Sometimes drugs that people have long taken for granted become less appropriate-possibly even dangerous-as patients grow older. Popular drugs used to treat heartburn probably should be considered in this category, although they are not usually listed as drugs that are too risky for older people.
Does Nexium Weaken Bones?
Q. My wife and I are in our 70s. She has been taking Nexium for years. We recently read that this kind of medication could increase her risk for bone fracture. How could this be true?
A. Acid-suppressing drugs such as esomeprazole (Nexium), lansoprazole (Prevacid) and omeprazole (Prilosec) interfere with the absorption of minerals such as calcium and magnesium. A recent article in the Journal of the American Geriatrics Society (Nov. 2015) suggests that taking such proton pump inhibitors (PPIs) for more than two months could be too risky for older people. It can lead to C. diff intestinal infections as well as bone loss and fractures. The most recent meta-analysis confirms that regular use of PPIs can increase the risk of both hip and spine fracture (International Journal of Clinical and Experimental Medicine, June, 2015).
Older People Are Not the Only Ones at Risk:
Withdrawal Symptoms:
There is a fair amount of evidence that everyone who takes a PPI for more than two months might experience some undesirable side effects. One that has been highly debated by gastroenterologists is the likelihood of rebound reflux (Gastroenterology, July, 2009). Volunteers with no history of reflux symptoms suffered heartburn or indigestion for several weeks when they stopped taking Nexium suddenly after being on it for two months.
Changes in Gut Bacteria:
There has been increased scientific attention to the importance of the balance of bacteria living in our digestive tracts. A recent experiment indicates that disruptions in the ecology of the microbiome can faciliate infection with Clostridium difficile, a type of bacteria that can cause a nasty, hard-to-treat diarrhea (Gastroenterology, Oct., 2015).
We are sending you our Guide to Digestive Disorders with a discussion of the pros and cons of these medications and the alternatives. It also has information on tactics to get off a PPI.
