Uses of proton pump inhibitors and hypomagnesemia

Pharmacoepidemiol Drug Saf. 2012 May;21(5):553-9. doi: 10.1002/pds.3224. Epub 2012 Feb 15.


Purpose: Hypomagnesemia associated with proton pump inhibitor (PPI) therapy has been documented in case reports. We performed a cross-sectional study to examine the association between PPI use and serum magnesium (Mg) levels or hypomagnesemia.

Methods: Data were extracted from hospitalized adults with basic metabolic panels and/or serum magnesium levels available during the hospital stays. The first Mg value was used for data analysis. Hypomagnesemia is defined as levels less than 1.7 mg/dL (or 0.70 mmol/L). Multiple linear and logistic regression analyses were used to assess the association between PPI use and Mg levels or hypomagnesemia, respectively.

Results: Among study patients, PPI users (n = 207) had a mean Mg level of 1.91[SD = 0.34] mg/dL, and non-users (n = 280) 2.00 (0.30) mg/dL, p = 0.004. PPI use was associated with lower serum Mg levels (adjusted coefficient β = -0.10, 95% CI = [-0.16, -0.04]) after adjusting for confounders. PPI use was associated with risk of hypomagnesemia after adjusting for confounders (adjusted OR = 2.50, 95% CI = [1.43, 4.36]). Both standard (1) and high (2 or higher) defined daily dose units of PPI therapy were associated with hypomagnesemia.

Conclusions: PPI use was associated with lower serum Mg levels and hypomagnesemia in a population of hospitalized adult patients. Our study supports the general notion that long-term PPI use could be associated with sub-clinical Mg insufficiency or deficiency status.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Dose-Response Relationship, Drug
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Linear Models
  • Logistic Models
  • Magnesium / blood*
  • Male
  • Middle Aged
  • Proton Pump Inhibitors / administration & dosage
  • Proton Pump Inhibitors / adverse effects*
  • Proton Pump Inhibitors / therapeutic use


  • Proton Pump Inhibitors
  • Magnesium