Researchers in Brazil have discovered new proof that prolonged use of proton pump inhibitors (PPIs) could intrude with the physique’s capability to soak up necessary vitamins. The examine was performed by scientists on the Federal College of São Paulo (UNIFESP) and the ABC Medical College (FMABC). PPIs embody extensively used medicines similar to omeprazole (Prilosec), pantoprazole (Protonix), and esomeprazole (Nexium), that are generally prescribed for ulcers, gastritis, and acid reflux disorder.
Whereas these medicine are efficient at lowering abdomen acid, utilizing them longer than really helpful by a doctor could result in nutrient deficiencies, together with anemia, and should negatively have an effect on bone well being. The findings have been revealed in ACS Omega.
Mineral Imbalances Linked to Omeprazole
With funding from FAPESP, the group examined how ongoing use of omeprazole influenced the absorption of key minerals in rats. They centered on iron, calcium, zinc, magnesium, copper, and potassium. Animals handled with the drug confirmed clear shifts in how these minerals have been distributed all through the physique.
The treatment appeared to trigger sure minerals to construct up within the abdomen, whereas creating imbalances within the liver and spleen. Blood checks revealed increased calcium ranges and decrease iron ranges, adjustments related to elevated dangers of osteoporosis and anemia. The researchers additionally noticed notable alterations in immune system cells.
To conduct the experiment, grownup rats have been separated into two teams: a management group and a bunch that acquired omeprazole. The remedy durations lasted 10, 30, and 60 days to replicate totally different lengths of extended use in people.
“Essentially the most worrying discovering was the numerous improve in calcium within the animals’ bloodstream, which can point out an imbalance with the elimination of the mineral from the bones and a future danger of osteoporosis. Nonetheless, longer research are wanted to verify this speculation,” says Angerson Nogueira do Nascimento, a professor at UNIFESP who coordinated the examine in partnership with Fernando Fonseca from FMABC.
How Proton Pump Inhibitors Have an effect on the Physique
Medicines similar to omeprazole, pantoprazole, and esomeprazole work by blocking the H+, Ok+, ATPase enzyme, often known as the proton pump. This enzyme controls the ultimate step within the manufacturing of hydrochloric acid within the abdomen. By suppressing abdomen acid, these medicine ease signs of ulcers, gastritis, and reflux.
Nonetheless, abdomen acid additionally performs a key position in serving to the physique take up sure vitamins. When acid manufacturing is decreased for prolonged durations, the absorption of minerals that rely upon an acidic surroundings could also be compromised.
Overuse and Over-the-Counter Entry Increase Considerations
Omeprazole has been obtainable for greater than 30 years and is regularly used, typically for months and even years with out medical supervision. “It is not a query of demonizing the drug, which is efficient for varied gastric circumstances. The issue is its trivialized use, even for delicate signs similar to heartburn, and for extended durations of months and even years. Its antagonistic results should not be ignored,” warns Andréa Santana de Brito, a researcher at UNIFESP. The examine fashioned the premise of her grasp’s analysis.
She notes that considerations could develop following a brand new rule from the Brazilian Well being Regulatory Company (ANVISA), which licensed over-the-counter gross sales of 20mg omeprazole in November 2025. “This ease of entry could encourage self-medication and steady use, disregarding the advice to restrict remedy to 14 days,” she warns.
ANVISA’s Place on OTC Omeprazole
ANVISA maintains that making omeprazole 20mg obtainable and not using a prescription is meant to advertise accountable use. The company describes the transfer as “a step ahead in rationalizing its use and selling its secure and accountable use.”
“By limiting remedy to a most of 14 days, the message that the drug ought to solely be used to alleviate delicate and momentary signs is strengthened, encouraging sufferers to hunt a medical analysis if their signs persist or recur,” ANVISA mentioned in an announcement to the Agência FAPESP newsroom. “Clear tips within the package deal insert and on the label, such because the period of use, warning indicators, and potential drug interactions, assist customers make knowledgeable selections.”
The company additionally states that packages containing greater than a 14 day provide can’t be offered and not using a prescription.
Results Could Prolong to Different PPIs
Though the experiments centered on omeprazole, the researchers emphasize that newer medicine in the identical class, together with pantoprazole and esomeprazole, perform in an identical method. In response to Brito, these medicines could have an excellent stronger influence as a result of they act extra powerfully and for longer durations.
“In these circumstances, the impact could also be much more intense since these molecules have a stronger and longer-lasting motion. Some take greater than 5 days to permit the formation of recent proton pumps, whereas omeprazole takes about one to 3 days, which may intensify unintended effects,” she explains.
The group notes that the hyperlink between PPIs and decreased nutrient absorption was already acknowledged. Nonetheless, this analysis expands that understanding by analyzing extra minerals, together with magnesium and zinc. “We reinforce the significance of the rational use of those medicine and even of assessing the necessity for supplementation in some circumstances. Nonetheless, medical supervision is critical to judge every case individually,” Nogueira says.
