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New warning on heartburn drugs: bone fracture risk

Consumer Reports News: May 26, 2010 12:00 PM

Heartburn drugs called proton pump inhibitors, or PPIs, can squelch that fire in your belly, but a recent warning from the Food and Drug Administration about a possible increased risk of bone fractures with these medications underscores why you should make sure you really need such a potent medicine. Our newly updated Best Buy Drugs report on these drugs warns of this serious side effect, and another recent study confirmed the risk.

The FDA said studies indicate that high doses of PPIs or taking the drugs for longer than a year could possibly increase the risk of fractures of the hip, wrist or spine. The agency said it was adding a warning about this possible risk to the labeling of PPIs, which include dexlansoprazole (Dexilant), esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec, Zegerid, and generic), pantoprazole (Protonix), and rabeprazole (Aciphex). Four are also available over-the-counter: generic omeprazole, Prilosec OTC, Prevacid 24HR and Zegerid OTC.

Broken bones aren't the only risk with these drugs. PPIs also increase the risk of bacterial infections and pneumonia, and can also negatively interact with other medications. Some studies indicate these drugs may reduce the effectiveness of clopidogrel (Plavix), a blood thinner used to prevent clots after heart attacks and stent placement.

So if your heartburn is mild and infrequent, you should first try lifestyle changes, like reducing how much alcohol and caffeine you drink, quitting smoking, eating smaller meals and losing weight if you need to. If those don’t work, try an inexpensive over-the-counter antacid, such as Maalox, Mylanta, Rolaids, Tums, or their generic equivalent, or drugs called H2 blockers, which include Pepcid AC, Zantac 150 or their generic equivalent.If you suffer from heartburn twice a week or more for weeks or months on end, you may have gastroesophageal reflux disease, or GERD, and may need a PPI. Our Best Buy picks are three over-the-counter PPIs—generic omeprazole, Prilosec OTC and Prevacid 24HR. But before you start taking one of these, see a physician to make sure you actually suffer from GERD and that a PPI is appropriate for your condition. And if you are already taking a PPI, discuss with your doctor whether you could try a lower dose or stopping.

Steve Mitchell, associate editor, Consumer Reports Health Best Buy Drugs

For more details on the PPIs drugs, heartburn and GERD, check out our free Best Buy Drugs report*.

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