Every week, I am asked by patients if their heartburn
medicine causes osteoporosis. The most
effective heartburn medicines are called proton pump inhibitors, or PPIs. If you watch more than an hour of TV per
week, then you have seen ads for some of them.
Nexium, Prilosec and Protonix are 3 examples of these medicines.
Many of them are now available over-the-counter at reduced
dosages.
Patients today are incredibly informed, and sometimes misinformed,
about their medical conditions and their treatments. Most of their information is from the
internet, and it’s easy for patients to become unwittingly trapped in the world
wide web.
The information dangling in cyberspace is entirely
unregulated. Information can be made to
appear authoritative and objective when it actually is a paid advertisement. Many blogs may appear to function to inform
the public, when their true purpose is to serve the corporation that sponsors
it. If you are learning about
probiotics, for example, consider the credibility of the site if you are
encouraged to purchase certain products.
Caveat emptor.
Nexium - Bad for Bones?
I personally do not believe that Nexium can break bones,
although I have read the same articles in the lay press that arouse my patients’
concerns. I understand that a headline
such as, Nexium Linked to Hip Fractures, will make my Nexium users so nervous
that they might get wobbly and slip and chip a hip.
However, there is no convincing medical
evidence that an individual user of Nexium or similar medicines has any
significant risk of sustaining a fracture.
The belief that they can cause or accelerate osteoporosis is derived
from large, pooled medical studies that are not truly capable of concluding
cause and effect, a critical point often omitted from your hometown gazettes.
However, no patient should be on Nexium, or any medication,
unless certain requirements have been satisfied. Here’s what runs through my mind when I am
recommending a medication for a patient.
- The drug is absolutely necessary.
- I am prescribing the lowest dose of the drug necessary for the medical task.
- There is no safer alternative medication or other treatment available.
Of course, cost may be an issue depending upon the patient’s
insurance coverage. However, the patient’s
financial status should not taint the physician’s recommendations. The patient, however, can indicate that the
doctor’s first choice is not possible, and he may choose a more affordable, but
less effective option.
If you want a second opinion on any of this, try the internet. That’s where I go when I need reliable
medical information.
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