Hypomagnesemia Induced by Long-Term Treatment with Proton-Pump Inhibitors - PubMed (original) (raw)

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Hypomagnesemia Induced by Long-Term Treatment with Proton-Pump Inhibitors

Simone Janett et al. Gastroenterol Res Pract. 2015.

Abstract

In 2006, hypomagnesemia was first described as a complication of proton-pump inhibitors. To address this issue, we systematically reviewed the literature. Hypomagnesemia, mostly associated with hypocalcemic hypoparathyroidism and hypokalemia, was reported in 64 individuals on long-term proton-pump inhibitors. Hypomagnesemia recurred following replacement of one proton-pump inhibitor with another but not with a histamine type-2 receptor antagonist. The association between proton-pump inhibitors and magnesium metabolism was addressed in 14 case-control, cross-sectional studies. An association was found in 11 of them: 6 reports found that the use of proton-pump inhibitors is associated per se with a tendency towards hypomagnesemia, 2 found that this tendency is more pronounced in patients concurrently treated with diuretics, carboplatin, or cisplatin, and 2 found a relevant tendency to hypomagnesemia in patients with poor renal function. Finally, findings likely reflecting decreased intestinal magnesium uptake were observed on treatment with proton-pump inhibitors. Three studies did not disclose any relationship between magnesium metabolism and treatment with histamine type-2 receptor antagonists. In conclusion, proton-pump inhibitors may cause hypomagnesemia. In these cases, switching to a histamine type-2 receptor antagonist is advised.

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Figures

Figure 1

Figure 1

Flowchart of the literature search process. Five of the 60 eligible reports had been identified exclusively from the Web-based search engine Google Scholar.

Figure 2

Figure 2

Relationship between circulating magnesium and total calcium (left panel) or potassium (right panel) in patients with proton-pump inhibitor associated hypomagnesemia. None of the correlations was found to be significant. The horizontal dotted lines denote the threshold level of hypocalcemia (2.20 mmol/L) and hypokalemia (3.5 mmol/L), respectively.

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