Low Prevalence of Hypomagnesemia in Long-term Recipients of Proton Pump Inhibitors in a Managed Care Cohort.
OBJECTIVE
Chronic intake of proton pump inhibitors (PPI) has been associated with hypomagnesemia, but prevalence of PPI-associated hypomagnesemia is not known.


METHODS
We examined the prevalence of hypomagnesemia among long-term PPI recipients by using a large health maintenance organization database. We collected data on 10,167 participants eligible for chronic drug prescriptions from 2008 through 2013. Adult subjects receiving continuous PPI therapy for ≥ 6 months between 2008 and 2013 and ≥ 1 serum magnesium determination(s) were identified. Patients with any magnesium levels less than 1.6 mg/dL were selected for analysis; those with recognizable causes of altered magnesium homeostasis were excluded.


RESULTS
Five hundred ninety participants received long-term PPIs, and 414 (70.2%) met the inclusion criteria for a total exposure of 2293 PPI-years (average, 5.7 years/subject). Of these patients, 57 (13.8%) had ≥ 1 low serum magnesium; 5 were no longer on PPIs, and 44 had other recognizable causes for hypomagnesemia (25 receiving diuretics, 8 with chronic diarrhea, 8 with chronic kidney disease, and 3 with malignancies). Of the 8 remaining patients (7 female; mean age, 71.2 ± 13.4 years; mean daily medications, 5.4 ± 1.1), mild hypomagnesemia (range, 1.2-1.5 mg/dL) was noted in 13.9% of 289 measurements. All 8 patients had normal serum levels of magnesium at their final measurement.


CONCLUSIONS
In the absence of known precipitating factors, chronic PPI use does not appear to be associated with hypomagnesemia.
Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address: ala.sharara@aub.edu.lb.
Ala I
AI
Sharara
Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Jean M
JM
Chalhoub
Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Nijmeh
N
Hammoud
Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Ali H
AH
Harb
Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Fayez S
FS
Sarkis
Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Ghassan
G
Hamadeh
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008275:Magnesium Deficiency / Q000139:chemically induced* / Q000453:epidemiology*; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D015995:Prevalence; D054328:Proton Pump Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*
D054328:Proton Pump Inhibitors
Acid Suppression; Adverse Events; Diuretics; Magnesium; Side Effects