Proton Pump Inhibitor (PPI) Side Effects

▸ Gastric or Stomach Cancer Risk

Concerns about the link between stomach cancer and Nexium, Prilosec or other PPI drugs emerged in late 2017, following the publication of two studies that suggested users may face a substantially greater risk, which was not seen with other types of heartburn drugs.

In a study published in the medical journal Gut, researchers from Hong Kong indicated that proton pump inhibitors could increase the risk of gastric cancer following treatment for Helicobacter pylori infections.

In October 2017, a separate study published in The BMJ (British Medical Journal) found that long term use of PPI heart burn medications were linked to a three-fold increased risk of gastric cancer.

The stomach cancer side effects of proton pump inhibitors were seen among both men and women, including all age groups. However, the risk was particularly high among younger users of the drugs, under the age of 40.

Experts now indicate that the manufacturers of these popular drugs knew or should have known about the cancer risk earlier, and that the findings challenge the widespread use of Nexium, Prilosec and other PPI drugs for long periods of time especially if there is not a strong medical need for the medications.

▸ Acute Interstitial Nephritis

Evidence suggests that proton pump inhibitors increase the risk of acute interstitial nephritis, which involves inflammation of the kidneys that may lead to chronic and long-term injury if the drug is not discontinued.

In late 2014, the FDA announced new proton pump inhibitor warnings would be added to the medications, including information for the first time that the drugs may cause acute interstitial nephritis, which may have caused many individuals suffering from this kidney complication to continue using the drugs since doctors were previously unaware of the connection.

Acute interstitial nephritis from proton pump inhibitors may cause symptoms like nausea, vomiting, fatigue and sudden weight loss. However, in severe cases this may lead to chronic kidney damage and kidney failure.

▸ Acute Kidney Injury

In April 2015, a study published in the medical journal CMAJ Open highlighted the risk of acute kidney injury with proton pump inhibitors.

Researchers from the Institute for Clinical Evaluative Sciences and St. Michael’s Hospital in Toronto examined data on 300,000 older individuals and found that those who started PPI drugs had a 2.5 fold increased risk of acute kidney injury, as well as 3 times higher risk of acute interstitial nephritis when compared to individuals who did not use the drugs.

Acute kidney injury involves the abrupt loss of kidney function, which may occur after taking a PPI drug. While many individuals regain normal kidney function, approximately 10% of patients with acute kidney failure may be permanently impacted, causing end-stage kidney failure and other complications.

▸ Chronic Kidney Disease

In January 2016, concerns about the PPI kidney risks were further increased with the publication of a study in the medical journal JAMA Internal Medicine, which found that the heartburn drugs may also increase the risk of chronic kidney disease (CKD) by 50%.

Researchers examined data on more than 10,000 participants over a period of more than 10 years, finding that compared with those who did not use the drugs, PPI treatments were associated with a higher incidence of chronic kidney disease. These findings have led researchers to call for further studies to evaluate whether limiting PPI use may mitigate the risk.

Experts have pointed out that the risk of chronic kidney disease from proton pump inhibitors likely stems from recurrent acute kidney injury or interstitial nephritis.

Chronic kidney disease from proton pump inhibitors may cause wastes to build up to high levels in the blood, which may eventually lead to kidney failure, the need for life-long dialysis treatments or a kidney transplant surgery.