Brief observationEffects of proton pump inhibitors on calcium carbonate absorption in women: A randomized crossover trial
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,
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This work was supported by a grant from the Investigator Sponsored Trial Program of AstraZeneca.