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PPIs induce hypomagnesemia but Serum magnesium levels to be monitored regardless of PPI use
Japan: The researchers in a recent study, published in the Die Pharmazie journal suggest measuring serum magnesium levels regardless of the use of proton pump inhibitors (PPIs). The findings will be useful for health professionals in adequate PPI use.
Proton-pump inhibitor-induced hypomagnesemia (PPIH) is a well-recognized phenomenon. Several observational studies in the inpatient and outpatient populations have established the association between PPI exposure and serum magnesium concentrations. pH-dependent regulation of transient receptor potential melastatin-6 transporters in the colonic enterocyte has been proposed to explain the impact of PPIs on magnesium reabsorption.
Proton pump inhibitors are used commonly for the prevention or treatment of gastric ulcers but can induce hypomagnesemia. Not much is known about the risk factors and onset duration related to patient characteristics of this adverse event in Japanese patients. Therefore, K Yamashiro, Laboratory of Public Health, Faculty of Pharmacy, Kindai University, Osaka, Japan, and colleagues analyzed the time-to-onset of PPI-induced hypomagnesemia and investigated the association between hypomagnesemia and PPIs utilizing the Japanese Adverse Drug Event Report (JADER) database. Hypomagnesemia cases between 2004 and 2021 were analyzed.
Using the Weibull distribution, the researchers performed the time-to-onset analysis. The analysis database consisted of 236,525 cases, 188 cases were associated with hypomagnesemia. The median onset duration of PPI-induced hypomagnesemia was 99.0 days, which is considered the random failure type.
The study led to the following findings:
- The multiple logistic regression analysis revealed that hypomagnesemia is significantly associated with male sex, age < 60, estimated body-mass index (eBMI), PPIs, and the interaction of age (<60)*PPIs.
- Diuretics were not significantly associated with hypomagnesemia.
Regardless of the duration of PPI use, the researchers suggest measuring serum magnesium levels, particularly in patients with age < 60, male sex, or low BMI.
"These findings will aid health professionals in the adequate use of proton pump inhibitors," the researchers wrote in their conclusion. "There is a need for evaluating these findings by cohort studies and long-term clinical investigations."
Reference:
Yamashiro K, Hosomi K, Yokoyama S, Ogata F, Nakamura T, Kawasaki N. Adverse event profiles of hypomagnesemia caused by proton pump inhibitors using the Japanese Adverse Drug Event Report (JADER) Database. Pharmazie. 2022 Sep 1;77(7):243-247. doi: 10.1691/ph.2022.2416. PMID: 36199184
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at  editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751