Table 3.
Potential effects of prolonged acid suppression with histamine2 receptor antagonists and PPI agents
| Reduced absorption of nutrients and calcium |
| B12, iron, calcium |
| Osteoporosis |
| Bacterial proliferation |
| Community acquired pneumonia |
| Clostridium difficile |
| Drug metabolism interference |
| Acid effects on drug absorption |
| PPI Effects on CYP2C19 pathway interference |
| Clopidogrel |
| Histamine2 receptor antagonists effects on cytochrome P-450 3A4 system |
| Warfarin, phenytoin, benzodiazepines, theophylline |
| Drug side effects |
| Delirium, especially cimetidine |
| Neurorologic |
| Antiandrogen |
| Cardiac side effects |
| Hematologic |
PPI: proton pump inhibitor.