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How Safe Are Heartburn Medications?

This news may give you some heartburn. A study recently published in JAMA Internal Medicine found that a commonly used type of heartburn medication (proton pump inhibitors or PPIs) may be associated with chronic kidney disease...

This is the latest burp in a class of medications that was considered safe enough to transition from being a prescription medication to an over-the-counter one (starting with Prilosec in 2003). Prior studies have suggested that PPI use may be associated with an increased risk of heart attacks. PPIs have become fairly pervasive. Chances are you have either taken a PPI, know someone who has taken a PPI or seen a PPI commercial on television (such as Larry…

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  The Dark Side of Antacids—What You Need to Know (Part 1)

Patients often consume these antacids for a longer duration of time than recommended by manufacturers. And because these pills are available over the counter, they’ve become the quick pick-me-up for any acid related conditions, with little warning of their side effects (and there are many).

  The Dark Side of Antacids—What You Need to Know (PART II)

Long-term dependence on PPI antacids, as you know, often triggers a host of dysfunctions in the body. This isn’t revelatory; PPIs work temporarily by suppressing the stomach’s healthy and necessary acid production to control the symptoms of heartburn. They are patchwork over a deeper issue, and unless we address the root cause of heartburn, we cannot expect to restore harmony to the body’s inner ecology. More problems will prop onto your diagnostics chart as the root problem is left untreated.

 Medication Monitor: The Dark Side of Proton Pump Inhibitors

The proven efficacy and ease of availability of prescription and over-the-counter (OTC) PPI products (see table) have contributed to their widespread use and, possibly, the common belief these medications can be used with minimal safety concerns. However, over the past decade there’s been mounting evidence that PPI use may be associated with significant risk, including an elevated risk of acute kidney injury, chronic kidney disease (CKD), bone fractures, infections, possible dementia, and increased mortality.

Articles of Interest

A buzzy new study on heartburn meds and dementia doesn’t actually clarify anything

But there are several other better studies that do.

Acid reflux drug linked to more than doubled risk of stomach cancer – study

A study published in the journal Gut identified an association between long-term use of the drug and a 2.4 times higher risk of developing stomach cancer. In the UK, there are more than 50m prescriptions for PPIs every year but they have been linked to side-effects and an increased risk of death. A link between PPIs and a higher stomach cancer risk has previously been identified by academics – but never in a study that first eliminates a type of bacteria suspected of fuelling the illness’s development.

Acid Reflux Problem? The Warning On the Pill’s Label Says Use for 14 Days

Though the warnings on the over-the-counter label and in all promotional ads state these pills should be used for a maximum of 14 days during any year, many patients continue on their prescribed medication for months or years without understanding or learning the risks.

Heartburn Drugs Can Lead to Fatal Heart or Kidney Disease

“We don’t want to imply that people shouldn’t be taking P.P.I.s when they really need them,” said the senior author, Dr. Ziyad Al-Aly of the Washington University School of Medicine. “In people taking them for the right reasons, the benefits outweigh the risks. But even then, they should be taken at the lowest doses and for the shortest period of time possible.”

Heartburn drugs linked to fatal heart and kidney disease, stomach cancer

Death risk increases the longer such drugs are used.

Heartburn Medications Are Bad For Good Bacteria

The incredible rise of PPIs has not been completely smooth, however, as over the years several side effects have been seen. Some are manageable, such as a lack of proper absorption of vitamin B12 and the mineral magnesium.

Heartburn Meds Alter the Gut

Acid blockers reduce the diversity of bacteria in the intestines—and that could lead to trouble.

How Your Antacid Drug Is Making You Sick (Part A)

Believe it or not, stomach acid isn’t there just to punish you for eating Indian food. Acid is in the stomach because it’s supposed to be there. It is found in all vertebrates. And while it isn’t necessary for life, it is certainly required for health. Meanwhile, millions of people around the world are taking acid suppressing drugs that not only fail to address the underlying causes of heartburn and GERD, but put them at risk of serious (and even life-threatening) conditions.

How Your Antacid Drug Is Making You Sick (Part B)

Not only do acid stopping drugs increase our susceptibility to infection, they weaken our immune system’s ability to fight off infections once we have them. In vitro studies have shown that PPIs impair nuetrophil function, decrease adhesion to endothelial cells, reduce bactericidal killing of microbes, and inhibit neutrophil phagocytosis and phagolysosome acidification.

Is Your Heartburn Medication Putting You At Higher Risk For A Hip Fracture?

According to new data from a recent meta-analysis, persons taking oral proton pump inhibitors (PPIs) may be at an elevated risk of sustaining a hip fracture. The elevated risk, however, was not found among those taking H2-receptor antagonists (H2RA).

New Risks Emerge For Some Stomach Drugs

Medications known as proton pump inhibitors, which suppress acid in the stomach and make up the third-biggest-selling class of drugs, appear to be associated with fractures in postmenopausal women and with higher rates of bacterial infections, new studies released Monday show.

People taking heartburn drugs could have higher risk of death, study claims

Millions of people taking common heartburn and indigestion medications could be at an increased risk of death, research suggests. The drugs, known as proton pump inhibitors (PPIs), neutralise the acid in the stomach and are widely prescribed, with low doses also available without prescription from pharmacies. In the UK, doctors issue more than 50m prescriptions for PPIs every year. Now researchers say the drugs can increase risk of death, both compared with taking a different type of acid suppressant and not taking any at all.

