Volume 190 - Issue 11
Risks of proton-pump inhibitors: what every doctor should know
Author: Adam P Morton
Med J Aust 2009; 190 (11): 652-653. || doi: 10.5694/j.1326-5377.2009.tb02606.x
Published online: 1 June 2009
Published online: 1 June 2009
To the Editor: In his recent editorial, Talley discusses a range of risks of proton-pump inhibitors (PPIs).1
Another rare but serious side effect of PPIs of which every doctor should be aware is hyponatraemia. Eleven cases of hyponatraemia caused by PPIs have been published.2,3 Consistent features were the rapid onset of hyponatraemia within days of commencement of the PPI therapy, the severity of hyponatraemia often being associated with confusion or delirium, and rapid recovery after cessation of the PPI medication. Test results in each case were consistent with inappropriate release of antidiuretic hormone. One case occurred 5 days after a patient changed from lansoprazole to esomeprazole.4
Hyoponatraemia needs to be considered whenever there is clinical deterioration, even after brief exposure to a PPI.
References
- Talley NJ. Risks of proton-pump inhibitors: what every doctor should know [editorial]. Med J Aust 2009; 190: 109-110.
- Shiba S, Sugiura K, Ebata A, et al. Hyponatremia with consciousness disturbance caused by omeprazole administration. A case report and literature review. Dig Dis Sci 1996; 41: 1615-1617. 0_pgfId-1737955
- Bebarta VS, King JA, McDonough M. Proton pump inhibitor-induced rhabdomyolysis and hyponatremic delirium. Am J Emerg Med 2008; 519: e1-e2. 0_BABEHHIG
- Mennecier D, Ceppa F, Gidenne S, Vergeau B. Hyponatremia with conscious disturbance associated with esomeprazole. Ann Pharmacother 2005; 39: 774-775. 0_pgfId-1738047