Drugs for Heartburn and Osteoporosis May Increase Risk of Spontaneous Hip Fracture
Dr. Noel Peterson
Drugs commonly prescribed for heartburn include Proton pump inhibitors, or PPIs, such as Prilosec, Nexium and Prevacid are often taken for years. Now studies show that patients who used proton pump inhibitors for more than a year had a 44 percent higher risk of hip fracture than nonusers. The longer they took the drugs, the higher their risk.
The biggest risk is seen in people who take high doses of the drugs for more than a year. That group has a 2 1/2 times greater risk of hip fractures than nonusers.
“Doctors should make sure patients have good reason to stay on heartburn drugs long term”, Dr. Yu-Xiao Yang of the University of Pennsylvania School of Medicine where the drugs were studied.
“The general perception is they are relatively harmless,” Yang said. “They often are used without a clear or justified indication for the treatment.” Men in the study had a higher drug-associated risk of hip fracture than women, possibly because women may be more aware of osteoporosis and may get more calcium in their diets, Yang said.
Questions have also emerged about the roll of popular drugs used to treat osteoporosis, linking them to spontaneous fractures of the hip. Because bisphosphonate drugs like Fosamax and Actonel inhibit bone remodeling, the microscopic bone cracks that appear with normal wear and tear are not repaired. These microscopic injuries are allowed to accumulate when on the drugs. Bones get denser but not stronger while taking the drugs. Bone scans and x-rays are not sensitive enough to show this accumulated damage and studies show an increase incidence of fracture after 5 years of use.
Another rare side effect is osteonecrosis of the jaw, in which a patient ’s jawbone rots and dies. Dentists report this drug complication among patients given intravenous bisphosphonates during cancer treatment, but oral bisphosphonate users are vulnerable too. For alternatives in the treatment of osteoporosis, contact the Center.