One of the main adverse effects of PPI is the decreased absorption of vitamins and minerals. PPIs can prevent absorption of vitamin B12 and vitamin C leading to deficiencies. More importantly, long-term use can also decrease absorption of calcium and magnesium leading to increase fracture risk and hypomagnesaemia. Additionally, different drugs can also have an interaction and not be absorbed, which can lead to treatment failure. It is important for pharmacists to inform the patient about the drugs, vitamins, and minerals that can interact with PPIs.
PPIs can also affect metabolism of medications, therefore pharmacists should be observant if the patient is on any drugs with a narrow therapeutic window. Medications such as warfarin, diazepam, phenytoin, and clopidogrel are all medications that can be affected by PPIs. Ultimately, it is the pharmacists’ role to educate patients’ about these potential interactions so that they can be avoided.