Review Drug safety: focus on long-term therapy with proton pump inhibitors. Probable side effects

Abstract

Currently, an important component of rational pharmacotherapy is drug safety. Proton pump inhibitors (PPIs) are the most effective drugs for the treatment of acid-related diseases. For a long time, PPIs were considered completely safe drugs for both short-term and long-term use. However, modern clinical guidelines note that when prescribing PPIs in large doses for a long period, the possibility of side effects should be taken into account. In recent years, a number of foreign reviews have been published that examine the connections between PPIs and a number of diseases/conditions, but in the domestic literature there are no reviews on the safety of PPIs during long-term use. A search was conducted in the PubMed and Scopus information databases for publications on the safety of PPI use, including sources up to November 15, 2023. However, long-term use of PPIs is associated with numerous side effects, and it is not possible to discuss all of them in detail in one review. This review examines the most likely side effects associated with long-term PPI therapy: the development of infections, increased risk of fractures and kidney pathology. The association of long-term use of PPIs with the development of these side effects is not denied or questioned in recent reviews.

Keywords

• proton pump inhibitors
• drug safety
• probable side effects
• clostridium difficile infection
• community-acquired pneumonia
• novel coronavirus infection (covid-19)
• osteoporosis
• hip fracture
• vertebral fracture
• wrist fracture
• acute interstitial nephritis
• acute kidney injury
• chronic kidney disease
• terminal stage renal failure