Risks associated with taking PPIs

I thought perhaps you would like to read this article about the use of PPIs. (I've used this link as it is "free-to-air")


It isn't just bone density that may be affected by long term use of omeprazole and its little friends that our doctors are so keen we should take.

"Available evidence suggests that PPI use is associated with

an increased risk of both acute and chronic kidney disease, hypomagnesemia, C difficile infection, and osteoporotic fractures. Caution in prescribing PPIs should be used in patients at high risk for any of these conditions. Given the association with kidney disease and low magnesium levels, serum creatinine and magnesium levels should probably be monitored in patients using PPIs, especially those using high doses.

Given the evidence that PPI use is linked with a number of adverse outcomes, we recommend that patients and clinicians discuss the potential benefits and risks of PPI treatment, as well as potential alternative regimens such as histamine H2 receptor antagonists or lifestyle changes, before PPIs are prescribed."

There will be people for whom it is worth it but there are alternatives and others should consider them. And those who MUST have a PPI should be monitored.

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9 Replies

  • Interesting reading especially as my Neurologist decided a few weeks ago that I should increase my dose of Omeprazole from 20 to 40mg. No discussion on side effects but that doesn't really surprise me. I have been on Omeprazole for 17 years. Supposedly damage to my stomach following severe Hyperemisis. What type of monitoring should be done whilst on PPI treatment?

  • For renal and cardiovascular disease and low magnesium levels at the very least I would think - which is what is in that extract I quoted. And bone density should be mandatory. With no messing about if there are any signs of any of them.

  • Thank you PMRpro. After reading that, I feel even more blessed that my body violently objected to both Omeprazole and Lansoprazole and they were stopped in their tracks due to the side effects. Obviously those treating me didn't have a clue about the risks of prescribing PPIs to someone who already had reduced sole kidney function!

  • Or anyone else if it comes to that! Sometimes I feel doctors are VERY gullible! But then - I did work the other side of the marketing divide...

  • Having just received coated preds (5mgs), you wisely informed me that I should decrease my daily dose of 20 mg omeprazole v slowly despite my GP's decision that it could be stopped immediately! I decided to "do my own thing" and ordered my new 10mgs in order to begin the reduction all thanks to you lot... any more advice about reducing the 20-10 asap??? Thanks for this article PMRpro.. what would we do without........

  • Hi PMRpro, I was prescribed Lansoprazole to control reflux 20+ years ago and was unaware of the side effects. When I developed PMR 2 years 4months ago I managed to get a DEXA scan privately. It revealed that I had osteoporosis in left arm. I have always been very active and seldom ate junk food. Gardening and walking being my main recreation. So surprised at my DEXA scan result I researched why I had osteoporosis because I was so shocked. The search resulted in me finding that the PPI could be the reason. To cut a long story short, I spoke to the GP who put me on the PPI in first place. I told him I was concerned that the Patient info pamphlet lists osteoporosis as a possible side effect. He promptly said it doesn't. I said why does the pamphlet say it does. He said just to protect themselves. He would not discuss it further and said "well it is controlling your reflux isn't it". At no time has he tested me for any vit and min deficiency. I despair at the quality of some Doctors. I have been trying to get of PP's for yonks'. Maybe the DSNS method will work. Sorry for length of this, just wanted to get it off my chest. Current dose of Pred 7mg ish redusing with DSNS.


  • Heck - doesn't he read any medical literature? I just googled "role of ppis in osteoporosis" and got a load of proper medical scientific papers (not the data sheet) dating back to at least 2008 saying they can increase the risk.

  • yes, our heath centre is useless, I am constantly checking on every thing they tell me now! I get more info on PMR from this forum than even my Rheumatologist!

    Best wishes

  • Indeed, thanks to PMR pro for her most useful contribution to this site.

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