Hypomagnesemia Induced by Long-Term Treatment with Proton-Pump Inhibitors

Simone Janett, Pietro Camozzi, Gabriëlla G A M Peeters, Sebastiano A G Lava, Giacomo D. Simonetti, Barbara Goeggel Simonetti, Mario G. Bianchetti, Gregorio P. Milani

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In 2006, hypomagnesemia was first described as a complication of proton-pump inhibitors. To address this issue, we systematically reviewed the literature. Hypomagnesemia, mostly associated with hypocalcemic hypoparathyroidism and hypokalemia, was reported in 64 individuals on long-term proton-pump inhibitors. Hypomagnesemia recurred following replacement of one proton-pump inhibitor with another but not with a histamine type-2 receptor antagonist. The association between proton-pump inhibitors and magnesium metabolism was addressed in 14 case-control, cross-sectional studies. An association was found in 11 of them: 6 reports found that the use of proton-pump inhibitors is associated per se with a tendency towards hypomagnesemia, 2 found that this tendency is more pronounced in patients concurrently treated with diuretics, carboplatin, or cisplatin, and 2 found a relevant tendency to hypomagnesemia in patients with poor renal function. Finally, findings likely reflecting decreased intestinal magnesium uptake were observed on treatment with proton-pump inhibitors. Three studies did not disclose any relationship between magnesium metabolism and treatment with histamine type-2 receptor antagonists. In conclusion, proton-pump inhibitors may cause hypomagnesemia. In these cases, switching to a histamine type-2 receptor antagonist is advised.

Original languageEnglish
Article number951768
JournalGastroenterology Research and Practice
Publication statusPublished - 2015

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology


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