Over-the-Counter Medications: Are They Really Safe? (Issue #3)
Read: Issue #1 and Issue #2 in this blog series
At Casco Bay Direct Primary Care, patient safety and education are two of our most important objectives.
This blog series was started with that in mind. Over the last few months, we’ve reviewed the use of aspirin and also reviewed the recent FDA Advisory Panel statement regarding common cold medications. Let’s now spend some time addressing the use of over-the-counter PPI’s (proton pump inhibitors) that you might be familiar with under the names of Prilosec, Omeprazole, Nexium, Esomeprazole, Prevacid and Lansoprazole.
PPI’s began to be used in 1989 and were exclusively by prescription until 2001.
The initial indications for use were severe heartburn that did not respond to other treatment, or complicated peptic ulcer disease.
Now that they are over the counter, many people reach for them for minor indigestion, reflux, “stomach aches,” and many other reasons. It is now also possible to take these medications long term without consulting a doctor.
Since these medications are now over-the-counter, they must be safe, right? Unfortunately, we know that these medications can cause serious health issues, particularly if taken for a long time. There are certainly some people that do require long term use, but this should be under the direction of a physician so we can monitor the potential risks.
In recent years, we’ve discovered that PPI’s can potentially be associated with the following:
Kidney disease
Bone fracture
Dementia
Predispose individuals to certain infections
Cause micronutrient deficiencies
May increase your risk of diabetes
And most concerning, there is mounting evidence that chronic use of PPI’s may increase your risk for developing several types of gastro-intestinal cancer.
Instead of reaching for PPI’s for the treatment of heartburn, reflux or indigestion, consider these things first.
Dietary adjustments: Avoid trigger foods like spicy or acidic foods. Opt for smaller, more frequent meals rather than large ones.
Avoid lying down after eating: Wait at least 2-3 hours before lying down or going to bed to reduce the risk of acid reflux.
Raise your upper body when sleeping: Elevating the head of your bed may help.
Weight management: If you’re overweight, losing weight can reduce pressure on your stomach and reduce heartburn.
Quit smoking: Smoking can contribute to acid reflux, so quitting may alleviate symptoms.
Moderate alcohol consumption: Limit alcohol intake, especially before bedtime.
Consider the use of H2 blockers like Zantac or Pepcid as needed as well as the periodic use of antacids, like Tums.
As always, please consult your physician with any questions or concerns. If you currently take a PPI under the direction of a physician, please do not stop your medication without consulting with your physician first.