The occasional Tums won’t hurt you, but long-term use of some other common medications could cause serious illness
Are you one of those people who sometimes lie awake at night, unable to sleep because of persistent and uncomfortable heartburn (...slowly raises hand...)? While some of us are fortunate enough not to have experienced this, most people have had uncomfortable heartburn at least occasionally.
But there are some things you should know about the side effects of common heartburn medicines, even those that are sold as over-the-counter (non-prescription) remedies.
Common types of heartburn medicines
If you begin to feel that burn, you might be heading to your medicine cabinet or the nearest pharmacy.
There are three types of heartburn medicine:
An H2 blocker reduces the amount of acid produced by your stomach by blocking histamine receptors that trigger acid production. These are drugs like Pepcid®, which begin to work within 15-30 minutes and usually relieve symptoms for up to 12 hours.
Antacids, like the well-known Tums® chewables, neutralize acid but don’t block production. You might feel relief for up to two hours after a dose.
Proton Pump Inhibitor (PPI) drugs shut down the pumps that release acid into the stomach. You must take a PPI for 14 days and it’s intended for people who suffer frequent heartburn, but not for immediate relief on an occasional basis. They don’t work right away; usually, it takes 1-4 days to get relief. You need to maintain a consistent dosing schedule with this type of heartburn medicine.
Common uses for heartburn medicines
Heartburn is often treated using PPIs, either in pill form or liquid. A doctor can prescribe these, but some are available without a prescription.
The most common PPI drugs are Prilosec and Nexium. You could also take Prevacid, Dexilant, Zegerid, Protonix or Aciphex for heartburn symptoms.
A PPI drug reduces gastric aid to relieve symptoms of heartburn.
Your doctor could suggest a PPI to relieve symptoms of other conditions, too. These include:
- Dyspepsia, or indigestion
- Gastritis, or an inflammation of the stomach lining
- Gastroesophageal Reflux Disease (GERD)
- Peptic Ulcer Disease (PUD), when ulcers form on the esophagus, stomach or small intestine linings
- Zollinger-Ellison Syndrome, which involves tumors in the pancreas or upper part of the small intestine
- Gastrinomas, which are tumors in the pancreas or duodenum that lead to ulcers
- Barrett’s Esophagus, or damage to the area connecting the mouth and stomach
Long- and short-term effects of heartburn medicines
You might think that you can deal with your heartburn and avoid medicine because it’s occasional and not that bad. But it’s important to consult your doctor rather than letting it go untreated. When GERD is left untreated, the stomach acid could scar the esophageal lining, which could make it difficult to eat and drink.
Untreated heartburn could also lead to cancer of the esophagus, tooth decay and ulcers.
However, there’s a risk/benefit analysis that you and your doctor need to consider for when (and how often) to use PPI drugs.
Short-term use of PPIs has been shown to cause headaches, rash or itching, flatulence or constipation, diarrhea, abdominal pain, fatigue, dizziness or nausea.
Long-term use of PPIs can result in more serious issues. These include:
- Stroke or heart attack
- Allergic reactions
- Bone fractures
- Clostridium difficile infection of the colon (C. diff)
- Acute interstitial nephritis (AIN), or a swelling between kidney tubules
- Chronic Kidney Disease (CKD), acute kidney injury (AKI), or renal failure or end-stage renal disease (ESRD)
- Pregnancy risks; babies born to mothers who used PPIs during the first trimester were twice as likely to develop a congenital heart defect
One of the major issues associated with PPI is kidney disease. Kidney disease happens gradually, so patients might not be diagnosed until the damage has progressed to dangerous levels.
Prilosec and Prevacid (generic names: omeprazole and lasoprazole, respectively) were most likely to cause interstitial nephritis.
Symptoms of interstitial nephritis include:
- Blood in urine
- Elevated blood pressure
- Water retention
Heartburn medicine lawsuits
There are two types of lawsuits currently pending related to heartburn drugs.
Zantac is the brand name for Ranitidine HCL. Ranitidine is alleged to be contaminated with N-nitrosodimethylamine (NDMA). NDMA is a highly toxic unstable organic chemical that is a recognized human carcinogen. It derives from dumethylhydrazine, which is a component in rocket fuel.
In 2020, the FDA reported that storing Zantac at a too-high temperature could lead to dangerous levels of NDMA. There are now more than 70,000 lawsuits by former Zantac users who have been diagnosed with various types of cancer.
There have been more than 15,000 lawsuits against manufacturers of PPI drugs for heartburn. Plaintiffs allege that they have suffered serious kidney damage.
A 2016 study published in BMC Nephrology (associated with the UK Kidney Association) indicated that PPI drugs are associated with an increased risk of chronic kidney disease and death. Chronic kidney disease could result from undiagnosed acute interstitial nephritis. This is when the kidney tubules are inflamed. It happens primarily in people older than 60 and most affected people suffer some level of permanent kidney function loss or they might require a kidney transplant. An earlier study found that Prilosec and Prevacid were most likely to cause interstitial nephritis.
Yet another study published in 2019 by The BMJ found that people using PPIs were at a higher risk of death from cardiovascular disease, chronic kidney disease and upper gastrointestinal cancer. People who used PPIs for a longer period were at higher risk.
Even more recently, a 2020 study published in the American Journal of Gastroenterology determined that people who used PPIs were at increased risk of contracting COVID-19. People who used H2 blockers were not at higher risk for covid infection.
Lawsuits have been filed for PPI injuries that include kidney disease, kidney injury, kidney failure and acute interstitial nephritis. There are also some lawsuits pending related to the manufacturers’ failure to warn about the risks of PPI drugs causing other types of injuries like bone fractures and heart attacks.
What to do if you think you’ve suffered illness from heartburn medicine
First, you should consult your doctor. Never stop a prescription medicine without checking in with the prescribing physician.
Second, talk to your doctor about your new symptoms and inquire about whether or not it’s possible that they were caused by the medication. Often, the challenge with lawsuits like these is proving that your illness is the result of the medication and would not have happened for any other reason (like genetics, aging, a pre-existing condition, etc.).
If your doctor believes that your illness was caused by heartburn medicine, you can consult a personal injury lawyer. Your lawyer can talk to you about pharmaceutical liability and whether you should file a claim.