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Heartburn drugs linked to early deaths

A hand arranges a variety of pills into a star shape around an empty orange pill bottle.

June 21, 2019—People who take heartburn medications called proton-pump inhibitors (PPIs) for months to years may face an increased risk of early death due to three specific causes, according to new research in The BMJ.

PPIs (like Prilosec, Nexium, Prevacid and Protonix) reduce acid in the stomach. Both prescription and over-the-counter PPIs are used to help treat heartburn, acid reflux and peptic ulcers.

A cause of premature death

Previous research has linked chronic use of PPIs to several serious risks, including:

  • Kidney and heart problems.
  • Dementia.
  • Osteoporosis-related fractures.

Earlier research also suggested that people who use PPIs for a long time have an increased risk of premature death, though the reasons for that were unclear.

To learn more about the link between PPIs and premature death, the research team compared people using PPIs to people using H2 blockers (like Pepcid and Zantac), which are another class of acid-suppressing drugs.

After following the people for up to 10 years, the researchers found that:

  • The PPI group had a 17% increased risk of death compared with the H2 blocker group. Specifically, they were more likely to die from heart disease, chronic kidney disease and stomach cancer. Since millions of people regularly take PPIs, this translates into thousands of deaths per year.
  • The risk of early death went up the longer the drugs were used. This was true even when people took PPIs at low doses.
  • The longer a person used PPIs, the more likely they were to die early from any of the three causes identified by the study.

For some, risk without benefit?

Another key finding from the study was that more than half of the people who took PPIs did so apparently without a clear medical reason. So it's not clear if they received any benefit from the drug. One of the study's authors called this finding "alarming."

It also highlights another concern: Many people take over-the-counter PPIs without being under a doctor's care and for longer than needed, the research team noted.

A useful medicine, when needed

The study's results do not mean that no one should take PPIs. Some people need them to treat heartburn and more serious conditions like GERD (gastroesophageal reflux disease). But taking PPIs for a long time may pose risks. For some people, the benefits will outweigh the potential risks. Even so, PPIs should be taken at the lowest dose for the shortest time possible, according to the research team.

They also had a word of advice for those who take over-the-counter PPIs: If you think you'll need to take them for longer than two weeks, check in with your doctor first.

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