Brief observation
Effects of proton pump inhibitors on calcium carbonate absorption in women: A randomized crossover trial

https://doi.org/10.1016/j.amjmed.2005.02.007Get rights and content

Section snippets

Methods

A randomized, double-blind, placebo-controlled, crossover clinical trial was conducted. Subjects were community-dwelling women ≥65 years of age. Individuals were excluded if they scored <23 on the Mini Mental Status Examination, if their weight was <80% or >130% of the ideal body weight, if they had current gastrointestinal disorders, a history of gastrointestinal surgery, or were taking medications known to influence calcium absorption. Bisphosphonates (5 women) and diuretics (6 women) were

Results

Eighteen of the 23 subjects completed the study. Reasons for withdrawal included personal wish (1), weight exclusion (3), and prednisone use (1).

For the 18 who completed the study, the mean age was 76 ± 7 years (range 65–89 years) and the mean weight was 61 ± 7 kg. Medication adherence was 100% in 17 of the subjects and 83% in the remaining subject.

Omeprazole markedly decreased fractional calcium absorption from 9.1% (95% confidence interval [CI]: 6.5% to 11.6%) on placebo to 3.5% (95% CI: 1.6%

Discussion

This study found that a 1-week course of omeprazole 20 mg daily significantly decreased fractional calcium absorption under fasting conditions in elderly women. Although not evaluated, this drug-drug interaction might occur with other proton pump inhibitors producing similar acid suppression.7 The package inserts for proton pump inhibitors state that an interaction with drugs dependent on gastric pH such as ketoconazole, digoxin, and nifedipine may occur. However, in contrast to our study, a

Acknowledgments

The authors wish to thank June Bierman, BSMT (ASCP), Creighton University, for making the 45CaCO3 capsules and analytical assistance; the staff at DaVita (formally Total Renal Research Inc., Minneapolis, Minn) for dispensing study medications and collecting patient data; Bruce Hasselquist, PhD, University of Minnesota and Hennepin County Medical Center, for assistance with nuclear medicine and radiation safety committee regulations and forms; and David Guay, PharmD, University of Minnesota,

First page preview

First page preview
Click to open first page preview

References (18)

  • R.A. Blum et al.

    The comparative effects of lansoprazole, omeprazole, and ranitidine in suppressing gastric acid secretion

    Clin Ther

    (1997)
  • R.P. Heaney et al.

    Meal effects on calcium absorption

    Am J Clin Nutr

    (1989)
  • R.P. Heaney

    Calcium, dairy products and osteoporosis

    J Am Coll Nutr

    (2000)
  • K.E. Ensrud et al.

    Low fractional calcium absorption increases the risk for hip fracture in women with low calcium intake

    Ann Intern Med

    (2000)
  • K. Alaimo et al.

    Dietary intake of vitamins, minerals, and fiber of persons ages 2 months and over in the United StatesThird National Health and Nutrition Examination Survey, Phase 1, 1988–91

    Adv Data

    (1994)
  • V.L. Rose

    IOM recommends increased calcium intakesInstitute of Medicine

    Am Fam Physician

    (1998)
  • C. Carr et al.

    Nutritional and pharmaceutical aspects of calcium supplementation

    Am Pharm

    (1987)
  • E.F. Verdu et al.

    Effects of omeprazole and lansoprazole on 24-hour intragastric pH in Helicobacter pylori-positive volunteers

    Scand J Gastroenterol

    (1994)
  • R.P. Heaney et al.

    Absorption of calcium as the carbonate and citrate salts, with some observations on method

    Osteoporos Int

    (1999)
There are more references available in the full text version of this article.

Cited by (344)

  • The hypocalcemic disorders

    2023, Feldman and Pike's Vitamin D: Volume Two: Disease and Therapeutics
View all citing articles on Scopus

This work was supported by a grant from the Investigator Sponsored Trial Program of AstraZeneca.

View full text