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[RC] Omeprazole - Bruce Weary DC

Those folks who support the use of Omeprazole during competition should be encouraged by the following article from 2002 regarding their short and long term safety in humans:
Proton Pump Inhibitors: An Update


BRUCE T. VANDERHOFF, M.D., and RUNDSARAH M. TAHBOUB, M.D.
Grant Medical Center, Columbus, Ohio

"Since their introduction in the late 1980s, proton pump inhibitors have demonstrated gastric acid suppression superior to that of histamine H2-receptor blockers. Proton pump inhibitors have enabled improved treatment of various acid-peptic disorders, including gastroesophageal reflux disease, peptic ulcer disease, and nonsteroidal anti-inflammatory drug­induced gastropathy./ Proton pump inhibitors have minimal side effects and few significant drug interactions, and they are generally considered safe for long-term treatment. /The proton pump inhibitors omeprazole, lansoprazole, rabeprazole, and the recently approved esomeprazole appear to have similar efficacy. (Am Fam Physician 2002;66:273-80. Copyright© 2002 American Academy of Family Physicians.)"

Until..........they read this more recent 2006 article regarding complications from the use of PPI's:

Study Links Hip Fracture to Proton Pump Inhibitors

"/An increased risk of hip fracture has been linked to the use of proton pump inhibitors/, a class of drugs used to treat acid-related conditions such as heartburn and GERD (gastroesophageal reflux disease). According to study results published in the December 27, 2006 issue of the Journal of the American Medical Association, researchers reported that /treatment with proton pump inhibitors for more than one year in people over 50 years old was associated with a 44 percent increased risk of hip fracture. /The risk was 2.6 times higher for longterm users of proton pump inhibitors at high doses. Duration and dosage of proton pump inhibitor use were both linked to increased hip fracture risk."

This is why it is so important to proceed cautiously when campaigning for the approval of the use of certain drugs in our endurance horses, in order to let them compete when they are not really healthy enough to withstand the rigors of competition. Though more studies need to be done to study the relationship between the increased incidence of fracture and the use of PPI's, it is reasonable to at least assume that since horses are mammals, they may experience a similar disruption of their calcium absorption/bone metabolism, placing them at increased risk as well.

Incidentally, in humans, after the age of 50, a hip fracture leads to death within 6 months in 30-50% of the cases. That pesky calcium ion is the most regulated substance in the body--horse and human. I think it's best not to mess with it's proper absorption and utilization, especially in the heat of competition. Stay tuned as this issue plays out in future studies.
Bruce Weary


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