More Bad News for Acid-Blocking Medications - NBI (2022)

Every day, millions and millions of people take acid blocking medications to treat the symptoms of acid reflux, for duodenal ulcers and as an important part of a treatment strategy to kill the H. pylori infection. The US FDA approved these medications, which include such popular brands as Prilosec, Protonix and Zantac, for short-term. However, people often end up taking these medications long-term—for many years—despite the fact that the FDA never approved them for longer than a couple of months.

While these medications, like many medications, are effective at treating the symptoms of disease, often they don’t treat the underlying cause and they can create deadly consequences.

There are two classes of acid-blocking medications, proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (“H2 blockers”). PPIs include Prilosec, Nexium, Prevacid. H2 blockers include Zantac, Prilosec and Tagamet.

The case against using acid-blocking medications long-term keeps growing. A 2018 study published in the journal Gut concluded that these drugs increase people’s risk of stomach cancer. The researchers followed 63,397 patients for 7.6 years who had been prescribed long-term acid-blocking therapy.

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Using PPIs was associated with an increased gastric cancer risk, while H2 blockers were not. The longer someone used PPIs, the greater their risk. After just one year the risk was 500% greater than people not taking acid blocking medications, a danger that increased by 834%.

In a second study, published in JAMA Neurology in 2016, acid-blocking medications were associated with increasing dementia risk.The German study evaluated medical records of 73,679 people ages 75 and older. Researchers found that regular PPI use increased dementia risk 44% compared with those not using the drugs. While more research still needs to be done on this issue to understand if there is a direct cause-and-effect relationship in humans, mice fed PPIs experienced an accumulation of beta-amyloid plaque in their brains. This unhealthy protein is known to be a major contributing factor in the development of dementia.

Both PPIs and H2 blockers have also been shown to increase hip fracture risk in people with osteoporosis. In 2010 the Journal of the American Medical Association (JAMA) reported that the risk of hip fracture increases by 22% after one year and nearly 60% after four years.

This story of medications causing dangerous, sometimes fatal side effects is not new. Another JAMA study in 1998 concluded that fatal drug reactions for hospital patients “appear to be between the fourth and sixth leading cause of death,” and that the rate of fatal drug reactions had been stable for the past 30 years, killing more than 100,000 people annually.While medications can be extremely helpful, and indeed life-saving, the data are clear, medications can be very dangerous as well. One has to always balance out the potential risks with the potential benefits, and that discussion should always be between you and your healthcare provider.

It’s not even that pharmaceuticals per se are the culprit, but it’s the underlying paradigm in medicine that could use some work. The current philosophy underlying medicine today is that diagnoses are based primarily on symptoms and mostly treated with medications to suppress the symptoms instead of identifying and treating the underlying causes of disease. For example, the conventional approach to acid reflux assumes that the stomach is producing too much acid and the fix is to block acid production using PPIs or H2 blockers. But this ignores the fundamental physiology of the body and doesn’t address the underlying causes of why people are actually experiencing acid reflux.

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Digestion involves the breakdown of large molecules into smaller, readily absorbed molecules. While some digestion begins with the production of enzymes in the mouth, the stomach is where the process of digestion really gets underway. Cells in the stomach excrete specific enzymes to break apart fats, starches, and proteins. The enzymes, however, are inactive and must be activated by stomach acid.

When someone produces enough stomach acid, proper digestion in the stomach occurs. But many people don’t produce enough stomach acid. Low stomach acid production is called hypochlorhydria, and when no stomach acid is produced it’s called achlorhydria. Decreased stomach acid production occurs from aging, caffeine, overeating, stress, medications (especially those that block the production or excretion of stomach acid such as Protonix, Tagamet, Pepcid, Axid, Zantac, Prevacid, Prilosec, Aciphex, Nexium), alcohol, and stomach surgeries that destroy the acid-producing cells.

