About 11 percent of the US population has diabetes. 20 percent have acid reflux. And many people with diabetes have acid reflux.

With so many people suffering from these conditions, we provide information about medications you may be taking and the problems they may have. The US Food and Drug Administration is investigating whether they pose a threat to consumers.

The FDA publishes a quarterly list of “potential safety concerns based on reports from consumers and health professionals through the FDA Adverse Event Reporting System (FAERS),” Rosanna Sutherby, PharmD, a North Carolina pharmacist, told Medical Daily in an e- Mail. But making the list doesn’t mean someone taking these drugs should throw them away. “The FDA uses this information, reports from other databases, and published research to determine if further action is needed,” said Dr. Sutherby.

Investigated

A group of drugs known as proton pump inhibitors, which include Dexilant, Nexium, Prevacid, Prilosec, Protonix, and Zegerid, and are commonly prescribed for reflux, appeared on the first two quarterly lists of 2020. “PPIs have been reported to cause hormonal imbalances, this can lead to low calcium levels or cause your body to retain too much water. Abnormal calcium levels can affect everything from bone health to muscle contractions to heart function. Retaining too much water can lead to low blood sodium levels. Symptoms of low blood sodium levels in severe cases can range from nausea and vomiting to seizures and coma, ”said Dr. Sutherby.

Another class of drugs on the last three FDA quarterly safety signal lists are glucagon-like peptide-1 (GLP-1) receptor agonists, which are diabetes drugs that include Bydureon, Byetta, and Saxenda. “There have been reports of these drugs causing low blood sugar or high ketone levels,” said Dr. Sutherby. Decreased platelet counts have been the subject of some reports. “If left untreated, any of these conditions can potentially be life-threatening,” she said.

These drugs can cause other problems. These diabetes medications can increase your risk of hypoglycemia, especially when used with others [diabetes medicines that lower blood sugar]Alireza Hayatshahi, PharmD, associate professor at Loma Linda University School of Pharmacy, emailed Medical Daily. Dr. Hayatshahi added that the risk of hypoglycemia and very low blood sugar “is less than 5 percent. “

Another quarterly report listed medicines called fibrates that lower cholesterol. These drugs can damage the liver. “[Fibrates] can cause liver damage, especially when used in combination with other drugs that can cause liver damage, ”said Dr. Hayatshahi.

People who take fibrates should have regular blood tests to make sure their liver is working well, said Dr. Sutherby. “People who already have liver disease should not take fibrates and may want to speak to their doctor about alternative ways to manage their cholesterol.”

But the news of fibrates is out there. “I have generally seen fewer prescriptions for fibrate. Also, I no longer see patients taking fibrate in combination with statins, which would increase their risk of liver toxicity.”

The take away

Consumers need to speak to their pharmacist or health care provider about problems with these drugs, ”said Dr. Sutherby. However, she said people shouldn’t stop taking medication without talking to their doctor first. Sometimes drugs interact with each other and cause side effects. People need to tell their doctors and pharmacists what drugs they are taking, said Dr. Sutherby.

Sometimes, said Dr. Hayatshahi, a health care provider may swap the medicine for a similar medicine that is better tolerated, or how often the medicine is taken, or even the dose.

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