PPI meds are toxic with time and dose
2014-02-17 11:42:32 UTC
1. Expert Rev Clin Pharmacol. 2013 Jul;6(4):443-51. doi:
10.1586/17512433.2013.811206.
Perils and pitfalls of long-term effects of proton pump inhibitors.
Wilhelm SM, Rjater RG, Kale-Pradhan PB.
Author information:
Department of Pharmacy Practice,
Eugene Applebaum College of Pharmacy and Health
Sciences, Wayne State University,
Detroit, MI, USA.
This review summarizes the literature regarding long-term adverse
effects of proton pump inhibitors (PPIs). A PubMed search
(1966 to February 2013) for English language studies was
conducted using key terms PPI: omeprazole, esomeprazole,
pantoprazole, lansoprazole, dexlansoprazole, rabeprazole,
pneumonia, Clostridium difficile, osteoporosis, risk of
fractures, thrombocytopenia, rhabdomyolysis, anemia,
iron deficiency, hypomagnesemia, vitamin B₁₂ and nephritis.
The risk of pneumonia was increased 27-39% in short-term
use of PPIs in three meta-analyses. C. difficile infections
were also associated with the use of PPIs
(odds ratio: 2.15; 95% CI: 1.81-2.55; p < 0.00001).
This effect appears to be dose related. The US FDA has
recently issued a warning regarding fractures and the
impaired magnesium absorption associated with the use of PPI.
Thrombocytopenia, iron deficiency, vitamin B12
deficiency, rhabdomyolysis and acute interstitial
nephritis have also been reported with the use of
PPIs. There is mounting evidence that PPIs are associated
with serious adverse effects. Practitioners should be
vigilant and counsel patients
accordingly.
PMID: 23927671
10.1586/17512433.2013.811206.
Perils and pitfalls of long-term effects of proton pump inhibitors.
Wilhelm SM, Rjater RG, Kale-Pradhan PB.
Author information:
Department of Pharmacy Practice,
Eugene Applebaum College of Pharmacy and Health
Sciences, Wayne State University,
Detroit, MI, USA.
This review summarizes the literature regarding long-term adverse
effects of proton pump inhibitors (PPIs). A PubMed search
(1966 to February 2013) for English language studies was
conducted using key terms PPI: omeprazole, esomeprazole,
pantoprazole, lansoprazole, dexlansoprazole, rabeprazole,
pneumonia, Clostridium difficile, osteoporosis, risk of
fractures, thrombocytopenia, rhabdomyolysis, anemia,
iron deficiency, hypomagnesemia, vitamin B₁₂ and nephritis.
The risk of pneumonia was increased 27-39% in short-term
use of PPIs in three meta-analyses. C. difficile infections
were also associated with the use of PPIs
(odds ratio: 2.15; 95% CI: 1.81-2.55; p < 0.00001).
This effect appears to be dose related. The US FDA has
recently issued a warning regarding fractures and the
impaired magnesium absorption associated with the use of PPI.
Thrombocytopenia, iron deficiency, vitamin B12
deficiency, rhabdomyolysis and acute interstitial
nephritis have also been reported with the use of
PPIs. There is mounting evidence that PPIs are associated
with serious adverse effects. Practitioners should be
vigilant and counsel patients
accordingly.
PMID: 23927671