Effects of Omeprazole on Iron Absorption: Preliminary Study

Tempel, Mila; Chawla, Anupama; Messina, Catherine R.; Celiker, Mahmut

doi:10.4274/tjh.2013.0042

Cited by 11 publications

(2 citation statements)

References 12 publications

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“…Tempel et al 8 showed no effect on iron absorption with short-term PPI therapy. Some studies suggest that prolonged omeprazole use for at least 3 to 4 years is unlikely to cause iron and ferritin malabsorption, 6 whereas Sarzynski et al 9 found that among adults on long-term PPI therapy, defined as >1 year, there was a significant decrease in hematologic indices from baseline.…”

Section: Discussionmentioning

confidence: 95%

A Case of Severe Iron Deficiency Anemia Associated with Long-Term Proton Pump Inhibitor Use

Dado

Loesch

Jaganathan

2017

Current Therapeutic Research

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The use of proton pump inhibitors (PPIs) in the treatment of gastrointestinal diseases has evolved over recent years. Initially intended for short-term use, PPIs are increasingly being used, often inappropriately, as long-term maintenance medications. The mechanism of action of PPIs is suppression of gastric basal and stimulated acid secretion by inhibiting the parietal cell H+/K+ ATP pump with a resultant increase in gastric pH and hypo- or achlorhydria. Although short-term use is related to few adverse effects, long-term use is associated with numerous complications. We present the case of a 58-year-old man with severe iron deficiency anemia due to malabsorption suspected to be caused by long-term PPI use. An extensive medical work up failed to reveal any definitive source of bleeding. An iron malabsorption test confirmed that iron was not being absorbed from the gastrointestinal tract. The Naranjo Adverse Drug Reaction Probability Scale and the Horn and Hansten Drug Interaction Probability Scale are suggestive of an association between long-term PPI use and the observed iron deficiency anemia. However, the patient’s death and lack of an autopsy prevented confirmatory follow-up data from being obtained to connect long-term PPI use as the culprit. Although there are currently no recommendations regarding screening for iron deficiency and/or anemia in patients on long-term PPI therapy, physicians should be aware of this potential side effect and consider monitoring in high-risk patients.

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Section: Discussionmentioning

confidence: 95%

A Case of Severe Iron Deficiency Anemia Associated with Long-Term Proton Pump Inhibitor Use

Dado

Loesch

Jaganathan

2017

Current Therapeutic Research

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“…Iron is absorbed in the ferrous form in the duodenum via a divalent metal transporter-1 (DMT1) [5]. Nonheme iron, in contrast to heme or animal iron, requires gastric acid to reduce its ferric to ferrous form and so facilitate its absorption [6]. Reduction of gastric acid production by pharmacological means may therefore reduce the bioavailability of nonheme iron.…”

Section: Introductionmentioning

confidence: 99%

Proton pump inhibitors reduce phlebotomy burden in patients with HFE-related hemochromatosis: a systematic review and meta-analysis

Dirweesh

Anugwom

et al. 2020

European Journal of Gastroenterology &Amp; Hepatology

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Background and aims Proton pump inhibitors (PPIs) may reduce iron absorption and serum ferritin levels in patients with homeostatic iron regulator (HFE)-related hemochromatosis, reducing the need for frequent phlebotomies. Our study aimed to perform for the first time a meta-analysis of existing observational and randomized controlled studies to ascertain the overall effect of PPI use in patients with HFE-related hemochromatosis. Methods Studies in adults reporting the outcomes of PPIs use in hereditary hemochromatosis patients from Medline, Embase, Scopus and Google Scholar databases from inception to December 2019 were systematically searched. The study outcomes were the serum ferritin levels and annual requirement for phlebotomies. Pooled mean difference, and 95% confidence intervals (CIs) were obtained by the random-effects model. Forrest plots were constructed to show the summary pooled estimate. Heterogeneity was assessed by using I2 measure of inconsistency. Results Following an initial search of 202 manuscripts, a total of three studies involving 68 patients with hemochromatosis (34 in the PPIs group and 34 in the placebo or non-PPI group) were included. A minimum duration of PPI use was 1 year. Patients who received PPIs therapy did not have a statistically significant lower serum ferritin levels (mean difference: −18.86, 95% CI: −60.44, 22.72, P = 0.37, I 2 = 88%) but required significantly less sessions of phlebotomies annually (mean difference: −3.10, 95% CI: −4.46, −3.08, P < 0.00001, I 2 = 93%). No publication bias was found on Egger (P = 0.94) or Begg (P = 0.98) tests. Conclusion PPIs can be used as an adjuvant therapy to reduce phlebotomy burden in patients with HFE-related hemochromatosis.

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