PPI and Mg

Q: Proton Pump Inhibitors (PPIs) may cause? - select one

A) Hypermagnesemia

B) Hypomagnesemia

Answer: B

ΡΡІѕ may cause hypomagnesemia by reducing intestinal absorption. In long term takers, it may cause symptoms of neuromuscular excitability i.e., tremor, tetany, convulsions - or - weakness, and apathy. 

Also, a life-threatening hypomagnesemia associated QT interval prolongation and torsades de pointes may occur.

Although not incorporated into any guidelines, some experts recommend monitoring serum magnesium levels in patients on long-term PPIs.

#pharmacology

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References:

1. Cheungpasitporn W, Thongprayoon C, Kittanamongkolchai W, et al. Proton pump inhibitors linked to hypomagnesemia: a systematic review and meta-analysis of observational studies. Ren Fail 2015; 37:1237.

2. Hansen BA, Bruserud Ø. Hypomagnesemia as a potentially life-threatening adverse effect of omeprazole. Oxf Med Case Reports 2016; 2016:147.