One of the most widely prescribed drugs in the US are the proton pump inhibitors (PPI). Millions of people take these drugs to treat gastritis, peptic ulcer disease and reflux. There are many PPIs in the market and many are now available over the counter. Sales of PPI have reached nearly $10 billion each year in the US alone. But the benefits of the PPIs also come at a price.
A new study published in the British Medical Journal reveals that PPIs are not as safe as initially believed. The researchers analyzed data from over 350,000 individuals who were prescribed either a PPI or a histamine receptor blocker. Patient data was gathered from the US Veterans Affairs database and the researchers traced patient health outcomes for a period of 8 years.
The types of PPIs prescribed included Nexium (esomeprazole,) and Prevacid (lansoprazole). The researchers noted that the individuals who were prescribed the PPIs had a 25% higher risk of dying than those who were prescribed the H2 blockers. The researchers also looked at several million people who took PPIs for heartburn relief and compared them to those who did not take PPIs. It was again observed that those who used PPIs had a 15% higher risk of death compared to non-PPI users. These findings persisted even after the researchers eliminated all other risk factors for death like infections or heart disease.
The results from this study add to the growing understanding of PPIs. While they do effectively neutralize acid in the stomach, it appears they have effects which extend way beyond the gut. These agents have been linked to pneumonia, hip fractures and even kidney problems. Other studies suggest that PPIs also increase the risk of hip fracture because they inhibit calcium absorption and inhibit new bone formation.
The overall feeling in the medical community is that the PPIs are overprescribed and are too easily available as over-the-counter drugs. Without any regulation on their usage, adverse effects are likely. For consumers who have acidity problems, the best advice is to take them for the shortest time possible. In addition, they should change their lifestyle, reduce risk factors for heart disease, discontinue smoking, eat healthy and exercise regularly. When a PPI is needed, it should be taken at the right dose for a limited time only.