Acid reflux drugs side effects
Pro Research Analysisby 
Searched over 200M research papers
Side Effects of Acid Reflux Drugs: A Comprehensive Overview
Introduction to Acid Reflux Drugs
Acid reflux, or gastroesophageal reflux disease (GERD), is a common condition that affects many individuals, including children and adults. Various medications are used to manage GERD, including proton pump inhibitors (PPIs), histamine H2 receptor antagonists (H2RAs), and prokinetic agents. While these drugs are effective in reducing symptoms, they are also associated with several side effects.
Proton Pump Inhibitors (PPIs) Side Effects
Common Adverse Effects
Proton pump inhibitors, such as omeprazole, esomeprazole, and lansoprazole, are widely used to treat GERD. However, they are associated with several common side effects. Studies have reported that up to 34% of patients experience headaches, diarrhea, nausea, and constipation when using PPIs1.
Risk of Infections
PPIs can also increase the risk of infections. Acid suppression may place immune-deficient individuals, particularly infants and children, at risk for lower respiratory tract infections and nosocomial sepsis1 8. This is a significant concern, especially in pediatric populations where the efficacy of these medications is still under scrutiny.
Histamine H2 Receptor Antagonists (H2RAs) Side Effects
Common Adverse Effects
Histamine H2 receptor antagonists, including ranitidine, cimetidine, and famotidine, are another class of drugs used to manage GERD. Adverse effects have been reported in at least 23% of patients treated with H2RAs, with common side effects including headaches, diarrhea, and nausea1.
Risk of Serious Infections
Similar to PPIs, H2RAs have been associated with an increased risk of serious infections such as necrotizing enterocolitis, sepsis, pneumonia, and gastrointestinal infections in infants and children8. This highlights the need for cautious use of these medications in pediatric patients.
Prokinetic Agents Side Effects
Limited Efficacy and Adverse Effects
Prokinetic agents like metoclopramide and domperidone are used to enhance gastrointestinal motility. However, their efficacy in treating GERD is limited, and they are associated with numerous side effects. Metoclopramide, for instance, has been reported to cause side effects in some patients, while domperidone appears to have fewer acute effects on esophageal motility2.
Neurological Side Effects
Baclofen, a GABA(B) receptor agonist, is another prokinetic agent that has shown promise in reducing GERD symptoms. However, it is associated with significant central side effects, including mild neurological and mental status deterioration, particularly in long-term users4 5 9.
Other Medications and Their Side Effects
Duloxetine
Duloxetine, an SNRI used for various conditions, has been reported to cause acid reflux in a small percentage of patients. This side effect is relatively rare, occurring in about 1.38% of the population3.
Alprazolam (Xanax)
Alprazolam, a benzodiazepine anxiolytic, has been shown to decrease upper esophageal sphincter pressure and increase nocturnal acid reflux in some healthy volunteers. This is likely due to central nervous system depression interfering with normal nocturnal acid clearance mechanisms7.
Conclusion
While acid reflux medications are effective in managing GERD symptoms, they come with a range of side effects that can impact patient health. PPIs and H2RAs are associated with common gastrointestinal side effects and an increased risk of serious infections, particularly in pediatric patients. Prokinetic agents have limited efficacy and can cause significant neurological side effects. Other medications like duloxetine and alprazolam can also contribute to acid reflux. Therefore, it is crucial to use these medications cautiously and consider the potential risks and benefits for each patient.
Sources and full results
Most relevant research papers on this topic
Adverse effects reported in the use of gastroesophageal reflux disease treatments in children: a 10 years literature review
Adverse effects from pharmacological agents for paediatric GERD include headaches, diarrhoea, nausea, and constipation, with potential risks for immune-deficient infants and children with indwelling catheters.
Systematic Review
Highly CitedLack of effect of metoclopramide and domperidone on esophageal peristalsis and esophageal acid clearance in reflux esophagitis
Metoclopramide and domperidone have few acute effects on esophageal motility in patients with erosive reflux esophagitis, but both drugs increase lower esophageal sphincter pressure.
RCTAcid Reflux: A Rare Adverse Effect of Duloxetine
Duloxetine may cause rare adverse events like acid reflux, which has been reported in only 1.38% of the population.
Case ReportReflux inhibitors: a new approach for GERD?
Reflux inhibitors targeting transient lower esophageal sphincter relaxations may offer a new approach to treat GERD, potentially improving symptoms without significant central side effects.
Baclofen as a therapeutic option for gastroesophageal reflux disease: A systematic review of clinical trials
Baclofen may improve gastroesophageal reflux disease symptoms and may be particularly beneficial for patients with concurrent conditions like alcohol use disorder, non-acid reflux, or obesity.
Systematic ReviewEffects of cisapride on parameters of oesophageal motility and on the prolonged intraoesophageal pH test in infants with gastro-oesophageal reflux disease.
Cisapride effectively improves oesophageal motility and reduces acid reflux in children with gastro-oesophageal reflux disease, with no adverse effects observed.
RCTHighly CitedEffect of alprazolam (Xanax) on esophageal motility and acid reflux.
Alprazolam (Xanax) has no significant effect on lower esophageal sphincter pressure or motility, but may decrease upper esophageal sphincter pressure and cause abnormal nocturnal acid reflux in healthy volunteers due to central nervous system depression.
RCTAre there risks associated with empiric acid suppression treatment of infants and children suspected of having gastroesophageal reflux disease?
Acid-suppressive medications should be used cautiously in infants and children with suspected gastroesophageal reflux disease due to the potential increased risk of serious infections.
Systematic ReviewTreatment of gastro‐esophageal reflux disease: the new kids to block
New treatments targeting the lower esophageal sphincter show promise for treating refractory GERD, but reducing central side effects is crucial for clinical use.
Very Rigorous JournalAcidic and non-acidic reflux during sleep under conditions of powerful acid suppression.
PPI treatment reduces overall reflux events, but non-acidic reflux events are more likely to occur, potentially explaining why some individuals continue to have symptoms after PPI treatment.
RCT