Hypomagnesemia Induced by Long-Term Treatment with Proton-Pump Inhibitors

Abstract EN

In 2006, hypomagnesemia was first described as a complication of proton-pump inhibitors.

To address this issue, we systematically reviewed the literature.

Hypomagnesemia, mostly associated with hypocalcemic hypoparathyroidism and hypokalemia, was reported in 64 individuals on long-term proton-pump inhibitors.

Hypomagnesemia recurred following replacement of one proton-pump inhibitor with another but not with a histamine type-2 receptor antagonist.

The association between proton-pump inhibitors and magnesium metabolism was addressed in 14 case-control, cross-sectional studies.

An association was found in 11 of them: 6 reports found that the use of proton-pump inhibitors is associated per se with a tendency towards hypomagnesemia, 2 found that this tendency is more pronounced in patients concurrently treated with diuretics, carboplatin, or cisplatin, and 2 found a relevant tendency to hypomagnesemia in patients with poor renal function.

Finally, findings likely reflecting decreased intestinal magnesium uptake were observed on treatment with proton-pump inhibitors.

Three studies did not disclose any relationship between magnesium metabolism and treatment with histamine type-2 receptor antagonists.

In conclusion, proton-pump inhibitors may cause hypomagnesemia.

In these cases, switching to a histamine type-2 receptor antagonist is advised.