Omeprazole and Its Adverse Reactions: Long-Term Management Precautions for Proton Pump Inhibitor Use and Hypomagnesemia Risk

Omeprazole, a widely used proton pump inhibitor (PPI), is effective in treating acid-related disorders such as gastroesophageal reflux disease and peptic ulcers. However, its long-term use has raised concerns regarding potential adverse reactions. This article delves into the potential side effects of omeprazole and the necessary precautions for its long-term management.

Exploring the Side Effects of Omeprazole

Prolonged use of omeprazole can lead to a range of complications. A recent study demonstrated that long-term omeprazole use may affect hematological and biochemical parameters, resulting in a significant reduction in red blood cells and an increase in cholesterol and triglyceride levels [1]. Additionally, elevated creatinine and urea levels in the blood have been observed, suggesting a potential impact on renal function.

Another significant adverse effect is hypomagnesemia, which has been associated with the prolonged use of PPIs, including omeprazole. One study found that patients using omeprazole had significantly lower magnesium levels compared to those on other PPIs [2]. Hypomagnesemia can lead to severe complications such as cardiac arrhythmias and seizures.

The risk of osteoporosis and fractures has also been linked to the long-term use of omeprazole. The decreased absorption of calcium due to gastric acid suppression may contribute to bone fragility [3]. Furthermore, omeprazole has been shown to induce changes in glucose metabolism and homeostasis, potentially increasing the risk of developing type 2 diabetes [4].

Conclusions

Long-term management of omeprazole requires careful evaluation of risks and benefits. It is crucial for physicians to consider these potential adverse reactions when prescribing omeprazole, especially in patients with pre-existing risk factors for conditions such as hypomagnesemia and osteoporosis. Periodic reassessment of the necessity to continue treatment and the implementation of preventive measures, such as magnesium and calcium supplementation, may be effective strategies to mitigate these risks.

Referencias

• [1] Long-Term Use of Omeprazole: Effect on Haematological and Biochemical Parameters
• [2] Is there a correlation between hypomagnesemia linked to long-term proton pump inhibitor use and the active agent?
• [3] Proton Pump Inhibitors and Bone Health: An Update Narrative Review
• [4] Long-Term Administration of Omeprazole-Induced Hypergastrinemia and Changed Glucose Homeostasis and Expression of Metabolism-Related Genes

Created 6/1/2025