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Severe hypomagnesaemia due to lansoprazole
Chit Hmu1, Probal Moulik, Andrew Macleod
1Royal Shrewsbury Hospital, Endocrinology, Mytton Oak, Shrewsbury SY3 8ZF, UK.
BMJ Case Reports
|December 20, 2011
Summary
Long-term use of proton pump inhibitors like lansoprazole can cause severe hypomagnesaemia. Discontinuing the medication or switching to H2 receptor antagonists effectively resolved symptoms and normalized magnesium levels.
Area of Science:
- Gastroenterology
- Clinical Pharmacology
Background:
- Proton pump inhibitors (PPIs) are widely used for acid-related disorders.
- Long-term PPI use has been associated with various adverse effects.
- Hypomagnesaemia is a potential, though less common, side effect of PPIs.
Purpose of the Study:
- To report a case of severe hypomagnesaemia in a patient on long-term lansoprazole therapy.
- To investigate the potential link between lansoprazole and hypomagnesaemia.
- To highlight the management and resolution of PPI-induced hypomagnesaemia.
Main Methods:
- A case study of a 71-year-old woman with dyspepsia on lansoprazole for 18 months.
- Clinical presentation of vomiting and diagnosis of severe hypomagnesaemia.
- Treatment with magnesium supplementation and subsequent medication change from lansoprazole to ranitidine (an H2 receptor antagonist).
Main Results:
- The patient presented with severe hypomagnesaemia and recurrent symptoms despite initial treatment.
- Switching from lansoprazole to ranitidine led to resolution of hypomagnesaemia and associated symptoms.
- Discontinuation of oral magnesium supplementation was possible after the medication change, indicating PPIs as the likely cause.
Conclusions:
- Long-term proton pump inhibitor use, specifically lansoprazole in this case, can lead to severe hypomagnesaemia.
- Patients on long-term PPIs with suggestive symptoms should be evaluated for hypomagnesaemia.
- Cessation or switching PPIs to H2 receptor antagonists is an effective strategy for managing and resolving PPI-induced hypomagnesaemia.
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