PPIs and Safety: General Risks of Using Proton Pump Inhibitors

Proton Pump Inhibitors are considered relatively safe to use for a temporary period of time. However, the long term use of these drugs for an extended period of time is linked to certain health problems.

Negative Effect on the gastrointestinal tract

Stomach acid is one of the body’s primary defenses, defending against microbes that enter through the gut. PPIs reduce the acid production in the stomach, which may increase the chances of a person getting an opportunistic infection.6 Recent studies have concluded that acid suppression drugs increase the chances for community acquired pneumonia and other infections.

Effect on the Cardiovascular system

Use of PPIs by patients suffering from GERD has been implicated in increasing the risk of myocardial infarction by 1.6 times. In a recent study researchers concluded that PPIs may be linked to damage of endothelial cells. When cultured endothelial cells were exposed to PPIs they caused them to age rapidly and eventually causing them to lose their ability to divide. This may be due to PPIs inhibiting the lysosomal component of the cell responsible to removal of waste and worn out organelles.

Effect on the Urinary system

PPIs have also been linked to the development of chronic kidney disease. A recent study focused on 76,462 patients using PPIs — 19,311 developed chronic kidney disease. They concluded that excessive use of PPIs increases the risk for the development of chronic kidney disease and also early death.

Effects on the bone

PPIs maybe also lead to malabsorption. This in turns lead to vitamin deficiencies, particularly vitamin B12, vitamin C, calcium and magnesium. Calcium and magnesium are crucial to development and strengthening of bones.

Effect on the Nervous system

Use of PPI may also lead to the development of cognitive deficits including dementia. A study suggested that the incidence of dementia increases by 44% in people who use PPIs regularly.


Medicines like Nexium and Prilosec often play an important role in treating gastrointestinal issues. They can relieve the discomfort of acid reflux and heartburn, and give the lining of the digestive track time to heal. Though they can be effective treatments, it is important that people be aware of the risks, especially of long-term use. Users should consult with their doctors over concerns using these drugs.


1. Khalili H, Huang ES, Jacobson BC, Camargo CA, Feskanich D, Chan AT. Use of proton pump inhibitors and risk of hip fracture in relation to dietary and lifestyle factors: a prospective cohort study. Bmj. 2012 Jan 31;344:e372.
2. Linsky A, Gupta K, Lawler EV, Fonda JR, Hermos JA. Proton pump inhibitors and risk for recurrent Clostridium difficile infection. Archives of internal medicine. 2010 May 10;170(9):772-8.
3. Leonard J, Marshall JK, Moayyedi P. Systematic review of the risk of enteric infection in patients taking acid suppression. The American journal of gastroenterology. 2007 Sep 1;102(9):2047.
4. Laheij RJ, Sturkenboom MC, Hassing RJ, Dieleman J, Stricker BH, Jansen JB. Risk of community-acquired pneumonia and use of gastric acid–suppressive drugs. Jama. 2004 Oct 27;292(16):1955-60.
5. Shah NH, LePendu P, Bauer-Mehren A, Ghebremariam YT, Iyer SV, Marcus J, Nead KT, Cooke JP, Leeper NJ. Proton pump inhibitor usage and the risk of myocardial infarction in the general population. PLoS One. 2015 Jun 10;10(6):e0124653.
6. Yepuri G, Sukhovershin R, Nazari-Shafti TZ, Petrascheck M, Ghebre YT, Cooke JP. Proton pump inhibitors accelerate endothelial senescence. Circulation research. 2016 May 10:CIRCRESAHA-116.
7. Arora P, Gupta A, Golzy M, Patel N, Carter RL, Jalal K, Lohr JW. Proton pump inhibitors are associated with increased risk of development of chronic kidney disease. BMC nephrology. 2016 Aug 3;17(1):112.
8. Ito T, Jensen RT. Association of long-term proton pump inhibitor therapy with bone fractures and effects on absorption of calcium, vitamin B12, iron, and magnesium. Current gastroenterology reports. 2010 Dec 1;12(6):448-57.
9. Gomm W, von Holt K, Thomé F, Broich K, Maier W, Fink A, Doblhammer G, Haenisch B. Association of proton pump inhibitors with risk of dementia: a pharmacoepidemiological claims data analysis. JAMA neurology. 2016 Apr 1;73(4):410-6.