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Acid Reflux Medications Can Cause Serious Side Effects

Oct 23, 2015

Widely used acid reflux medications like Nexium (esomeprazole), Prevacid (lansoprazole), and Prilosec (omeprazole), which are taken daily, can have serious side effects.

They "are not the benign drugs the public thinks they are," said Dr. Shoshana J. Herzig of Harvard Medical School, the New York Times reports.

Over the past five years, the Food and Drug Administration (FDA) has issued a number of warnings about proton pump inhibitors. Long-term use, defined as a year or more, increases the risk of hip, wrist and spine fractures. Some studies have found an increase in bone fractures with use over shorter periods, according to the Times. Long-term use can also lead to low levels of magnesium in the blood, which can cause seizures, arrhythmias and muscle spasms, according to the FDA. Such deficiencies cannot always be corrected with supplements. Patients who take diuretics or the heart medication digoxin, which can also cause low magnesium levels, should avoid proton pump inhibitors.

Stomach acid plays an important role in breaking down food and absorbing nutrients, and also kills bacteria and microbes, the Times explains. Maintenance use of acid-suppressing drugs like proton pump inhibitors over the long term may disrupt these processes and make the users more susceptible to infections and nutritional deficits.

Use of these acid reflux medications for any period of time is also associated with an increase of intestinal infections and a higher risk of Clostridium difficile-associated diarrhea, a potentially life-threatening disease. A 2012 FDA advisory recommended patients who take these drugs contact a health care provider if they develop persistent diarrhea that does not improve.

Studies have also reported that proton pump inhibitors increase the risk for pneumonia in hospital patients, though patients taking histamine-2 receptor blocker (Pepcid, Zantac) did not experience a similar increase, Dr. Herzig said. H2 blockers are known to have side effects like headaches, constipation and nausea, but their long-term use has not been studied as extensively as that of proton pump inhibitors.

According to the Times, long-term use of a protein pump inhibitor may reduce the body's absorption of important nutrients such as calcium, iron and vitamin B12, and has been linked with anemia. PPIs can also interact with other medications, leading to an FDA warning to heart and stroke patients that Prilosec (omeprazole) weakens the effectiveness of the anticlotting drug Plavix clopidogrel).

Taking antacids like Tums, Rolaids, Pepto-Bismol or milk of magnesia occasionally to relieve heartburn is unlikely to have these effects, the Times says. Dr. Herzig says "people with conditions like Barrett's esophagus should be on long-term acid suppression." But Dr. Herzig advises, the majority of people with heartburn and reflux should not take PPIs long-term.

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