Drugs to relieve heartburn and acid-reflux are among the best selling drugs in the country, used by millions of Americans annually in both prescription and non-prescription strength.
Excess acid can cause stomach ulcers and damage to the esophagus. A reduction in stomach acid reduces irritation of the stomach lining and allows ulcers and irritation of the esophagus to heal, according to WebMD.
But evidence is accumulating that the active ingredients in certain popular heartburn drugs might actually increase the risk of premature death, CBS News reports.
Parker Waichman notes that PPIs have been associated with a number of serious side effects in addition to the risk of death. People taking either a prescription or an over-the-counter PPI should consider the risk of adverse side effects.
Three Types of Heartburn Medications
Dr. Max Gomez, a medical expert with CBS2 New York, explains that there are three main types of heartburn remedies. Antacids, like Tums and Rolaids, which neutralize stomach acid, can help ease heartburn or indigestion. H-2 blocker medications, like Pepcid and Zantac, help reduce the amount of acid the stomach produces, lessening heartburn.
The newest group of heartburn medicines, proton pump inhibitors (PPIs) like Prilosec (omeprazole), Nexium (esomeprazole), and Prevacid (lansoprazole), block the enzyme in the stomach wall that makes acid. PPIs block acid production more effectively and for a longer period of time than the H2 blockers, according to WebMD. PPIs are best taken an hour before meals.
According to Dr. Gomez, some patients experience symptoms that are not what most people think of heartburn. One woman in the CBS2 reports said, “I couldn’t breathe. My ribs were hurting the cough was so hard and dry.” Another woman said she had shortness of breath and was “completely exhausted,” and had terrible post-nasal drip, according to CBS2. Both women had acid reflux though neither woman wanted to take a PPI for her respiratory symptoms.
But Dr. Jamie Koufan, of the Voice Institute of New York, explains that reflux comes in two forms. In addition to the heartburn and indigestion people think of in connection with acid reflux, there is respiratory reflux, involving “asthma, allergies, chronic throat clearing, post-nasal drip.”
Doctors have been prescribing PPIs for patients with hoarseness, cough, and other respiratory symptoms. But a new study of 350,000 people in the Veterans Affairs health care system found that those taking PPIs had a 25 percent greater risk of premature death compared to those taking H2 blockers.
The doctors examined medical records of about 275,000 PPI users and nearly 75,000 people who took H2 blockers to reduce stomach acid. The researchers calculated that, for every 500 people taking PPIs for a year, there is one extra death that would not have otherwise occurred. Given that millions of people take PPIs regularly, this could translate into thousands of extra deaths every year, according to one of the study authors, Dr. Ziyad Al-Aly, an assistant professor of medicine at Washington University School of Medicine in St. Louis. The research team included others at Washington University as well as doctors in the VA St. Louis Health Care System.
Increased Risk of Death for PPI Users
The St. Louis researchers tracked deaths for up to five years. The research team found a 25 percent increased risk of death in the patients who took PPIs compared with those who took H2 receptor blockers. Dr. Al-Aly told CBS, “The results were very clear. We were startled by this.” However the researchers “sliced the data, analyzed it, there was always a consistent relationship between PPI use and risk of death,” according to Dr. Al-Aly.
PPIs gained wide popularity because they relieve symptoms quickly and were thought to have low toxicity. But research has linked these drugs to significant health risks. The study is just the latest study to link PPIs to adverse health effects. Earlier studies link PPI use to hip fractures, kidney disease, infections, dementia, and esophageal cancer.
PPI users have filed lawsuits alleging that manufacturers, including Takeda, AstraZeneca and Pfizer “failed to adequately inform consumers and the prescribing medical community against the serious risks associated with PPIs,” one legal complaint states.
Many doctors now advise that if a PPI is used, it should be taken for the shortest time necessary to allow an ulcer or irritated esophagus to heal. Patients should also consider diet and lifestyle changes to help reduce symptoms.
Legal Help for Injuries Linked to PPI Use
If you or someone you know has taken a PPI and suffered adverse health effects including kidney damage, kidney failure, fractures, or a nutrient deficiency, the drug-injury attorneys at Parker Waichman LLP can advise you about your legal options. For a free, no-obligation consultation, fill out the online contact form or call 1-800-YOURLAWYER (1-800-968-7529).