Many people produce less stomach acid as they age, and it’s been estimated that 10–21% of people sixty to sixty-nine years old, 31% of those seventy to seventy-nine years old, and 37% of those above the age of eighty have hypochlorhydria or achlorhydria, and this rate may be higher in people with autoimmune conditions.

One question that could be posed to patients to screen for their risk of low stomach acid is, “Do you feel fuller sooner than you used to and stay full longer than you used to when you eat?” If the answer is yes, it may be that they have low stomach acid since decreased stomach acid increases the amount of time food sits in the stomach before passing into the small intestines.

When stomach acid is low, vitamins and minerals may not be efficiently released from the food that contains them. This may result in decreased availability of nutrients for absorption and nutritional deficiencies. People with low stomach acid have been shown to be at increased risk for vitamin and mineral deficiencies. For example, low stomach acid is a known risk for iron deficiency.

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Symptoms of low stomach acid production include:

  • bloating or distension after eating
  • diarrhea or constipation
  • flatulence after a meal
  • hair loss in women
  • heartburn
  • indigestion
  • malaise
  • prolonged sense of fullness after eating

Stomach acid plays two other important roles. It acts to sterilize food and signals the lower esophageal sphincter (the muscle separating the esophagus from the stomach) to close.The gut normally contains about four hundred different species of bacteria, which are required for normal digestion and absorption of nutrients.

It has been estimated that there are more bacterial cells in the gut than all the cells in the body combined.These beneficial bacteria are required for normal digestion and absorption of nutrients. When inadequate sterilization of food occurs, however, pathogenic (bad) bacteria, viruses, and fungi can pass into the small intestines. This disrupts the healthy ecology in the gut and alters the delicate balance between healthy and unhealthy microbes.

This imbalance in intestinal flora is called dysbiosis, and it can occur with the overgrowth of pathogenic bacteria and/or fungus. Symptoms of intestinal dysbiosis include abdominal gas and bloating, post-nasal drip, “brain fog” (feeling like you’re just not mentally sharp), and sugar cravings.Abdominal gas and bloating are caused by fermentation of food by the bacteria and fungus, which causes the production of gas, such as methane. Post-nasal drip is caused by immune system activation by bacteria and fungi. Sugar is the preferred energy source for the fungi, which can lead to sugar cravings. Bacteria and fungi secrete their own waste products, such as ammonia, that can enter the blood stream, cross into the brain, and cause brain fog. Additionally, intestinal bacterial overgrowth is now understood to be a risk factor for developing gastroesophageal reflux disorder (GERD).

When low stomach acid production decreases the ability of the lower esophageal sphincter to close, the result is that the acid produced in the stomach can reflux up into the esophagus and cause symptoms of GERD.The typical medical response to gastric reflux, which can cause burning, coughing, and asthma-like symptoms, is to prescribe acid-blocking medications. However, the actual cause in many people is too little acid and not too much acid.Stomach acid production can also be tested by using a meter, called a Heidelburg pH capsule test.

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Low stomach acid can also occur in from infections, such as Helicobacter pylori (H. pylori) in the stomach.And treating this infection can correct the underlying problem and improve GERD symptoms.

When people have low stomach acid, some doctors may also provide hydrochloric acid capsules for people to take with meals that help improve their digestion and eliminate GERD. There are some instances when people should not supplement with acid pills, and it’s important to only pursue this option while working with a healthcare provider.

Taking time to understand the underlying possible causes and then working to correct them is a more rational approach to helping people than simply prescribing more and more medications. Doing so could not only help people improve their health, but also avoid dangerous drug side effects.

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Are acid blockers bad for you? ›

Over the past several years there have been concerns regarding the side effects of proton pump inhibitors. PPIs have been blamed for increasing the risk of pneumonia, clostridium difficile infections (an infection of the colon), osteoporosis, chronic kidney disease, dementia, and even death.

Why cimetidine was removed from the market? ›

The FDA said the medicines may contain "unacceptable" amounts of N-Nitrosodimethylamine (NDMA), a substance the World Health Organization has classified as a "probable human carcinogen."

