Seniors Warned About Proton Pump Inhibitors

New York, NYAlthough they are widely-prescribed medications, people may not realize the risks associated with the use of proton pump inhibitors. In the wake of news about proton pump inhibitor side effects comes a warning that seniors should be careful when taking such medications.

A blog post at blogs.nytimes.com (08/11/2010) notes that doctors who work in geriatric wards noticed that some of their patients had been taking acid reducing medications for longer than the recommended time—in at least one case a patient took an acid reducing medication for 15 years.

The risk of significant side effects is increased in older patients. The FDA recently requested a label change for PPIs to reflect the increased risk of fracture that patients—especially those over the age of 50—face if they use the medications for more than a year.

According to an FDA news release (05/25/10), the label change was based on a review of several epidemiological studies, "that reported an increased risk of fractures of the hip, wrist, and spine with proton pump inhibitor use. Some studies found that those at greatest risk for these fractures received high doses of proton pump inhibitors or used them for one year or more."

Proton pump inhibitors—including Prevacid, Protonix, Prilosec and Nexium—are reportedly linked to an increased risk of pneumonia, gastrointestinal infections and Clostridium difficile infections. Doctors are not sure why PPIs have these increased risks, but they note that seniors are already at an increased risk of pneumonia, infections and fractures, even without the use of PPIs.

A further concern is the overuse, or misuse, of medications that suppress acid. According to a 2006 study conducted by Dr. Randolph Regal, of 213 patients admitted to the University of Michigan Hospital, only 29 percent were taking an acid suppressant prior to being admitted. After being admitted, however, more than 70 percent of patients used the medications. According to the study, only one-third percent of the patients who took the medications had a condition that required the use acid suppressants.

This led researchers to conclude, "there is considerable excess usage of acid suppressants in both the inpatient and outpatient settings."

Some doctors now say that surgery is a preferable alternative to long-term PPI use. These doctors say surgery is a permanent solution that allows the patient to eat virtually any foods he likes. This is compared to PPIs, which require the patient to restrict certain foods. Furthermore, PPIs prevent acid from moving into the esophagus but does not prevent other substances from doing so, which can cause different health problems for patients.