Cut on heartburn pills to avoid serious side effects: Study

Toronto: Doctors must prescribe heartburn and acidity pills in lowest possible doses and for shortest time to patients to ward off potential side effects, researchers warn.

Called Proton pump inhibitors (PPIs), such common over-the-counter pills like omeprazole, rabeprazole and pantoprazole are taken to alleviate gastric distress from stomach acid.

"Proton pump inhibitors are associated with a number of rare but potentially serious adverse effects,” wrote Dr Todd C. Lee, internal medicine specialist at McGill University Health Centre in Montreal, Quebec.

"These uncommon effects become highly relevant when considering the tens of millions of patients who take PPIs worldwide,” he added.

Some PPIs have been associated, in observational studies, with increased risk of heart attack in patients taking the antiplatelet agent called clopidogrel.

Other adverse effects, which occur in varying frequencies, include rebound heartburn after discontinuing PPIs, malabsorption of vitamin B12, iron and magnesium, an increased risk of infection with Clostridium difficile and possible increased risk of fractures in patients receiving long-term PPI therapy.

"The review outlines the potential risks of long-term use of PPIs to help physicians and their patients understand the implications. It looks at drug interactions and noninfectious and infectious complications,” the study noted.

To minimise the risk of adverse effects, the authors recommend lifestyle modifications such as limiting caffeine and alcohol which can cause gastric distress.

"We believe that PPIs should be prescribed at the lowest dose and for the shortest duration of therapy appropriate to the condition being treated,” the authors concluded.

The review appeared in the Canadian Medical Association Journal.