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Heartburn Drugs, When Combined with Other Drugs, May Worsen Kidney Damage

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Recent studies have linked popular heartburn drugs like Prevacid and Nexium—so called “proton-pump inhibitors” or PPIs—to side effects like chronic kidney disease, bone fractures, and dependency.

Now, a new study published in the International Journal of Basic & Clinical Pharmacology suggests that the drugs may interact with other drugs that may impair kidney function to actually worsen kidney damage. This could be a major concern in patients who are taking multiple medications.

Study Finds PPIs in Combination with Other Common Drugs Worsen Kidney Damage

For the study, researchers administered omeprazole (Prilosec), pantoprazole (Protonix), and rabeprazole (Aciphex) for 28 days to three different groups of rats.

  1. Group 1: received only the PPI medication
  2. Group 2: received both the PPI medication and diclofenac (a pain-relieving drug sold as Voltaren, Cambia, Cataflam, Zipsor, and Zorvolex)
  3. Group 3: received both the PPI medication and ofloxacin (an antibiotic used to treat a variety of infections, sold as Floxin)

Results showed that when the PPI drug was used in combination with the pain-relieving drug or the antibiotic, participants showed signs of developing acute interstitial nephritis (AIN). This is a type of kidney damage that can progress to kidney failure.

High doses of Aciphex and all doses of Protonix were also found to cause mild structural changes in the kidney.

“PPI alone are prone to cause AIN,” the researchers concluded, “but the incidence of AIN increases with addition of other nepohrotoxic a [potentially kidney-damaging] drugs.”

The researchers also noted that they would have stopped use of the drug at the first sign of kidney problems, they might have seen reversal of the damage. They cautioned that especially in patients with pre-existing kidney damage, the use of PPIs should be carefully considered. They also warned that the drugs can produce kidney damage without being combined with other drugs.

PPIs Linked with Chronic Kidney Disease

Interstitial nephritis is a kidney disorder in which the spaces between the kidney tubules become inflamed and swollen. Its most often caused as a side effect of certain drugs.

Extended use of standard medications like acetaminophen (Tylenol), aspirin, and other nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can cause interstitial nephritis. Other drugs, like PPIs and diuretics, may also increase the risk of developing the condition.

Recent studies have also linked PPI drugs to chronic kidney problems. In a 2015 study, participants 66 years of age and older who took the drugs suffered an increased risk of both acute nephritis and acute kidney injury. A 2016 study of over 10,000 participants also found that those taking PPIs had a 20-50 percent increased risk of kidney disease compared to those who never took the drugs.

Several PPI lawsuits are currently pending around the country. Plaintiffs who took PPIs like Nexium, Prilosec, Prevacid, and Protonix have alleged that they then suffered serious side effects, including kidney damage and kidney failure after use of the drugs. The plaintiffs further claim that the manufacturers failed to provide adequate safety warnings about these risks.