Why was famotidine taken off the market? ›

They may contain unacceptable levels of a potential cancer-causing substance known as NDMA, or N-Nitrosodimethylamine.

What are the risks of taking omeprazole long-term? ›

Long-term side effects

Taking omeprazole for more than a year may increase your chances of certain side effects, including: bone fractures. gut infections. vitamin B12 deficiency – symptoms include feeling very tired, a sore and red tongue, mouth ulcers and pins and needles.

What is the safest medication to take for acid reflux? ›

Options include:
  • Antacids that neutralize stomach acid. Antacids containing calcium carbonate, such as Mylanta, Rolaids and Tums, may provide quick relief. ...
  • Medications to reduce acid production. ...
  • Medications that block acid production and heal the esophagus.
26 Jul 2022

What is the safest acid reflux medicine for long term use? ›

According to Dr. Ghouri, Prilosec OTC “is usually sufficient in controlling symptoms in a majority of [heartburn] cases” and has been the #1 Doctor Recommended frequent heartburn relief medicine for 14 years.

Is Zantac back on the market 2022? ›

Because all retailers did stop selling Zantac, though, the product is as good as recalled now and is no longer on the market. In 2021, Sanofi introduced a replacement for Zantac, called Zantac 360, which replaced ranitidine with famotidine. Famotidine is also found in other heartburn medications.

Which is safer omeprazole or famotidine? ›

Famotidine has no major contradictions with other medications. Omeprazole, however, has many interactions with medications including HIV medications, clopidogrel, methotrexate, and certain antibiotics. Because of this, it may be safer for you to take famotidine if you are on many medications.

Is cimetidine back on the market? ›

The branded over-the-counter (OTC) product Tagamet HB is still available.

What is the new warning on famotidine? ›

Check with your doctor right away if you have the following symptoms: confusion, delirium, hallucinations, disorientation, agitation, seizures, or unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness. These are more likely to occur if you are older or if you have a kidney disease.

Is there a lawsuit against famotidine? ›

Sanofi's new drug, Zantac 360 made with famotidine is not a part of the recalls or lawsuits. Zantac (ranitidine) lawsuits claim that: Lawsuits claim Zantac's design is defective because its active ingredient, ranitidine, is an unstable molecule.

What are the long term side effects of famotidine? ›

Side Effects
  • Anxiety.
  • blistering, peeling, or loosening of the skin.
  • blood in the urine or stools.
  • bloody, black, or tarry stools.
  • difficulty breathing.
  • discouragement.
  • fast, irregular, pounding, or racing heartbeat or pulse.
  • feeling sad or empty.
1 Aug 2022

What can I take instead of omeprazole? ›

  • Famotidine.
  • Protonix.
  • Prilosec.
  • Dexilant.
  • Prilosec OTC.
  • Aciphex.

What is the longest you should take omeprazole? ›

If you bought the medicine yourself from a pharmacy or supermarket, you can take it for up to 14 days. If you feel no better after taking omeprazole for 14 days, tell your doctor. They may want to do tests to find out what's causing your symptoms or change you to a different medicine.

Can you stay on omeprazole for life? ›

Only take omeprazole for the short-term, anywhere from 10 days to eight weeks. Very few medical conditions require omeprazole to be taken for longer periods. Continual use of omeprazole not only raises the risk of side effects in general, but it also raises the risk of more serious side effects.

