The National Health Service has published an urgent advisory for the millions of patients across the UK prescribed the common heartburn drug lansoprazole, particularly those who have been using it for an extended period.
Understanding Lansoprazole and Its Uses
Lansoprazole belongs to a class of medicines known as proton pump inhibitors (PPIs), which are among the most frequently dispensed prescriptions in England. It works by significantly reducing the production of stomach acid.
Doctors commonly prescribe it to treat conditions such as persistent indigestion, heartburn, gastro-oesophageal reflux disease (GORD), stomach ulcers, and infections linked to H. pylori bacteria. It is also used for more rare conditions like Zollinger-Ellison syndrome.
Patients typically start to feel relief within two to three days, although it can take up to four weeks for the full effect to be realised. The NHS emphasises that the medication should be taken at the lowest effective dose and for the shortest possible duration to manage symptoms.
The Critical NHS Warning for Long-Term Use
The central alert from the health service focuses on individuals who have been taking lansoprazole for more than three months. According to the official guidance, prolonged use can lead to a drop in magnesium levels in the blood, a condition known as hypomagnesaemia.
Low magnesium can cause serious symptoms, including unusual tiredness or confusion, feelings of dizziness, noticeable muscle twitches or tremors, and an irregular heartbeat. Magnesium is vital for over 300 bodily functions, including nerve transmission, muscle contraction (heart muscle included), and bone health.
Furthermore, taking lansoprazole for longer than one year may increase the risk of other complications. These include a higher chance of bone fractures, certain gut infections like Clostridium difficile, and a deficiency in vitamin B12. Signs of B12 deficiency encompass severe fatigue, a sore, red tongue, mouth ulcers, and pins and needles.
Monitoring, Interactions, and When to Seek Help
The NHS states that patients on long-term lansoprazole should have regular health check-ups with their GP to assess if they need to continue treatment. It is also crucial to inform your doctor about all other medications, vitamins, or herbal supplements you are taking.
Lansoprazole can interact with drugs including the blood-thinner warfarin, digoxin for heart conditions, and some HIV medicines. Patients are advised not to take antacids like Gaviscon within two hours of a dose and to avoid the herbal remedy St John's wort.
Seek immediate medical attention if you experience signs of a severe allergic reaction (such as face or throat swelling), worsening stomach pain, persistent diarrhoea, or the symptoms of very low magnesium like muscle spasms or significant confusion.
Lifestyle Changes and Potential Cancer Link
To help manage acid-related symptoms and potentially reduce reliance on medication, the NHS recommends several lifestyle adjustments. These include maintaining a healthy weight, avoiding trigger foods like spicy or fatty meals, cutting down on alcohol and caffeine, and stopping smoking.
For night-time symptoms, try not to eat within three hours of bedtime and prop your head and shoulders up while sleeping.
Regarding a potential link to stomach cancer, the NHS notes that some data suggests a very small increased risk for people taking acid-reducing medicines like PPIs for more than three years. However, more research is needed to confirm if the medication is the direct cause. Patients are urged to report any new symptoms like difficulty swallowing, persistent sickness, feeling full quickly, or unexplained weight loss to their doctor.
If you feel your lansoprazole is no longer working effectively, do not simply stop taking it. The NHS advises having a conversation with your GP or pharmacist to discuss your concerns and explore alternative treatments, which may include other PPIs like omeprazole or esomeprazole.
