Vol. 20, No. 1 (February 2011)
Proton Pump Inhibitors’ Impact on Mineral Nutrition
According to a recent report, [Arch Intern Med. 2010;170(9):747-748], the sales of proton pump inhibitors were $13.9 billion US dollars per year and rising. In the US alone, there are 113.4 billion prescriptions written for these drugs in a year. In addition, there are several popular over- the-counter (OTC) brands that are top selling items. This category is one of the largest selling categories of medications in the world. They had been implicated as a cause for increasing the risk of certain bacterial infections, as well as bone fractures. It is prescribed for 70% of the elderly, during hospital stays, and is a major cause for pneumonia related deaths in these patients, according to several studies published in medical journals over the last 2 years. Proton pump inhibitors are prescribed for a variety of conditions, but most commonly for the treatment of erosive and ulcerative esophagitis, Barrett esophagus, Zollinger-Ellison Syndrome, and gastro-esophageal reflux disease, in an effort to prevent the stomach acid from backing up into the esophagus, leading to severe end points, such as cancers of the esophagus. It is also prescribed for the treatment and healing of duodenal ulcers and related peptic disorders. Over-the-counter purchasers are using it for common problems, like simple stomach upset due to hyperacidity. Since this category has gone to over-the-counter as well, and the pharmaceutical companies have invested a lot of ad money on promoting the use of these items, people are using this type product far too commonly, and for the wrong indications. In fact, according to a recent article in the Archives of Internal Medicine [Katz M; Arch Int Med; 2010; 170(9):747-748], 53-69% of proton pump inhibitor prescriptions are for inappropriate indications. There has been talk of taking these types of drugs off the OTC market, and making them restricted to prescription only, but that doesn’t seem likely to happen, given the economics of the situation. More needs to be done to educate the consumer in a situation like this.