What is the best natural acid reducer? ›

Home remedies to relieve heartburn, also called acid reflux, include:
  • Apple cider vinegar. "Apple cider vinegar works for some, but makes it worse for others," reports Rouzer. ...
  • Probiotics. ...
  • Chewing gum. ...
  • Aloe vera juice. ...
  • Bananas. ...
  • Peppermint. ...
  • Baking soda.
9 Jan 2022

How can I reduce acid without medicine? ›

10 home remedies for heartburn
  1. Eat a ripe banana. ...
  2. Chew sugar-free gum. ...
  3. Keep a food journal and avoid trigger foods. ...
  4. Resist the urge to overeat or eat quickly. ...
  5. Avoid late meals, snacking before bed and eating before exercising. ...
  6. Wear loose-fitting clothing. ...
  7. Adjust your sleep position.
10 Dec 2021

What foods help acid reflux go away? ›

Foods That Help Prevent Acid Reflux
  • High-fiber foods. Fibrous foods make you feel full so you're less likely to overeat, which may contribute to heartburn. ...
  • Alkaline foods. Foods fall somewhere along the pH scale (an indicator of acid levels). ...
  • Watery foods. ...
  • Milk. ...
  • Ginger. ...
  • Apple cider vinegar. ...
  • Lemon water.

Can you live a long life with GERD? ›

Dr. Chandra said that once a diagnosis of GERD has been established, it may become a lifelong condition that will need management. She added that it's best to identify certain causes of your symptoms and learn to avoid or control circumstances to alleviate or even prevent symptoms.

Can probiotics help with acid reflux? ›

In conclusion, probiotic use can be beneficial for GERD symptoms, such as regurgitation and heartburn. However, proper placebo-controlled, randomized, and double-blinded clinical trials with a sufficient number of participants are warranted to confirm its efficacy in alleviating these symptoms.

Can you take H2 blockers everyday? ›

Staller says generally speaking, there are no long- or short-term health risks of using H2 blockers.

When will the Zantac lawsuit be settled? ›

October 2022 Zantac Lawsuit Update

But two state court Zantac lawsuits are moving forward. There is a trial in California is set for February 2023 and there is another Zantac trial that same month in Madison County, Illinois in February 2023.

Why is Zantac now famotidine? ›

Following a major recall and allegations that NDMA contamination in Zantac causes cancer, manufacturers have updated the Zantac formula to remove potentially dangerous ranitidine and replace it with another ingredient called famotidine. The new Zantac is being marketed with a new name, as well — Zantac 360.

Is famotidine safer than ranitidine? ›

Famotidine 40 mg given once at night appears to be as safe and effective as conventional therapy with ranitidine, indicating the importance of overnight gastric acidity in the pathogenesis of duodenal ulcer disease.

Is it OK to take famotidine every day? ›

Do not take more than two tablets, capsules, or chewable tablets of over-the-counter famotidine in 24 hours and do not take over-the-counter famotidine for longer than 2 weeks unless your doctor tells you that you should.

Why are H2 blockers better than PPI? ›

In short, while PPIs and acid controllers both reduce the amount of acid your stomach produces, H2 blockers work more quickly than PPIs, providing relief in as little as 15-30 minutes. PPIs can take longer to kick in, but provide longer-lasting relief, making them ideal for sufferers of frequent heartburn.

Are H2 blockers safer than PPIs? ›

If you had to choose between long-term PPI use or long-term H2 blocker use, the H2 blocker would be the safer bet. H2 blockers reduce stomach acidity to a much lesser extent while maintaining the stomach's ability to react to internal stimuli and change the acidity as needed.

Which H2 blocker is best? ›

Famotidine is the most potent, selective H2-receptor antagonist yet available for ulcer therapy. On a weight basis, famotidine is approximately eight times more potent than ranitidine and 40 times more potent than cimetidine.

What is the problem with cimetidine? ›

Headache, dizziness, drowsiness, or diarrhea may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. If your doctor has directed you to use this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects.

Is it safe to take cimetidine long term? ›

Do not take over-the-counter cimetidine for longer than 2 weeks unless your doctor tells you to. If symptoms of heartburn, acid indigestion, or sour stomach last longer than 2 weeks, stop taking cimetidine and call your doctor.

Is it OK to take famotidine long term? ›

Famotidine (brand name: Pepcid AC, Zantac 360) should not be used for longer than 14 days if you are treating heartburn symptoms. Talk to your healthcare provider right away if you need to use this product for longer than 14 days or you've had heartburn for longer than 3 months, as you may have a more serious problem.

