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Side Effects of
Proton Pump Inhibitors


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Description: Proton pump inhibitors (often referred to as “PPIs”) are primarily used in reducing gastric acid production and secretions. They are used in a number of conditions including: dyspepsia, peptic ulcers, GERD (gastroesophageal reflux disease), and Barrett’s esophagus.

Serious Side Effects of Proton Pump Inhibitors

Serious adverse reactions, according to Harvard Health Publications “Proton-Pump Inhibitors” (Apr 2011), include:

  • Gastrointestinal bleeding
  • Fracture risk
  • Pneumonia risk
  • Iron and B12 deficiency
  • (Current Allergy and Asthma Reports “Immediate and Delayed Hypersensitivity Reactions to Proton Pump Inhibitors: Evaluation and Management,” Mar 2016).

    Common Side Effects of Proton Pump Inhibitors

    The most common adverse reactions to PPIs are:

  • Diarrhea
  • Fever
  • Vomiting
  • Rash
  • Nausea
  • Constipation
  • Abdominal pain
  • (Indian Journal of Medical Research “Genetic polymorphism of CYP2C19 & therapeutic response to proton pump inhibitors,” Jun 2008).

    Understand Your Risks with the Rxight® Genetic Test

    Proton pump inhibitors are a widely prescribed class of medications that are not usually associated with severe adverse reactions. However, some patients may suffer from a number of side effects that can result in the cessation of pharmacotherapy. This variation between patients is largely accounted for by pharmacogenetic testing – that is the differences between genomes of the patients. Polymorphisms in the genes that code for enzymes and receptors that interact with proton pump inhibitors, can increase the probability of developing side effects. For instance, a number of studies suggest that individual differences, called “polymorphisms,” in a key liver enzyme responsible for metabolizing PPI medications can increase the probability of developing side effects. One mutation has been shown to increase the QT interval of heart contraction. Therefore, identifying these polymorphisms is crucial to clinical decision making. Doctors can alter the starting dose of proton pump inhibitors given a patient’s genome which could reduce their risk of developing side effects. (Pharmacogenomics “Update on the pharmacogenomics of proton pump inhibitors,” Jun 2011).

    How Does Pharmacogenetic Testing Work?

    MD Labs’ Rxight® genetic testing for medications is designed to reduce the probability of suffering side effects when taking PPIs. Rxight® is based on the analysis (called “SNP genotyping”) of a number of genes, including those involved in the metabolism of drugs in the proton pump inhibitor class, along with over 200 other clinically relevant medications across dozens of pharmacological classes. This pharmacogenetic test analyzes how well your body is able to metabolize the different medications. Slow metabolizers of a particular drug are more susceptible to adverse reactions, while fast metabolizers may not derive a therapeutic benefit. With the results of the Rxight® test, your prescriber(s) can determine – preferably ahead of time – the dose that is right for you, instead of relying on trial-and-error, a process that can be both lengthy and dangerous.

    Contributors to this Article:
    Michael Sapko, MD, PhD; Deborah Kallick, PhD, Medicinal Chemistry

    Proton Pump Inhibitors Tested Include:

    • Dexlansoprazole (Dexilant, Kapidex)
    • Esomeprazole (Nexium)
    • Lansoprazole (Prevacid)
    • Omeprazole (Prilosec)
    • Pantoprazole (Protonix)
    • Rabeprazole (Aciphex)

    Read more about Rxight® Pharmacogenetics