Proton pump inhibitors are a class of novel drugs that are the most potent acid suppressors on the market today. Since omeprazole's introduction in 1990, they have been clinically proven to be better than H2RAs. Over the past decade their use has been scrutinized because of several harmful disease associations. • C. difficile infection: FDA's analysis of over 28 studies revealed that patients taking PPIs were at a 1.4-2.75 times greater risk of developing an infection • Fractures: FDA reviewed several studies and have concluded that PPIs in high doses, multiple daily doses, and/or continued therapy for longer than a year increase a person's risk of osteoporosis related fracture • Magnesium: PPIs may decrease magnesium level, which can lead to muscle spasms, arrhythmias, seizures, and fatigue. This typically occurs after long-term administration of PPIs, usually longer than a year. Treatment may require magnesium replacement and PPI discontinuation • Dementia: Although several theor

Proton pump inhibitors are a class of novel drugs that are the most potent acid suppressors on the market today. Since omeprazole's introduction in 1990, they have been clinically proven to be better than H2RAs. Over the past decade their use has been scrutinized because of several harmful disease associations. • C. difficile infection: FDA's analysis of over 28 studies revealed that patients taking PPIs were at a 1.4-2.75 times greater risk of developing an infection • Fractures: FDA reviewed several studies and have concluded that PPIs in high doses, multiple daily doses, and/or continued therapy for longer than a year increase a person's risk of osteoporosis related fracture • Magnesium: PPIs may decrease magnesium level, which can lead to muscle spasms, arrhythmias, seizures, and fatigue. This typically occurs after long-term administration of PPIs, usually longer than a year. Treatment may require magnesium replacement and PPI discontinuation • Dementia: Although several theor

Proton pump inhibitors are a class of novel drugs that are the most potent acid suppressors on the market today.  Since omeprazole's introduction in 1990, they have been clinically proven to be better than H2RAs.  Over the past decade their use has been scrutinized because of several harmful disease associations.

• C. difficile infection: FDA's analysis of over 28 studies revealed that patients taking PPIs were at a 1.4-2.75 times greater risk of developing an infection
• Fractures: FDA reviewed several studies and have concluded that PPIs in high doses, multiple daily doses, and/or continued therapy for longer than a year increase a person's risk of osteoporosis related fracture
• Magnesium: PPIs may decrease magnesium level, which can lead to muscle spasms, arrhythmias, seizures, and fatigue.  This typically occurs after long-term administration of PPIs, usually longer than a year.  Treatment may require magnesium replacement and PPI discontinuation
• Dementia: Although several theories exist to possibly explain the mechanism, the association needs to be validated in large cohorts and tested in case-control studies. For now, it is probably safe to say a causal link is plausible.