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Caution on long-term use of "proton pump inhibitor" drugs

     The Department of Health (DH) today (March 3) cautioned the public about the long-term use of proton pump inhibitor (PPI) drugs because of a safety alert from the United States (US). Common PPI drugs include esomeprazole, lansoprazole, omeprazole, pantoprazole and rabeprazole.

     Through its surveillance system, the DH noted that the US Food and Drug Administration (FDA) cautioned that PPI drugs might cause low serum magnesium levels if taken for prolonged periods of time, in most cases longer than one year. In approximately one-quarter of the cases reviewed, magnesium supplementation alone did not improve the low serum magnesium levels and required the discontinuation of the PPI drugs.
     PPI drugs work by reducing the amount of acid in the stomach and are used to treat conditions such as gastroesophageal reflux, stomach and small intestine ulcers, and inflammation of the esophagus.

     According to the FDA, healthcare professionals should consider obtaining serum magnesium levels prior to initiation of PPI drugs treatment in patients expected to be on these drugs for long periods of time, as well as patients who take PPI drugs with medications such as digoxin, diuretics or drugs that may by themselves cause hypomagnesemia.

     For patients taking digoxin, a heart medicine, this is especially important because low magnesium can increase the likelihood of serious side effects. Thus, healthcare professionals should be vigilant about symptoms of hypomagnesemia in patients taking PPI drugs and advise them to seek immediate care if they experience arrhythmias, tetany, tremors, or seizures while taking such drugs.

     In Hong Kong, there are 140 PPI drugs registered with the Pharmacy and Poisons Board (PPB). All these products are prescription medicines except omeprazole.

     In view of FDA's alert, DH decided to issue a letter to inform healthcare providers about the latest position in the US first. DH will also advise on any reported any side effects from the use of PPI drugs.

     Further, the issue will be discussed in the coming meeting of the Registration Committee of the PPB.

     Members of the public should consult their healthcare providers if in doubt or feel unwell.

Ends/Thursday, March 3, 2011
Issued at HKT 19:31


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