The Medical Letter on Drugs and Therapeutics
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1527
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Safety of Long-Term PPI Use

Proton pump inhibitors (PPIs), which are used for treatment of gastroesophageal reflux disease (GERD) and for prevention of upper gastrointestinal adverse effects caused by NSAIDs and aspirin, are one of the most commonly prescribed classes of drugs in the US. All PPIs are similarly effective and generally well tolerated,1,2 but their long-term use has been associated with a number of safety concerns.3,4 Recommendations addressing these concerns have recently been published.5,6

FRACTURES — The labels of all prescription PPIs include a warning about an increased risk of fractures with long-term use.7

Mechanism – Reduced gastric acidity might interfere with calcium absorption.

Clinical Studies – A meta-analysis of 18 ... more      

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