proton pump inhibitors (PPIs) and hypomagnesaemia
Last reviewed 04/2021
- prolonged use of proton pump inhibitors (PPIs) has been associated with
case reports of hypomagnesaemia
- some cases occurred after 3 months of PPI therapy, but most occurred
after 1 year of treatment
- serious manifestations of hypomagnesaemia - fatigue, tetany, delirium,
convulsions, dizziness, and ventricular arrhythmia - can occur, but
they may begin insidiously and be overlooked. In most case reports,
hypomagnesaemia improved after magnesium replacement and discontinuation
of the PPI
- serious manifestations of hypomagnesaemia - fatigue, tetany, delirium,
convulsions, dizziness, and ventricular arrhythmia - can occur, but
they may begin insidiously and be overlooked. In most case reports,
hypomagnesaemia improved after magnesium replacement and discontinuation
of the PPI
- some cases occurred after 3 months of PPI therapy, but most occurred
after 1 year of treatment
- healthcare professionals should consider measuring magnesium levels before starting PPI treatment and repeat measurements periodically during prolonged treatment, especially in those who will take a PPI concomitantly with digoxin or drugs that may cause hypomagnesaemia (eg, diuretics)
The MHRA advise that healthcare professionals should:
- consider measurement of magnesium levels before starting PPI treatment and periodically during prolonged treatment, especially in those who will take a PPI concomitantly with digoxin or drugs that may cause hypomagnesaemia (eg, diuretics)
- take into account any use of PPIs obtained over-the-counter
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