Popular Class of Heartburn Drugs Have Serious Side Effects

Over the past five years, the Food and Drug Administration (FDA) has issued a number of warnings about long-term use of proton pump inhibitors, a popular class of acid reflux medications.

Nexium (esomeprazole), Prevacid (lansoprazole), and Prilosec (omeprazole) can have serious side effects, the New York Times reports. They “are not the benign drugs the public thinks they are,” according to Dr. Shoshana J. Herzig of Harvard Medical School.

Long-term use—defined as a year or more—increases the risk of hip, wrist and spine fractures and some studies have found an increase in bone fractures even with shorter periods of use, the Times reports. Long-term use can also lead to reduced levels of magnesium in the blood, which can cause seizures, arrhythmias and muscle spasms, according to the FDA. These 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.

Heartburn is the symptom an individual feels when stomach acid splashes up and out of the stomach, according to WebMD; “heartburn” is sometimes used interchangeably with “acid reflux.” Stomach acid plays an important role in the breakdown food and the absorption of nutrients, and it also kills bacteria and microbes, the Times explains. Daily 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.

Extended protein pump inhibitor use is also associated with an increase of intestinal infections and a higher risk of Clostridium difficile-associated diarrhea, a potentially life-threatening disease. In 2012, an FDA advisory to patients taking these drugs told them to contact a health care provider if they develop persistent diarrhea that does not improve.

Some studies report that proton pump inhibitors increase the risk for pneumonia in hospital patients, though patients taking another class of acid reflux drugs—histamine-2 receptor blocker acid reflux drugs (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 the 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. The FDA has warned heart and stroke patients that Prilosec (omeprazole) weakens the effectiveness of the blood-thinning drug Plavix (clopidogrel).

Occasionally taking antacids like Rolaids, Tums, Pepto-Bismol, or milk of magnesia to relieve heartburn is unlikely to have adverse effects, the Times says. According to Dr. Herzig, “people with conditions like Barrett’s esophagus should be on long-term acid suppression,” but the majority of people with heartburn and acid reflux should not be on PPIs long-term, she says.

from Parker Waichman http://www.yourlawyer.com/blog/popular-class-of-heartburn-drugs-have-serious-side-effects/