4 ms·

To be clear in case it's not clear to others, the PPI is not the 'regime' that creates the risk of bleeding, it's the thing you take to provide some stomach pro

To be clear in case it's not clear to others, the PPI is not the 'regime' that creates the risk of bleeding, it's the thing you take to provide some stomach protection against the damage/potential damage from the other drugs.

favorited 5y ago
Right. PPIs are available without prescriptions in the US, and are considered very low risk medications.
- MarcoZavala 5y ago
- jonathan-adly 5y ago
  Using PPIs for a short duration is safe, using PPIs chronically is not safe and the risks have to be weighted very carefully. It's by far the most intervened on medications by clinical pharmacists (usually discontinuing for inappropriate use)
  - allturtles 5y ago
    Maybe. Here's a skeptical view: "Despite a large number of studies, the overall quality of evidence for adverse effects of long-term use of PPIs is low to very low." [0] [0]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463334/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463334/
    - jonathan-adly 5y ago
      10 years ago, as a young post-grad I spent a ridiculous amount of hours analyzing ALL the published peer-reviewed literature on the pros/cons of PPI prophylaxis for CVD patients and published my results in a peer reviewed article. I am literally the expert in that topic lol. Here is a nice paper[0] by Adly (me!), et al. I am biased, but I find it to be very comprehensive (and an excellent cure for insomnia!) [0]: https://pubmed.ncbi.nlm.nih.gov/23386069/ https://pubmed.ncbi.nlm.nih.gov/23386069/
      - sizzle 5y ago
        Awesome, what else can you teach us about PPI that isn’t mainstream knowledge
    - phnofive 5y ago
      On the other hand, it has been linked to much higher rates of autoimmunities: https://doi.org/10.3389/fimmu.2021.736036 https://doi.org/10.3389/fimmu.2021.736036
      - allturtles 5y ago
        Many of those autoimmune disorders cause pain and inflammation. And many pain relievers and anti-inflammatories can cause damage to the stomach lining, which leads to a prescription for a PPI. I don't see any accounting for this possibility in the paper (that ADs cause PPIs, rather than vice versa).
deleted 5y ago
[deleted]

favorited 5y ago

Right. PPIs are available without prescriptions in the US, and are considered very low risk medications.

MarcoZavala 5y ago
jonathan-adly 5y ago
Using PPIs for a short duration is safe, using PPIs chronically is not safe and the risks have to be weighted very carefully. It's by far the most intervened on medications by clinical pharmacists (usually discontinuing for inappropriate use)
- allturtles 5y ago
  Maybe. Here's a skeptical view: "Despite a large number of studies, the overall quality of evidence for adverse effects of long-term use of PPIs is low to very low." [0] [0]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463334/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463334/
  - jonathan-adly 5y ago
    10 years ago, as a young post-grad I spent a ridiculous amount of hours analyzing ALL the published peer-reviewed literature on the pros/cons of PPI prophylaxis for CVD patients and published my results in a peer reviewed article. I am literally the expert in that topic lol. Here is a nice paper[0] by Adly (me!), et al. I am biased, but I find it to be very comprehensive (and an excellent cure for insomnia!) [0]: https://pubmed.ncbi.nlm.nih.gov/23386069/ https://pubmed.ncbi.nlm.nih.gov/23386069/
    - sizzle 5y ago
      Awesome, what else can you teach us about PPI that isn’t mainstream knowledge
  - phnofive 5y ago
    On the other hand, it has been linked to much higher rates of autoimmunities: https://doi.org/10.3389/fimmu.2021.736036 https://doi.org/10.3389/fimmu.2021.736036
    - allturtles 5y ago
      Many of those autoimmune disorders cause pain and inflammation. And many pain relievers and anti-inflammatories can cause damage to the stomach lining, which leads to a prescription for a PPI. I don't see any accounting for this possibility in the paper (that ADs cause PPIs, rather than vice versa).

deleted 5y ago

[deleted]