Nexium, a widely used medication for heartburn, ulcers, and acid reflux, is available as both a prescription medication and in an over-the-counter formula available at local supermarkets and drugstores.
Nexium (esomeprazole) belongs to a class of drugs called proton pump inhibitors (PPIs). The class includes Prilosec (omeprazole) and Prevacid (lansoprazole). Proton pump inhibitors reduce the production of acid in the stomach, so that if stomach juice backs up into the esophagus, it is less irritating. The reduction in acid allows the esophagus to heal.
Many people think that if a drug is sold over the counter it is among the safest medications because it does not require a prescription. But over-the-counter medications can pose serious risk for users, and this is the case with Nexium.
CBS News recently reported that Nexium increases the risk of kidney problems, including chronic kidney disease. The CBS report is based on a study published in January 2016 in JAMA Internal Medicine. According to the study, people who take a PPI have a 20 to 50 percent greater risk of developing chronic kidney disease compared to individuals who do not use PPIs. A study published on April 14, 2016 in the Journal of the American Society of Nephrology echoes the JAMA results.
The JAMA study did not demonstrate a cause-and-effect relationship, but it did establish a link between Nexium use and kidney problems.
Dr. Morgan Grams, a Baltimore nephrologist and an author of the study, said that kidney-related side effects had reportedly been linked to Nexium use. Acute kidney injury and acute interstitial nephritis, a type of inflammatory kidney disease, were implicated in earlier studies.
The JAMA study suggests that the kidneys may lose their ability to properly filter the blood, allowing toxins to build up in the body. A patient with chronic kidney disease may eventually need kidney dialysis or may require a kidney transplant. If the toxins cannot be successfully filtered from the blood, the individual may die from the toxicity.
The researchers are not certain why kidney disease may result from proton pump inhibitor use. Dr. Grams said that some researchers think Nexium and other PPIs reduce magnesium levels in the body, and kidney damage results from the lack of this important mineral. Another theory is that the constant acute kidney inflammation caused over time by Nexium or other PPIs may cause kidney damage in the long term.
Kidney problems are not the only serious side effect linked to PPIs. These medications are also associated with bone fractures and chronic infections, including C. difficile and pneumonia.
In response to these recent results, researchers say doctors may need to be use greater caution when prescribing proton pump inhibitors in order to avoid kidney disease and damage. Physicians may choose to prescribe a heartburn drug from another class, such as H2 blockers like Zantac and Tagamet.