Antacid Drugs Raise Fracture Risk

A study published in the Canadian Medical Association Journal reveals that PPIs for treating acid reflux elevate the risk of osteoporosis-related fractures.

A study published in the Canadian Medical Association Journal reveals that popular proton pump inhibitors (PPI) for treating acid reflux, peptic ulcers, GERD, and related disorders elevate the risk of osteoporosis-related fractures.

A study of 15,792 adults age 50 years or older with osteoporosis-related fractures of the hip, vertebra, or wrist was conducted from April 1996 to March 2004. Compared to a control group, those with a hip fracture were twice as likely to have used a PPI for more than seven years. Further, 62% with a hip fracture had been on PPI medication for more than five years, and when PPI use was extended to more than seven years, the risk for hip fracture quadrupled.

It is unclear what specifically about the extended use of a PPI increases the risk for fracture; however, it is known that this class of drugs, “inhibits the production and intragastric secretion of hydrochloric acid, which is believed to be an important mediator of calcium absorption in the small intestine.”

PPIs—common brands include Aciphex, Prevacid, Priolsec, and Protonix—are surging in popularity. Often times, patients will develop a dependency on these drugs or take advantage of their medication’s effects by not balancing it with a change in lifestyle or diet. But experts say, excluding chronic cases, seven years is a more than adequate amount of time for peptic ulcer disease to improve or be placed under control. Pairing PPI drug treatment with osteoporosis medication may be one solution; however, this study shows a need for further patient education about the adverse orthopedic effects of extended PPI use.

Additional Resources

American College of Physicians: Guidelines for Screening for Osteoporosis in Men

New Test for Osteoporosis Fracture Risk