Reversible pheripheral edema in female patients taking proton pump inhibitors for peptic acid diseases

Pheripheral edema was observed in five female patients after taking proton pump inhibitors omeprazole, lansoprazole, or pantoprazole for 7-15 days for peptic acid diseases in recommended standard doses. Edema disappeared two to three days after stopping therapy but reappeared in all five patients af ter being reexposed to the drugs. Tn three of the patients drug kinetic inv estigations were performed and revealed a slow metabolizer status. During d ose-finding studies for intravenous proton pump inhibitors omeprazole and p antoprazole, three of six young female volunteers receiving omeprazole and two young female volunteers receiving pantoprazole developed peripheral ede ma within 8 hr when high doses of the proton pump inhibitors were applied b y continuous infusion together with large volumes of fluid. The edema disap peared within 24 hr after stopping the infusion therapy. Serum hormone conc entrations in these patients did not change during therapy, neither did the edema factor CI-esterase inhibitor. As a possible mechanism, a competitive inhibition at the receptor site of female hormones involved in water regul ation is suspected.