Does famotidine raise blood pressure? ›

Your blood pressure might get too high while you are using this medicine. This may cause headaches, dizziness, or blurred vision. You might need to measure your blood pressure at home. If you think your blood pressure is too high, call your doctor right away.

Is famotidine back on the market? ›

While labeled as a new formula, famotidine is not a new medication. Famotidine, also known under the trade name Pepcid® and Pepcid® AC, has been available OTC since 1995 and is currently available in both brand-name and generic formulations.

What happens if you just stop taking famotidine? ›

If you stop taking the drug suddenly or don't take it at all: Your acid reflux, heartburn, or ulcer symptoms may not get better or may get worse. If you miss doses or don't take the drug on schedule: Your medication may not work as well or may stop working completely.

Which antacid was taken off the market? ›

Zantac, generics ordered off the market after FDA finds they're a ticking time bomb. Nearly four decades after it was approved, the FDA has ordered that heartburn drug Zantac and its generics be removed from the market, saying they have been exposing consumers to the risk of cancer.

Is famotidine or Nexium better? ›

Nexium (esomeprazole) gives you long-lasting heartburn relief but has some risks if used long term. Relieves heartburn. Pepcid (Famotidine) works well for heartburn but may not last as long or start working as quickly as other antacids.

How long does it take for famotidine to leave your body? ›

HPLC reveals famotidine in the urine up to five days after a single 20 mg oral dose. Drugs Exp Clin Res. 1988;14(6):419-21.

How long can I take famotidine 20 mg? ›

To treat gastroesophageal reflux disease (GERD): Adults and children weighing 40 kilograms (kg) or more—20 milligrams (mg) 2 times per day, in the morning and at bedtime for up to 6 weeks. Children weighing less than 40 kg—Use and dose be determined by your doctor.

Can famotidine cause kidney stones? ›

"Use of PPIs and H2 blockers is associated with a small increase in risk of incident kidney stones.

Is Gaviscon safer than omeprazole? ›

Tolerance and safety were good and comparable in both groups. Conclusion Gaviscon® was non-inferior to omeprazole in achieving a 24-h heartburn-free period in moderate episodic heartburn, and is a relevant effective alternative treatment in moderate GERD in primary care.

Can you treat GERD without medication? ›

Avoiding dietary triggers, eating several small meals instead of fewer large ones, losing weight, quitting smoking, and avoiding lying down for a few hours after eating can all help reduce acid reflux. Elevating the head of your mattress six to eight inches when you sleep can help prevent night time heartburn.

Can omeprazole cause kidney damage? ›

In recent years, the use of proton pump inhibitors (PPI), especially omeprazole, has been associated with development of chronic kidney disease (CKD). These drugs are widely used worldwide. Although some studies have found an association between the use of PPI and the onset of acute renal failure and CKD.

What happens if you take omeprazole every day? ›

Bone fractures warning: People who take several doses of a proton pump inhibitor drug, such as omeprazole, every day for a year or longer may have an increased risk of bone fractures. These bone breaks may be more likely to happen in your hip, wrist, or spine. Talk to your doctor about your risk of bone fractures.

Does omeprazole affect blood pressure? ›

Treatment with omeprazole causes endothelial dysfunction without significantly increasing arterial blood pressure.

Can I take PPI for years? ›

The normal duration for treatment is from two to 12 weeks. In some circumstances, a PPI needs to be continued indefinitely, such as when an ulcer doesn't heal, when an older patient has an ulcer that's larger than 2 centimeters, or when a patient has three or more ulcers per year.

What are the dangers of taking omeprazole? ›

Long-term side effects

Taking omeprazole for more than a year may increase your chances of certain side effects, including: bone fractures. gut infections. vitamin B12 deficiency – symptoms include feeling very tired, a sore and red tongue, mouth ulcers and pins and needles.

