PPIs and hypomagnesaemia

MOST cases of proton pump inhibitor (PPI)-induced hypomagnesaemia have developed in people using PPIs for more than a year; however it has been reported after three months.1-5 People already at risk of magnesium deficiency from other causes such as inflammatory bowel disease and chronic pancreatitis, as well as people taking drugs such as diuretics, may be at greater risk.5-8 

Consider measuring serum magnesium levels in these people before starting the PPI and routinely during long term therapy.6 Hypomagnesaemia can be asymptomatic but may present as severe tetany, seizures, muscle cramps, delirium

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