Safety Profile of Acid Suppression with Proton Pump Inhibitors

Review

The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2009;9(1):11-17.
Published online July 10, 2009.

PPI 사용시 경험할 수 있는 부작용과 그 대책

박혜원ㆍ정훈용

울산대학교 의과대학 서울아산병원 내과학교실

Abstract

PPIs are being used with increasing frequency to treat acid-related disorders. In general, the tolerability profile of PPIs is good. The most common adverse events of headache, diarrhea, and nausea have been reported in fewer than 5% of patients treated with short-term use of PPIs. Few clinically important interactions have been observed between PPIs and other drugs metabolized by the cytochrome P-450 system. Chronic administration of PPIs may lead enterochromaffin-like cell hyperplasia, but has not been demonstrated to increase the risk of carcinoid formation. Long-term PPIs use has not been documented to hasten the development or the progression of atrophic gastritis and gastric cancer. Bacterial overgrowth and the risk of enteric infection may increase with acid suppression, although this does not seem to be a common clinical problem with prolonged PPIs use. The absorption of fats and minerals does not appear to be significantly impaired with PPIs-induced hypochlorhydria. However, vitamin B12 concentration may be decreased when gastric acid is markedly suppressed for prolonged periods. Taking into account all the available risk/benefit data, PPIs use is strongly justified when clinically indicated. Therefore PPIs should not be used in higher doses or for longer durations than necessary to achieve the desired outcomes. (The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2009;9:11-17)

Key Words: Proton pump inhibitors, Acid secretion, Side effects, Safety