Rapid Rx Quiz: Proton Pump Inhibitors (PPIs)

Mary L. Windle, PharmD


February 22, 2022

Along with systemic lupus erythematosus, cutaneous lupus erythematosus has been reported with PPIs. PPIs should not be used longer than medically indicated and should be discontinued if signs or symptoms consistent with cutaneous lupus erythematosus are observed; discontinuation of PPI alone is enough to see improvement in most patients within 4-12 weeks. Serologic test (eg, antinuclear antibody) results may be positive, and elevated serologic test results may take longer to resolve than clinical manifestations.

Hypomagnesemia may occur with prolonged use (ie, > 1 year). Adverse effects may result and include tetany, arrhythmias, and seizures; in 25% of cases reviewed, PPI had to be discontinued because magnesium supplementation alone was not sufficient to improve low serum magnesium levels. Consider monitoring magnesium levels prior to initiation of PPI treatment and continuing periodically. PPI use has not been linked to ectopic pregnancy or hypoglycemia.

Learn more about warnings associated with omeprazole.


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