documented severity first. Open any medication for its full interaction and depletion guide. Absence from this table means no documented record, not proven safety.
| Medication | Severity | How it lowers iron | Monitor |
|---|---|---|---|
| Esomeprazole Proton Pump Inhibitor | Moderate | Reduced gastric acidity lowers conversion and solubility of non-heme iron, decreasing long-term absorption. | Ferritin + transferrin saturation |
| Lansoprazole Proton Pump Inhibitor | Moderate | Reduced gastric acidity lowers conversion and solubility of non-heme iron, decreasing long-term absorption. | Ferritin + transferrin saturation |
| Omeprazole Proton Pump Inhibitor | Moderate | Reduced gastric acidity lowers conversion and solubility of non-heme iron, decreasing long-term absorption. | Ferritin + transferrin saturation |
| Pantoprazole Proton Pump Inhibitor | Moderate | Reduced gastric acidity lowers conversion and solubility of non-heme iron, decreasing long-term absorption. | Ferritin + transferrin saturation |
| Rabeprazole Proton pump inhibitor | Moderate | Reduced gastric acidity can lower solubilization and absorption of non-heme iron. | Ferritin, transferrin saturation, hemoglobin |
| Aluminum/Magnesium Hydroxide Antacid | Mild | Antacids reduce iron absorption by raising gastric pH and reducing non-heme iron solubility. | Ferritin + transferrin saturation |
| Calcium Carbonate Antacid | Mild | Calcium carbonate can reduce non-heme iron absorption by competing during intestinal uptake and by buffering gastric acidity. | Ferritin + transferrin saturation |
| Cimetidine H2 Receptor Antagonist | Mild | Acid suppression can reduce non-heme iron solubility and food iron absorption during chronic therapy. | Ferritin + transferrin saturation |
Binds iron, not depletion.
These medications form poorly absorbed complexes with iron in the gut when doses overlap. That blunts absorption of the medication, the mineral, or both at that dose, but it does not drain the body's stores. The fix is separating doses by the window on each medication's page, not supplementing more.
| Medication | Severity | What happens when taken together | Monitor |
|---|---|---|---|
| Cefdinir Cephalosporin antibiotic | Moderate | Cefdinir is not depleted by iron, but the two form a clinically important interaction: cefdinir chelates ferrous iron in the gut to produce a... | Not routinely monitored; separate dosing rather than supplement |
| Minocycline Tetracycline antibiotic | Moderate | Tetracyclines including minocycline chelate iron in the gut to form poorly absorbed complexes, reducing absorption of supplemental and dietary... | Serum ferritin and hemoglobin (only with prolonged courses or pre-existing deficiency) |
| Doxycycline Tetracycline Antibiotic | Mild | Tetracyclines chelate iron in the gut, reducing iron availability and drug absorption when taken together. | Ferritin + transferrin saturation |
| Moxifloxacin Fluoroquinolone antibiotic | Mild | Ferrous and ferric iron form stable chelate complexes with the 4-oxo and adjacent carboxyl groups of fluoroquinolones, including moxifloxacin.... | Serum ferritin and hemoglobin (only if pre-existing iron deficiency is being treated) |
| Tetracycline Tetracycline antibiotic | Mild | Tetracycline and iron form mutual chelation complexes in the gastrointestinal tract, impairing absorption of both. Co-administration significantly... | Serum ferritin and transferrin saturation |
If you need to restore iron.
Repletion is not automatic: dose, form, and timing depend on the medication involved, and some pairings need separation from the very drug causing the depletion. Confirm with your prescriber before adding iron.
Common iron depletion questions.
Quick answers drawn from the table above.
Which medications deplete iron?
8 medications in the NutriStack database are documented to lower iron, including Esomeprazole, Lansoprazole, Omeprazole, Pantoprazole, and Rabeprazole. Severity differs by drug; the full table with mechanisms and monitoring biomarkers is on this page.
How do I know if my iron is low?
The biomarkers used to track iron status in this context include Ferritin + transferrin saturation and Ferritin, transferrin saturation, hemoglobin. If you take one of the medications above long term, ask your prescriber whether checking is worthwhile; depletion develops gradually.
Should I take an iron supplement with these medications?
Not automatically. Documented depletion makes repletion worth discussing, but the right answer depends on your labs, dose, and the specific drug, and some pairings need iron doses separated from the medication itself. Bring it up with your prescriber or pharmacist.
Check your whole stack
See what your medications deplete.
NutriStack screens your full routine for interactions and depletions, and updates the moment you change it.