Elderly Father Takes Prevacid for last 20 years, seems to do more harm, how to stop [closed]

Question

Note: Requesting guidance on how to approach, not medical advice.

My Dad is in his early 70s and has taken Prevacid once a day for nearly 20 years.

After eating food would come up after an hour. Nowadays my dad barely eats anything so very rarely something would come up.

I am reading that drugs such as Prevacid have increased risk of Kidney failure. (link)

For past 2 years when Dad took blood tests he had slightly low levels of Sodium, Chloride, Potassium and CO2

Last week he took blood tests and here were results

1. Sodium 132 Lo (reference 135 - 147 mmol/L)
2. Chloride 93 Lo (reference 96 - 108 mmol/L)
3. C02 17 Lo (22 - 29 mmol/L)

The Internal Medicine doctor said these levels are so insignificant there are no associated Pathology to treat these small ranges and on the physiological level they don't do anything clinical

Now I am questioning this. What if they are related.

Plus FDA (link) warn long term use of Prevacid

can cause bone fractures in the hip, wrist, or spine. Long-term use is defined as multiple daily doses for a year or longer.

If you take this drug for three months or more you may also develop low magnesium levels. This can be serious and may or may not come with symptoms.

Question: How can my Dad stop taking Prevacid? Will the doctor take him off completely or gradually lower his dose? What other questions to ask Doctor regarding this.

As it is my Dad barely eats anything, let alone anything acidic. Mostly eats fruits, veggies, fibers, drinks lots of water.

Thank you for any guidance.

If it helps, below is a summary of his daily meds and vitamins

Plus his daily routine

Answer 1

First, we can't give advice specific to an individual on Health SE. See rules.

BUT what I CAN do is help guide your next discussion with his doctor. (Those are great diagrams and will help your doctor when you and your dad go to see him/her. )

• The first and most important question to understand is: why was he put on Prevacid (a protein pump inhibitor) in the first place? Before trying to stop it, you need to know whether there is a medical indication for continuing it.

• This kind of conversation you want is called a "risks vs benefits" discussion. The decision to start/stop/continue a medication often involves this.

• The long-term use of PPIs is a current topic of discussion, as we're reaching nearly 30 years since they came out on the market.

• Yes the kidney is the major regulator of Sodium, Chloride and some other electrolytes. But the primary lab values monitored for signs of kidney dysfunction are creatinine, urea nitrogen, often potassium, and sometimes urine tests.

• With some labs, there is a tolerated range even outside the reference range for normal. Sodium and chloride are examples. This is in part due to laboratory variations between readings. Often the trend of lab values is more important than individual readings - but of course, a significantly out-of-range value is different. It's a complicated topic.

• Discernment in how aggressively to manage abnormal values comes from study, practice, and experience. This is an example of why it takes so many years of training before you can practice medicine. Don't expect you'll fully understand electrolyte balance after talking with the doc, but DO set a reasonable goal of what you want to understand through the discussion.

Again, I am not commenting at all on your dad's lab values. We cannot evaluate him online. But this is some information to guide YOUR understanding and WHAT to ask his doc.