A basic tenet often associated with the practice of medicine is that physicians ‘do no harm.' But even with the best intentions, sometimes a drug prescribed for one ailment can cause other problems. One example is a side effect of a popular class of drugs used for acid reflux disease. A new study shows a significant percentage of older patients taking this kind of drug are at risk of fracturing a hip.
Acid reflux disease commonly affects millions of people. Most are elderly. Sufferers often complain of heartburn and a sour taste caused by the backup of stomach acid in the throat. Changes in the diet and a reduction of stress can usually help alleviate the pain. Yet sometimes the only relief comes from a pill. In the United States, Nexium, Prilosec, and Prevacid are three popular brand names of a class of drugs called proton pump inhibitors.
A recent study of thousands of people in Britain over the age of 50 indicates that this kind of medication can also increase the risk of a hip fracture. Researchers found that after more than a year on the drug, patients were likely to have a 44 percent higher risk of hip fracture than patients who did not take the drug. Patients who took stronger doses of the medication were three times more likely to experience fractures than those who did not.
The scientists concluded that while the drug may help reduce the amount of stomach acid, it also affects the way the body absorbs calcium, which is needed for bone density. The study recommends that doctors prescribe the lowest dose of a proton pump inhibitor, as well as a calcium supplement.
For millions of women worried about osteoporosis and possible bone fractures, there is good news about a drug called alendronate. Alendronate is also known by the brand name Fosamax.
A study, paid for by the drug's manufacturer, was published in the Journal of the American Medical Association. It says alendronate helps build bone strength even years after women stopped taking it.
Fifty-eight-year-old Judy Sheridan began taking the drug when a bone test showed signs of osteoporosis. "It is helping me because I've had a follow-up test a couple years after I started, and my bone strength had improved," she says
Dennis Black of the University of California at San Francisco says the study answers the question of how long it is safe to take the drug: "The drug was safe to use for as long as ten years. We didn't see any negative effects of long-term use."
Dr. Black says women in the study who had taken alendronate for five years were then randomly assigned five more years of the drug or a placebo. While there was some bone loss among those who took the sugar pill, fracture rates among both groups of women were basically unchanged.
"…Suggesting that for many women, they may be able to discontinue alendronate after five years and still maintain a five-year additional fracture benefit," says Black.
One note of caution from researchers: women who have already had fractures are at risk for breaking another bone and probably should not stop taking the drug.