Fracture Risk and Bone Mineral Density Reduction Associated with Proton Pump Inhibitors

Yuen Ting Lau, Pharm.D.; Nasiya N. Ahmed, M.D.


Pharmacotherapy. 2012;32(1):67-79. 

In This Article


The current data suggest that PPIs are associated with a slightly increased risk of hip and vertebral fracture, but further studies are required to evaluate if the association is a causal relationship and to determine the true effect measure not affected by residual confounding. Since a causal relationship between PPIs and fracture is yet to be confirmed, PPI therapy for appropriate indications should be continued. Nonetheless, patients who are taking PPIs should be evaluated periodically with regard to the necessity for continued PPI therapy to minimize unwarranted prolonged PPI use or inappropriate use of PPIs in patients without a clear indication.