Proton Pump Inhibitors (PPIs) like Tecta, Prilosec, Protonix, Nexium are commonly prescribed for heartburn, a symptom for gastro-oesophageal reflux disease (GERD) and erosive esophagitis. The use of PPIs reduces stomach acidity. PPI’s are also used to treat stomach ulcers caused by Helicobacter pylori infection. However, over 30% of people in North America fail to respond to Tecta and other PPIs because they have an Ultrarapid CYP2C19 liver enzyme, and their body metabolizes and eliminates the medication very quickly.
Treatment failure not only results in people suffering through heartburn but may also have other health consequences. People with GERD have a higher risk of developing esophageal and stomach cancer.
People with an Ultrarapid CYP2C19 liver enzyme need either a much higher dosage of PPI’s or different medications. Another 5% of the population metabolize and eliminate the drug very slowly, and are at risk of side effects as the drug lingers in their system.
Relieving symptoms is essential, but are PPIs safe for long-term use?
Reports associate long-term use of Tecta and other PPIs with a substantially increased risk of bone fracture, chronic lung disease and the risk of kidney failure.
Can these risks be reduced?
Use of most medications is associated with the risk of attendant side effects and this can depend on an individual’s ability to metabolize specific medications.
The risk of lung and kidney complications, as well as bone fractures associated with PPI’s is most likely related to a person’s inability to metabolize the medications.
When liver enzymes do not metabolize and eliminate PPI’s, there is a gradual buildup of the medication in the bloodstream. The presence of these medications may block absorption of magnesium and calcium leading to muscle pain and bone fractures. The mechanism for PPI induced lung disease and kidney damage is not well understood, but is believed to be related to drug clearance.
A pharmacogenetics test like Pillcheck can help your healthcare advisor understand how you metabolize PPI’s, to identify the correct dosage for you and your risk of side effects, not only for Tecta but many other medications as well. Pillcheck’s medication optimization service is most useful for people taking multiple medications who experience side effects or low clinical efficacy of medications. The cost of the service can be covered through the health spending accounts, as well as by insurance provider for people on disability.