Powerful Antacid Drugs Raise Fracture Risk

Aug. 12 -- MONDAY, Aug. 11 (HealthDay News) -- New Canadian research shows that long-term use of proton pump inhibitors for acid reflux, peptic ulcers and related disorders elevates the risk of osteoporosis-related fractures.

This is now the third large study finding an increased risk of such fractures in people who use these medications. This latest study, reported in the current issue of the Canadian Medical Association Journal, found the longest period of time from starting the drugs to seeing problems emerge.

Physicians and patients may need to curb their enthusiasm for prescribing proton pump inhibitors, which have surged in popularity, experts said.

"Almost all of us gastroenterologists and internists have become complacent about the use of these medications," said Dr. Felice Schnoll-Sussman, director of research at the Jay Monahan Center for Gastrointestinal Health, Weill Cornell Medical Center at New York Presbyterian Hospital in New York City. "This makes us all take a step back and look at all the patients we have on these medications and ask whether they require still being on this medication, at this dosage, at this frequency. Can we make some alterations in their dosing regimen? Can we switch them? Do they need to be on anything at all at this point?"

An option for patients who can't do without PPIs would be to add osteoporosis medications, added Dr. Elton Strauss, chief of orthopedic trauma and adult reconstruction at Mt. Sinai Medical Center in New York City. "The other thing is that patients have to be made aware that if they are taking these medications [PPIs], and they drink or smoke or take drugs like prednisone, they don't do well orthopedically."

PPIs are powerful antacid drugs prescribed for peptic ulcer disease, gastroesophageal reflux disease (GERD) and other related conditions. Brand names include Aciphex, Nexium, Prevacid, Prilosec and Protonix. The drugs are often taken for indefinite periods of time.

The drugs work by inhibiting secretion of hydrochloric acid; this may affect calcium absorption in the small intestine.