ICJIM
Intercontinental Journal of Internal Medicine

The Intercontinental Journal of Internal Medicine aims to publish issues related to all fields of internal medicine of the highest scientific and clinical value at an international level and accepts articles on these topics.

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Letter to the Editor
Reevaluating long-term proton pump inhibitor safety: potential metabolic drug interactions and personalized prescribing
Abstract
Proton pump inhibitors (PPIs) are widely prescribed, but concerns regarding their long-term safety, particularly gastric cancer risk, remain unresolved. Observational studies have reported associations between PPI use and gastrointestinal cancers; however, causality remains unproven because of potential confounding, including Helicobacter pylori infection and underlying gastrointestinal disease. CYP2C19 genetic polymorphisms and CYP2C19/CYP3A4-mediated drug interactions may alter PPI metabolism and systemic exposure, potentially influencing treatment response and safety. Nevertheless, direct evidence linking these factors to PPI-associated gastric cancer risk is insufficient. Future prospective studies should integrate PPI exposure, concomitant medications, CYP2C19 genotype, and relevant confounders to investigate these potential relationships. Until stronger evidence emerges, PPI prescribing should be guided by established clinical indications and evidence-based pharmacogenetic recommendations.

Keywords : Proton pump inhibitors, omeprazole, stomach neoplasms, cytochrome P-450 CYP2C19, cytochrome P-450 CYP3A, drug interaction

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Author Contributions

The author is solely responsible for the conception, data collection, analysis, and writing of this manuscript.

Conflict of Interest

The author declares no conflicts of interest.

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No financial support was received for the preparation or publication of this article.


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Article available in :
Volume 4, Issue 4, 2026
Page : 98-99
https://doi.org/10.51271/ICJIM-0086
Article Information
Received : 04 Haz 2026
Accepted : 23 Eki 2026
Published : 28 Eki 2026
Corresponding Author :

Syed Abdul Rafay Sher: Department of Internal Medicine, Faculty of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan

[email protected]
Citation : Sher SAR. Reevaluating long-term proton pump inhibitor safety: potential metabolic drug interactions and personalized prescribing. Intercont J Int Med. 2026;4(4):98-99. doi:10.51271/ICJIM-0086

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