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Powerful Antacids Raise Chances of Fracture
Date:6/2/2009

But benefits still outweigh risks for patients who rely on them, experts say

TUESDAY, June 2 (HealthDay News) -- Powerful and widely used antacids called proton pump inhibitors and histamine-2 receptor antagonists relieve stomach acid, but also appear to increase the risk of hip and thigh fractures, a new study confirms.

This new report, when coupled with findings from several other studies, supports the idea that these drugs increase the risk of bone breaks. Common proton pump inhibitors include Prilosec, Prevacid and Nexium, while common histamine-2 receptor antagonists include Pepcid, Tagamet and Zantac. These drugs are typically used to treat gastroesophageal reflux disease (GERD).

"The medicines may increase the risk of fracture," said study author Dr. Douglas A. Corley, a gastroenterologist at Kaiser Permanente in San Francisco. "People should only take the medications for a defined indication and should take them at the minimal effective dose," he added.

"The next step is evaluating whether taking calcium or vitamin D actually changes the risk, because we don't know for sure what the mechanism is," he said. "The main thing right now is to be aware that there is this association."

Stomach acid is there for a reason, Corley said. "Completely eliminating it may have adverse effects. People are at an increased risk of getting food-borne infections when they are on these drugs, and this [fracture risk] is something else that may be at increased risk as well," he said.

The findings were presented Monday in Chicago at the Digestive Disease Week 2009 meeting.

For the study, Corley collected data on 33,752 people taking these medications and 130,471 people who were not taking them. People who had hip fractures were 30 percent more likely to be taking proton pump inhibitors over two years, he found.

In addition, people with hip fractures were 18 percent more likely to have had
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