Mr. Liu, 38 years old this year, works as a salesman, and usually needs to drink alcohol for socializing, so his stomach has not been very good. Three years ago, he had stomach pain after a dinner party, thinking that it was a stomach problem, so he turned over some omeprazole that his father had been eating and took it. After taking the medicine, his stomach stopped hurting quickly, and since this experience, he will take omeprazole every time he has a stomach ache.
Recently, he found that his stomach pain did not work very well after taking stomach medicine, and the pain was becoming more and more frequent. After going to the hospital for examination, he was diagnosed with advanced stomach cancer. After learning about the past history, the doctor said that Mr. Liu's long-term use of omeprazole masked the signals sent by the cancer, which allowed the disease to progress to the middle and advanced stages.
1. Omeprazole has been monitored by many provinces, and long-term use may face 4 major consequences?
Omeprazole is a very commonly used drug in clinical practice, which has a good effect on acid reflux heartburn, epigastric fullness, Helicobacter pylori infection, etc. Many families will regard it as a common medicine, and take a few tablets whenever the stomach is upset, but can omeprazole really be used like this?
Omeprazole, a proton pump inhibitor, is the most commonly used antigastric acid drug in clinical practice. After entering the body, it can close the pump channel through which gastric acid passes, so that the gastric acid secreted by cells cannot enter the stomach, inhibiting the last link of gastric acid secretion, and is one of the most powerful gastric acid inhibitory drugs.
Ding Hui, deputy chief physician of the Department of Gastroenterology of Henan Provincial People's Hospital, introduced that there are three main application scenarios of omeprazole, including gastric mucosal erosion, esophagitis and upper gastrointestinal bleeding related to gastric acid secretion, dyspepsia symptoms mainly related to epigastric pain, and prevention of stress ulcers such as cerebral hemorrhage and neurosurgery.
However, in the "Second Batch of National Key Monitoring and Rational Use of Drugs" issued by the National Health Commission last year, omeprazole was listed as a key monitoring drug, and subsequently, many provinces and cities also included omeprazole in the provincial key monitoring and rational use of drugs.
This time, omeprazole was included in the monitoring, mainly related to its abuse and overdose. Many people who experience gastrointestinal discomfort in their daily lives will not seek medical attention as soon as possible, but will choose to buy low-cost omeprazole on their own. However, this can easily lead to drug dependence and abuse, which greatly increases the risk of adverse drug reactions.
Hong Huaizhang, pharmacist in charge of the Department of Pharmacy of Huizhou First People's Hospital, said that long-term use of omeprazole may face four major harms:
- Omeprazole will affect the absorption of calcium ions, and long-term use will increase the risk of osteoporosis and fractures;
- Taking omeprazole will lead to a decrease in gastric acid secretion, and bacteria and viruses ingested through the mouth cannot be killed in time, and the risk of infection will increase;
- Omeprazole affects the absorption of vitamin B12 and increases the risk of anemia;
- When gastric acid secretion decreases, the body's absorption of minerals and vitamins decreases, which can easily lead to malnutrition over time.
2. Take omeprazole safely, keep in mind the following 5 precautions
Of course, this does not mean that omeprazole cannot be taken, and you should pay attention to these 5 points when taking medicine.
- 3 groups of people should be taken with caution
Breastfeeding women are not recommended to take omeprazole, because the drug will be secreted into breast milk, and the baby will have adverse health effects after drinking; people with severe renal insufficiency are not recommended to take the drug, because omeprazole needs to be metabolized by the kidneys, and such people are prone to metabolite accumulation poisoning after taking the drug; it is not recommended to take clopidogrel anticoagulation after cardiac stent or bypass, otherwise it is prone to thrombotic events.
- Time and method are of the essence
It is generally recommended to take the drug in the morning or divided into 2 times in the morning and evening, the same dose of omeprazole in the morning will bring better acid suppression effect than in the evening, and the best effect is to take the drug 30 minutes before meals. If it is an enteric-coated preparation, it should be swallowed directly and not chewed.
- Short-term medication is safer
It is generally recommended to take medication for gastric ulcer for 6~8 weeks, duodenal ulcer for 4~6 weeks, and gastroesophageal reflux for 4~8 weeks.
- Avoid combining multiple medications
Omeprazole increases the absorption of aspirin, statins, and nifedipine, decreases the absorption of domperidone, calcium carbonate, and clopidogrel, and decreases the clearance of drugs such as warfarin, clarithromycin, and estazolam. For people who take multiple medications at the same time, it is important to consult a doctor before taking them.
- Avoid rebound of stomach acid after stopping the drug
Some people find that the symptoms of heartburn and acid reflux are more severe after stopping the drug, which is the rebound of stomach acid after stopping the drug. If you want to avoid this phenomenon, you should gradually reduce the amount of medication and stop it slowly.
- Repeat the gastroscopy regularly
Patients who have been taking omeprazole >for more than 1 year should have regular gastroscopy and it is recommended to do it once every six months.
3. 3. You can't take 3 types of drugs for a long time, and if you eat too much, you may become "poison"
There is a scientific basis for the saying "it is a medicine that is three parts poisonous", especially these three drugs, which will bring great risks to health when taken for a long time.
1. Ranitidine
Ranitidine was launched in 1983 and has been widely used in the treatment of peptic ulcer, gastroesophageal reflux and other diseases. In 2019, a petition issued by a U.S. citizen made ranitidine deeply affected by cancer. Subsequently, the US Food and Drug Administration found dimethylnitrosamines, which may cause cancer, in some ranitidine drugs, and long-term use of the drug may cause dimethylnitrosamines in the body to exceed the acceptable safe level of the human body and increase the risk of cancer. On April 1, 2020, the U.S. Food and Drug Administration officially required all ranitidine products on the market to be withdrawn from the market.
2. Phenacetin
Phenacetin is a commonly used antipyretic and analgesic drug, and studies have found that long-term use of phenacetin can induce bladder cancer and renal pelvic cancer.
3. Ribavirin
Ribavirin is a broad-spectrum antiviral drug that is mainly used in infants and preschool children. Many people use it as an antiviral "artifact", but long-term use of ribavirin in children will cause reproductive toxicity, hemolytic anemia, and in severe cases, teratogenicity and cancer.
No matter what medication you take in your life, you must follow the doctor's instructions to avoid improper medication and bring some unnecessary effects to your body.
Resources:
[1] "Omeprazole is listed as a key monitoring drug!", Longtv News Network 2023-04-06
[2] "Friends with stomach problems, please check the precautions for taking omeprazole". Department of Pharmacy, Second Xiangya Hospital, Central South University 2021-05-13
[3] "Annual sales exceed 300 million yuan, pharmacies and primary medical institutions sell more! ranitidine involved in carcinogenic turmoil". Health Times 2022-04-17
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