Doctors sometimes worry that mentioning a side effect of a medication will make a patient more likely to experience it. Such a response might be due to a type of negative placebo effect. There are times, though, when learning about an adverse effect is actually reassuring. The person with a puzzling problem realizes that he is not, in fact, the only one. One reader who read about a rare skin reaction from omeprazole recognized that was what was behind her husband’s agony.
A Rare Skin Reaction to Omeprazole:
Q. I appreciate you reporting side effects of PPIs. Because you wrote about a small study from Denmark, I learned what was causing a horrible scaly patchy rash all over my husband’s body. It was driving him crazy, and none of his doctors, including a dermatologist, could diagnose the rash. It turned out to be a rare skin reaction to omeprazole (Prilosec).
The rash disappeared in two weeks after he stopped taking the medicine. When I looked into other side effects, I found that his muscle weakness and mental confusion were also related to the drug.
Just days before I read your article, he had said he didn’t see the point of living if he would always feel like this. I have not seen the study reported anywhere else and I am eternally grateful to you.
Subacute Cutaneous Lupus Erythematosus:
A. We are glad that reading about this rare skin reaction to acid-suppressing drugs like omeprazole was the key to alleviating your husband’s suffering. Proton pump inhibitors (PPIs) are used to treat acid reflux and heartburn.
Subacute cutaneous lupus erythematosus (SCLE) is an autoimmune condition that can be triggered by certain medications, including PPIs (Aggarwal, Drugs-Real World Outcomes, June, 2016).
PPIs can also lower absorption of magnesium and vitamin B12. That might explain the muscle weakness and confusion your husband experienced.
Other Drugs That Can Trigger This Rare Skin Reaction:
According to the American Osteopathic College of Dermatology,
Drugs such as hydrochlorothiazide, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, terbinafine, procainamide, antihistamines and tumor necrosis factor antagonists may also precipitate this disease.
Why Doctors Must Mention Common AND Serious Side Effects:
Many prescribers and pharmacists are reluctant to mention what they perceive as rare side effects. SCLE is relatively rare, but very serious. It can drive patients “crazy” as this wife testified above in her question. If people are unaware that a medicine can trigger their symptoms they can go for months trying to figure out what is going on. That can lead to depression and suicidal thoughts as described above.
Stopping some popular medicines suddenly can also trigger unbearable skin reactions as these people have shared in this article: