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RMJ. 2012; 37(1): 1-1

PPI safety concerns

Nasir Khokhar.


Proton Pump Inhibitors (PPIs) are among the most prescribed therapeutic agents worldwide. Their role in management of acid related disorders and in critically ill patients at risk for the development of stress related mucosal bleeding is well established.1 However, reports on their safety have appeared recently. Hypochlorhydria, hypergastrinemia, interactions on hepatic cytochrome P450 enzymes, nutritional deficiencies, anemia, osteoporosis and bone fractures (especially vertebral), increased risk for pulmonary or enteric infections, polyp or tumor formation and risk of cardiovascular events in patients on PPIs and clopidogrel have been recent highlighted concerns.2 While there is considerable debate regarding the negative impact of concomitant PPIs therapy with clopidogrel, platelet function studies did not demonstrate a clear or consistent interaction between clopidogrel and PPIs.3

Key words: PPI, osteoporosis, pneumonia

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