PPIs and Risk of Hip Fracture

Older people are often prescribed powerful acid suppressing drugs called proton pump inhibitors. These PPIs include over-the-counter drugs like Prilosec and Prevacid or prescription medications such as Nexium or Protonix. Such acid suppressors are often taken to control reflux, heal ulcers or prevent symptoms of heartburn associated with other medications such as bisphosphonates. Such drugs, like alendronate, known by the brand name Fosamax, frequently cause serious heartburn.
Doctors in Denmark wondered whether the simultaneous use of PPIs with alendronate might interfere with the effectiveness of the osteoporosis drug. Over 38,000 patient records were reviewed. During the course of about 3.5 years, alendronate was much more effective at preventing hip fractures in people who were NOT taking an acid-suppressing drug. The scientists caution that while their data do not prove PPIs cancel the benefits of bisphosphonates, doctors should be much more cautious about prescribing such medications together.
[Archives of Internal Medicine, June. 13, 2011]