I took that acid reducer, Acifex, without much thought. It wasn't really working though, so I asked my GP to raise the dose. I realized that I was on a very low dose. She refused and said there are too many side effects. I'd always thought it to be an innocuous medication and thought her statement was odd, so I looked it up. I had been using it long and would have used it long-term. Here is the list:
Oncologic
Any drug which increases gastric pH would be anticipated to stimulate release of gastrin. Animal studies have demonstrated an increase in plasma gastrin concentrations following the administration of rabeprazole (the active ingredient contained in Aciphex) In addition, lifelong high-dose animal studies have revealed a dose-related increase in the incidence of gastric enterochromaffin-like (ECL) cell carcinoids (especially in female rats). However, to date, human studies of up to 1 year have not found any suggestion of gastric carcinoid formation due to rabeprazole use.
Oncologic side effects have not been reported.
Gastrointestinal
Gastrointestinal side effects have included diarrhea, nausea, abdominal pain, vomiting, dyspepsia, flatulence, constipation, dry mouth, eructation, gastroenteritis, rectal hemorrhage, melena, anorexia, cholelithiasis, mouth ulceration, stomatitis, dysphagia, gingivitis, cholecystitis, increased appetite, abnormal stools, colitis, and esophagitis. Rarely, cholangitis, duodenitis, salivary gland enlargement, and thirst have also been reported.[Ref]
Nervous system
Nervous system side effects have included headache (2.4%), insomnia, anxiety, dizziness, depression, nervousness, somnolence, hypertonia, neuralgia, vertigo, convulsion, abnormal dreams, decreased libido, neuropathy, and tremor. Agitation, amnesia, confusion, extrapyramidal syndrome, and hyperkinesia have rarely been reported. Hand and facial numbness have also been reported.[Ref]
Endocrine
Endocrine side effects have included gynecomastia, breast enlargement in females, and breast tenderness.[Ref]
Dermatologic
Dermatologic side effects have included rash, pruritus, sweating, urticaria, photosensitivity, and alopecia. Rare reports of dry skin, psoriasis, and skin discoloration have also been reported.[Ref]
Hepatic
Hepatic side effects have included rare cases of hepatic encephalopathy, hepatitis, hepatoma, and fatty deposits in liver.[Ref]
Respiratory
Respiratory side effects have included dyspnea, asthma, epistaxis, laryngitis, hiccup, and hyperventilation. Rare reports of apnea and hypoventilation have also been reported.[Ref]
Genitourinary
Genitourinary side effects have included cystitis, urinary frequency, dysmenorrhea, and dysuria. Rare reports of impotence, hematuria, orchitis, and urinary incontinence have also been reported.[Ref]
Cardiovascular
Cardiovascular side effects have included rare reports of angina, tachycardia, sinus bradycardia, palpitations, hypertension, myocardial infarction, syncope, angina pectoris, bundle branch block, palpitations, supraventricular tachycardia, and peripheral edema. Electrocardiogram abnormalities have also been reported.[Ref]
Hematologic
Hematologic side effects have included rare reports of anemia, ecchymosis, lymphadenopathy, and hypochromic anemia.[Ref]
Hypersensitivity
Hypersensitivity side effects have included fever, allergic reaction, chills, malaise, and face edema.[Ref]
Metabolic
Metabolic side effects have included weight gain, gout, dehydration, and weight loss. FDA warns that prescription proton pump inhibitor (PPI) drugs may cause low serum magnesium levels (hypomagnesemia) if taken for prolonged periods of time (in most cases, longer than one year). Patients who develop hypomagnesemia may experience seizures, dizziness, abnormal or fast heart beat, or skipped heartbeat, jitteriness, jerking movements or tremors, muscle weakness, spasms of the hands and feet, cramps or muscle aches, and spasm of the voice box.[Ref]
Musculoskeletal
Musculoskeletal side effects have included myalgia, arthritis, leg cramps, muscle spasm (tetany) bone pain, bone fracture, arthrosis, bursitis, and rarely rhabdomyolysis. Hip fracture and muscle stiffness have also been reported.[Ref]
An increased risk of hip fracture has been reported. This risk is significantly increased among patients prescribed long-term high dose PPIs.[Ref]
Ocular
Ocular side effects have included cataract, amblyopia, glaucoma, dry eyes, and abnormal vision. Cornea opacity, blurry vision, diplopia, eye pain, and retinal degeneration have been reported rarely. Ocular lesions have also been reported.[Ref]
Psychiatric
Psychiatric side effects have included insomnia, anxiety, depression, nervousness, somnolence, abnormal dreams, decreased libido, agitation, amnesia, confusion, and panic reaction. A least one case of marked anxiety associated with panic attacks, night terror (pavor nocturnus), episodic mental confusion, and attention deficit has been reported.[Ref]
A 55-year-old female with dyspepsia experienced marked anxiety associated with panic attacks, night terror (pavor nocturnus), episodic mental confusion, and attention deficit coincident with rabeprazole therapy. She presented with the neuropsychiatric manifestations 10 days after being administered rabeprazole 20 mg per day. Within two days of discontinuing rabeprazole, she recovered completely.[Ref]
Renal
Renal side effects have included at least one case of interstitial nephritis.[Ref]
A 57-year-old male with diverticulosis, esophageal reflux due to diaphragmatic hernia, and eczema experienced interstitial nephritis coincident with rabeprazole therapy. He was administered rabeprazole 20 mg daily for esophagitis. Renal biopsy revealed interstitial nephritis with unspecified glomerular sclerosis with predominantly interstitial changes. His condition improved when rabeprazole was withdrawn.[Ref]