Popular Acid Reflux Drugs Are Linked To Kidney Disease Risk

When PPIs were first approved in the 1980s, the drugs appeared to be very safe. Since then, concerns have been rising about their safety. Evidence has emerged that the drugs may increase the risk for a variety of problems, including bone fractures, infections and possibly even heart problems.

Popular Antacids Increase The Risk Of B-12 Deficiency

People who took acid-inhibiting drugs for two or more years were more likely to have B-12 deficiency, according to a study published Tuesday in JAMA, the journal of the American Medical Association. The more medication they took, the more apt they were to be short on the vitamin. That was particularly true if they took drugs called proton pump inhibitors, which can suppress 90 percent of stomach acid. Over-the-counter brand names for those include Prevacid and Prilosec.

Popular Heartburn Pills Can Be Hard To Stop, And May Be Risky

"The teaching for many years was that these drugs were quite safe," says John Clarke, a gastroenterologist at Johns Hopkins Hospital in Baltimore. "But there is data that's emerging that suggests PPIs may not be as safe as we think they are."

PPI Long Term Use: Risk of Neurological Adverse Events?

PPIs were considered to be completely safe drug substances for both short and long-term use. In recent years, there have been a few contradictory studis of absolute safety, especially in patients, who have long been using PPIs. At this time when depression and dementia are rising in the population, this is a very worrying fact that needs to be highlighted, and which needs to be carefully studied and evaluated, ideally trying to prevent it.

Proton Pump Inhibitors Do Not Cause Dementia: Refuting Sensationalized Claims in a Post-Modern Epidemiologic Era

Unfortunately, since PPIs are over-prescribed in individuals with any digestive symptoms, I educate my patients that PPI use in poorly, but sensationalized, epidemiologic studies are essentially identifying patients with multiple co-morbidities and polypharmacy. Therefore, I encourage patients with erosive esophagitis, recurrent or complicated peptic ulcer disease, Barrett’s esophagus, or chronic and frequent GERD symptoms that are only responsive to PPIs, to continue their medications (albeit at the lowest effective dose) and not be scared by media reports. Having said that, PPIs are overprescribed and should be de-prescribed if there isn’t an appropriate indication.

Risks: Acid Reflux Drugs Tied to Bone Fractures

A new analysis adds to growing evidence that people using proton pump inhibitors to control symptoms of acid reflux are more likely to fracture bones than those who do not. The analysis did not find a similar increase in fracture risk among patients taking older acid reflux medications, called histamine-2 receptor antagonists.

Safety of Proton Pump Inhibitors Based on a Large, Multi-Year, Randomized Trial of Patients Receiving Rivaroxaban or Aspirin

Proton pump inhibitors (PPIs) are effective at treating acid-related disorders. These drugs are well tolerated in the short term, but long-term treatment was associated with adverse events in observational studies.

Should You Be Worried About Your Heartburn Medication Causing Dementia?

If you’re concerned that your heartburn medication could cause dementia, you’re not alone. A study published last year in the journal JAMA Neurology claimed to show a strong correlation between use of the meds and dementia, and headlines quickly sounded the public health alarm. But a new study challenges those findings, calling into question whether there’s really any cause for concern (at least about dementia).

Study Finds Growing Reason to Be Wary of Some Reflux Drugs

Since their introduction in 1990, the drugs collectively known as proton pump inhibitors (common brand names: Nexium, Prevacid, Prilosec) have become among the most frequently prescribed in the country; as the Cable Guy points out, they are also available over the counter. They suppress stomach acid more effectively than a previous class of drugs called H2 blockers (Zantac, Tagamet, Pepcid).

The Dangerous Side Effects of Acid Reflux Drugs

Research suggests proton pump inhibitors may increase the risk of kidney disease.

The Dark Side of the Long-Term Use of Proton Pump Inhibitors in Chronic Liver Disease

In recent years, several observational studies have raised concern regarding the potential long-term side effects of PPIs, including acute and chronic kidney disease, hypomagnesemia, cardiovascular events, bone fractures, dementia, and infections such as Clostridium difficile colitis, bacterial pneumonia, and spontaneous bacterial peritonitis...

These Heartburn Drugs Are Linked to a Higher Risk of Early Death

The people who were prescribed PPIs (which include esomeprazole, or Nexium, and lansoprazole, or Prevacid) had a 25% higher risk of dying during the study period than those who took the H2 blockers (such as famotidine, or Pepcid, and ranitidine, or Zantac).

Think Twice Before Taking Popular Heartburn Drugs

What to make of it all? Lay off the PPIs unless you really need them. The drugs are great for severe gastroinstestinal reflux disease (GERD) ulcers and a few other conditions. But half or more of the time, the medicines may be prescribed inappropriately.

“Doc, I heard on the news that this heartburn medicine is bad for my kidneys. What should I do?”

PPI use has been linked to several adverse effects including Clostridium difficile infections, vitamin malabsorption, atrophic gastritis, and even dementia and cardiovascular disease. From a kidney perspective, it has long known to be associated with acute interstitial nephritis and hypomagnesemia.