Last year, the FDA issued a warning about a possible link between a class of antacids called proton pump inhibitors and increased risk of fracture of the hip, wrist, and spine. Proton pump inhibitors (PPIs) help reduce the amount of acid in the stomach and are used to treat conditions such as gastroesophageal reflux disease (GERD), stomach and small intestine ulcers, and inflammation of the esophagus. According to the seven studies the FDA reviewed, the risk was highest in adults over age 50 who took the drugs at high doses or for more than one year. Although these drugs have not been directly linked to increased risk of fracture, these population studies suggest that there might be a connection, and the evidence was strong enough for the FDA to make this announcement:
“In summary, the available data, including findings from several epidemiological studies, suggest a possible increased risk of fractures of the hip, wrist, and spine in patients using proton pump inhibitors. The data suggest that the increased risk may be dependent upon dose, duration of use, or both. At the present time, there is uncertainty about the magnitude of this risk. In light of this uncertainty, when prescribing proton pump inhibitors, healthcare professionals should consider whether a lower dose or shorter duration of therapy would adequately treat the patient’s condition.” —FDA website
Prescription PPIs (Nexium, Prilosec, Dexilant, Zegerid, Prevacid, Protonix, Aciphex, and Vimovo) and over-the-counter drugs (such as Prilosec OTC, Zegerid OTC, and Prevacid 24HR) now carry a warning label advising consumers of this potential increased risk of fracture.
The FDA is reviewing other studies and waiting for results of studies currently underway to help clarify these findings. In the meantime, if you take one of these medications, don’t stop, but please talk to your doctor about the risks vs. benefits. I strongly recommend trying lifestyle changes like quitting smoking, losing weight, eating smaller portions, and modifying your diet (such as avoiding spicy foods, caffeine, mint, citrus, and tomatoes), which could help you lower your dose or allow you to take the drugs less frequently or for a shorter period of time.
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