What happens when you stop omeprazole? ›

When omeprazole is stopped, a common side effect is rebound acid secretion, where the acid secretion in your stomach increases significantly. This should return to normal within 2 weeks.

How do I get off omeprazole? ›

Slowly taper off the PPI over 2-4 weeks (the higher the dose, the longer the taper). While the taper is being completed, use the following for bridge therapy to reduce the symptoms of rebound hyperacidity. Encourage regular aerobic exercise. Encourage a relaxation technique such as deep breathing.

Is it OK to take an acid reducer everyday? ›

While PPIs are helpful in managing severe heartburn, they are not recommended for more than a 14-day treatment. Recent studies show that overuse of PPIs can be harmful to your health and should not be used long-term.

Can you take H2 blockers long-term? ›

Staller says generally speaking, there are no long- or short-term health risks of using H2 blockers.

What happens if you take too much acid reducer? ›

Many antacids — including Maalox, Mylanta, Rolaids and Tums — contain calcium. If you take too much or take them for longer than directed, you could get an overdose of calcium. Too much calcium can cause: nausea.

Is it bad to take Tums every night? ›

If you experience heartburn or chest pain and find yourself popping antacids more than two or three times a week, it is time to see your doctor. While antacids may relieve your symptoms, they won't fix the root of the problem if you have an underlying health condition.

What is the best natural acid reducer? ›

Home remedies to relieve heartburn, also called acid reflux, include:
  • Apple cider vinegar. "Apple cider vinegar works for some, but makes it worse for others," reports Rouzer. ...
  • Probiotics. ...
  • Chewing gum. ...
  • Aloe vera juice. ...
  • Bananas. ...
  • Peppermint. ...
  • Baking soda.
9 Jan 2022

Is milk good for acid reflux? ›

The fat in milk can aggravate acid reflux. But nonfat milk can act as a temporary buffer between the stomach lining and acidic stomach contents and provide immediate relief of heartburn symptoms."

What is the safest H2 blocker? ›

Thus, famotidine is a safe and potent H2-receptor blocker of acid secretion.

Who should not take H2 blockers? ›

Who should avoid taking H2 blockers?
  • over the age of 50.
  • with kidney problems.
  • with hepatic impairment.

How can I reduce acid without medicine? ›

10 home remedies for heartburn
  1. Eat a ripe banana. ...
  2. Chew sugar-free gum. ...
  3. Keep a food journal and avoid trigger foods. ...
  4. Resist the urge to overeat or eat quickly. ...
  5. Avoid late meals, snacking before bed and eating before exercising. ...
  6. Wear loose-fitting clothing. ...
  7. Adjust your sleep position.
10 Dec 2021

How long should you take acid reflux medication? ›

“The FDA recommends that PPIs be administered over a four week course of treatment, three times a year.”

Can acid reducers cause problems? ›

Antacids and acid reducers rarely cause side effects. If they do, the side effects usually are minor and go away on their own. These may include headaches, nausea, constipation, or diarrhea. Talk to your doctor before taking antacids if you have kidney disease.

How long can you take an acid reducer? ›

Do not use more than 2 tablets in 24 hours unless directed by your doctor. Do not take for more than 14 days in a row without talking with your doctor.

What can I use as a natural antacid? ›

Baking soda can quickly neutralize stomach acid and relieve indigestion, bloating, and gas after eating. For this remedy, add 1/2 teaspoon of baking soda to 4 ounces of warm water and drink. Sodium bicarbonate is generally safe and nontoxic.

What helps acid reflux at night? ›

  1. Sleep with your upper body elevated. ...
  2. Wear loose-fitting clothes. ...
  3. Avoid foods that trigger your heartburn. ...
  4. Steer clear of late-night meals or big meals. ...
  5. Relax when you eat. ...
  6. Stay upright after eating. ...
  7. Wait to exercise. ...
  8. Chew gum.
17 Mar 2022


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