Reported Side Effects and Complications of Long-term Proton Pump Inhibitor Use

Dissecting the Evidence

David A. Johnson; Edward C. Oldfield IV


Clin Gastroenterol Hepatol. 2013;11(5):458-464. 

In This Article


The reported associations for harm relative to PPI use have received considerable attention across a broad range of adverse effects. Clearly, the literature does show that some of these are related, albeit quite rare and more typically idiosyncratic (eg, hypomagnesemia and interstitial nephritis). As such, these potential adverse effects should be not dismissed but put in perspective relative to the vast universe of patients receiving this class of therapy. The evolving data on C difficile should be monitored carefully. The clinical risk/benefit of any medical intervention or therapy always should be evaluated for each patient and appropriate use of therapy should be directed accordingly. Because PPIs are overprescribed in many patients, in particular for continued long-term use, the clinical effects always should be reviewed and attempts should be justified to stop any therapy that may not be needed.