Click here for an explanation of these scores
Answer Rating key
|
search
|
|
strong
|
|
appraisal
|
|
weak
|
|
confidence
|
|
moderate
|
Question answered:08/04/08
A 1994 article in the BMJ [1] examined 5 cases of arthralgia associated with the use of omeprazole. They reported:
“In the first three cases arthralgia developed 10-20 days after starting omeprazole and disappeared after stopping it. The third patient also developed erythema nodosum, a single case of which has previously been reported to the manufacturer. In the fourth case the reaction was delayed, although an underlying rheumatological disease cannot be excluded. The last patient's polyarthritis may have been aggravated by omeprazole either as a direct effect or through a drug interaction. ”
A 1997 paper [2], also in the BMJ, compared the relative risk of developing acute idiopathic polyarthralgia during and after exposure to omeprazole, ranitidine, or cimetidine, antiulcer drugs used for similar indications. They reported:
“Our results suggest that omeprazole use is not associated with an increased risk of inducing polyarthralgia compared with ranitidine and cimetidine. The absence of increased risk of current drug use compared with use in the past or distant past makes a causal role for the study drugs unlikely. These findings, however, do not rule out the possibility that these drugs may sometimes cause adverse effects on the musculoskeletal system in particular people.”
The American Drugs.com site, using FDA data reports that joint pain affected less than 1% of patients taking omeprazole [3]. However, they point out that the relationship between joint pain and omeprazole is not clear.
We found no specific guidance regarding switching to other drugs (such as PPIs). We can forward this question to a specialist medicines information unit who will be better placed to answer this question. If you would like us to do this can you let us know via ‘Contact us’ (http://www.clinicalanswers.nhs.uk/index.cfm?action=contact)
References
1) http://www.bmj.com/cgi/content/full/309/6969/1620
2) http://www.bmj.com/cgi/content/full/315/7118/1283
3) http://www.drugs.com/pro/omeprazole.html
DISCLAIMER: TRIPanswers is a collection of clinical questions and answers. Each provider will have their own methodology in answering questions and these are likely not to be as rigorous as systematic review. If you have any doubt as to the implications of this contact the Q&A Service Provider for further information. This document is presented for information purposes only. This document cannot and should not be used as a basis of diagnosis or choice of treatment, and is in no way intended to replace professional medical care or attention by a qualified practitioner. TRIPanswers and TRIP Database Ltd are not responsible or liable for, directly or indirectly, ANY form of damage whatsoever resulting from the use/misuse of information contained in or implied by this document. Also, ensure you have read the terms and conditions for using the site.