A 2015 Stanford study linked proton-pump inhibitors (like omeprazole) with an elevated risk of heart attack (summary here; full report here). A recent study at Washington University came up with similar results (summary here, full report here).
Have any Dopers stopped taking omeprazole, or another PPI, due to the risks? If so, what (if anything) are you taking instead, and is it working for you? H2 blockers like ranitidine and famotidine are apparently still okay.
Also, what is the baseline that these increased deaths are measured against? If death rates go up by 50% over 5 years, but only 1 in 100 die naturally that means 1 in 200 people will die who wouldn’t. On a society wide scale that is a problem, but as an individual if the drugs really help you, I’d probably gamble those dice if nothing else helped me.
I’ve discussed it with my doctor and agreed the risk is worth the avoidance of esophageal damage/cancer. I’m otherwise healthy and not that worried about it. If I don’t take it, the burn is there nearly constantly, and the alternatives haven’t worked in the forms I’ve taken them - granted I haven’t tried higher dosing than the recommended OTC directions.
I was on those kind of meds for 25 years (age 33-58). Was told by my doctors I’d be on them for rest of my life unless I wanted to consider surgery, which my personal doctor advised against but even when I started taking them, I’d always assume sometime down the road, there would be some study that would link it up to higher health risks of something, which happened. I don’t think the risk is all that great though, and the alternative to not taking at all is not so good either if you’re having major problems with GERD.
I accidentally lost 10 lbs (meaning wasn’t really trying to lose weight), and my GERD disappeared completely. Last 15 months, still no acid reflux, and now I eat everything and anything. Still no problems. All that time, all I needed was just to lose a few pounds. Everybody is different, but I hope others will consider this might answer your problem as well. I have since lost more weight, just because I found a easy way to lose weight, and wanted to see how it made me feel. Which is great, although I probably looked better at the heavier weight.
There is increasing evidence about the possibility of significant health effects from PPIs but to me the most serious is the effect it has on lysosomes.
I was taking 40mg twice per day and stopped as soon as I read that article. I switched to famotidine (and H2 blocker). That works just as well for me but you may have different results. Some people need a PPI but it can sometimes be avoided with lifestyle changes like a low fat diet, losing weight, etc.
Goddammit. I take omeprazole, and I am not at all happy with this news.
My primary care physician, who was awesome, retired early last year. My new one is… less impressive. She has so far seemed baffled by everything I’ve asked her about, leaving me to guide myself through trying to stay on top of the research on my conditions and meds. My google-fu is weak.
Last year my GERD was out of control and getting worse, and I went to see a gastroenterologist, and they were rather problematic and in many ways unhelpful. Reminded me of the old HMO days, really, where it felt more like I was just being passed through an assembly line rather than having anyone actually pay attention to things like symptoms and whether treatments are effective.
All of this cranky rambling is to say that I’m pretty shocked at this information, I don’t know if I should be seriously concerned or not, and I lack faith that my current healthcare providers will be of any more help than they have been.
H2 blockers (all of which end in “-dine”) are okay. I’ve already bought some ranitidine and will be trying that first. My GERD isn’t as bad as some people have it. I had an endoscopy several years ago and there was no sign of esophageal damage. I’m hoping that an H2 blocker will be enough.
The cardiovascular side effects are scary enough, but the lysosome problem (cited by allotrope above) has me even more concerned. The increased dementia risk I cited in my OP is believed to result from PPIs shutting down acid production everywhere in the body (including the brain).
Stick with ranitidine or famotidine. Cimetidine just has too damn many interactions with other drugs.
As for PPIs, well, we’ll be getting more evidence in the near future, since some folks have now been taking it continually for over two decades. I advise my patients to use it with caution, try it every other day, take holidays if possible, move to H2 blockers and acid neutralizers, and so forth.
The official medical recommendation these days:
BUT: If they have Barrett’s esophagus or other severe reflux conditions there’s really no substitute for the PPIs.
Well this is disconcerting. I’m 28 and I’ve been on omeprazole off and on for about 7 years. I’ve lost about 60 lbs (then gained some back, that’s a topic for a different thread) and, while I still had a ways to go to a healthy body weight, I was about half way at that point. My acid reflux did not get better. I tried weaning off at that point but found that I couldn’t go less than 20 mg per day without feeling like I was going to digest my esophagus in my sleep. I tried ranitidine while I was a pregnant and found it less than effective. I’m not sure what I’m going to do but I suppose I’ll start with talking to my doctor.
I am on omeprazole, and talked to my doctor about the risks. I am still taking it.
The dementia and kidney disease links are very tenuous right now, so I was told that until more information comes in, to probably not lose a lot of sleep over it.
I’m 37, and I have a hiatal hernia. Without my meds, I often literally wake up choking/drowning in stomach acids, then get to spend the next several hours feeling/hearing the faint sizzling and popping of my lungs as the acid does its job, which makes for a rather excruciating night. I’d rather take the meds!
Yes, my GP talked me out of it. Fortunately an alternate medicine was available (Ranitidine aka Zantac). My condition isn’t anything too serious (just some stomach agitations if I eat the wrong things which I don’t anymore, mainly fried foods).
I’m currently taking 20mg once daily and it’s totally effective. I had an ENT suggest a higher dose due to a different issue, but I told her it’s well controlled with the 20mg and I really didn’t see any need to raise it, the scoping she did showed no acid related problems in the area of concern, so she backed down on that. I’ll have to re-address the issue if the 20mg stops working (so far 8 years). I’m still not too concerned at this dose, but aware enough that I’ll look into adding a second med if needed down the road rather than raising the dose of this one.
My doctor told me to stop taking omeprazole. I switched to a generic version of Zantac and so far it is working for me. I have also found eating dinner earlier and avoiding any after dinner snacking has helped the night time hearburn issues that would wake mu up at night.
I’m on pantoprazole (which was the 4th one i tried, the only one that worked). I tried getting off it a couple years ago when my script ran out but I was pretty much in tears by the time I got to the doctor 3 weeks later, asking her either to refill or kill me
I guess since I’m diabetic I should perk up more with regards to kidney disease. Perhaps I shall switch to one every other day. I do watch my diet and avoid triggers but really at this point I think the main trigger is being alive.
Add chronic liver disease to the list of potential issues associated with PPIs. Although technically, any antacid could have similar results to those listed in the article only to a lesser degree.
I give omeprazole to my dog because she otherwise tends to stop eating, but I give her holidays from it when she seems to be feeling OK. The vet mentioned that other heartburn meds don’t seem to work for dogs, but I might confirm that with her.
My doctor told me to take breaks from my pantoprazole. So when my bottle runs out, I usually use Zantac for a few days before I get the pantoprazole refilled.
Ignore the mouse data. It can’t be meaningfully extrapolated to the human population. It’s useful for planning and modeling further studies.
As for the higher rate of alcoholic liver disease in alcoholic patients who use PPIs, my clinical experience suggests to me that one possible explanation is that those alcoholics who use PPIs also are able to consume more alcohol, because the horrible gastritis and esophagitis is reduced. Hence continued years of more alcohol consumption, more liver disease.
Not saying that is what is happening, but I consider it more likely than attributing the increase to the PPI itself.
