Hooked on prilosec?

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A recent article in The New York Times sheds light on a little known problem: A class of drugs used to prevent heartburn may reduce the body s ability to absorb essential nutrients. Studies show that proton pump inhibitors (PPIs) such as Nexium, Prilosec and Prevacid can inhibit absorption of nutrients such as magnesium, calcium, and vitamin B12.

Any significant adverse effects of PPIs has wide-ranging implications, since they are the third highest-selling class of drugs in the U.S. And while short-term use of the drugs is considered mostly safe, long term use reduces the normal acidity of the stomach necessary for breaking down food and absorbing nutrients. Furthermore, this reduced stomach acidity may also interfere with gallbladder and pancreas functioning.

But if the risks associated with these drugs increase with their duration of use, why do many patients continue taking them? As ACSH s Dr. Gilbert Ross explains, Patients who begin to use PPIs for heartburn or reflux (GERD) may develop a reliance on them. This may be based on physiology, because suppressing acid for a prolonged period can produce a rebound increase in acid production when the drug is stopped. Often, when patients stop taking the drugs, they begin to experience a return of symptoms sometimes even stronger than before they were first treated, he says. Thus patients resort to taking these drugs again sometimes for years on end, with no specific therapeutic end-point.

Yet patients aren t the ones to blame, Dr. Ross observes: It is the physicians duty to have a discussion with their patients about the proper use of these drugs, instead of simply prescribing PPIs on an on-going basis.