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  • Jefferson Adams
    Jefferson Adams

    Severe Intestinal Malabsorption Linked with Olmesartan (Benicar)

    Reviewed and edited by a celiac disease expert.

    Caption: Olemsartan linked to celiac disease and malabsorption. This image does not depict olmesartan or Benicar. Photo: CC--stupid systemus

    Celiac.com 09/15/2016 - Some doctors and clinicians have reported cases of severe sprue-like enteropathy associated with olmesartan, but, until now, no clear demonstration of an increased risk has been documented by epidemiological studies.

    Now, a French nationwide observational cohort study has shown a connection between severe intestinal malabsorption and the drug olmesartan, according to results presented by a team of researchers. Olmesartan is an angiotensin II receptor antagonist which has been used for the treatment of high blood pressure. Olmesartan is also sold commercially under the name Benicar.

    The research team included Mickael Basson, Myriam Mezzarobba, Alain Weill, Philippe Ricordeau, Hubert Allemand, Francois Alla, and Franck Carbonnel. They are variously affiliated with the French National Health Insurance Fund, Paris, France, and the Université Paris-Sud, Assistance Publique-Hôpitaux de Paris and Gastroenterology unit, Hôpitaux Universitaires Paris Sud, Le Kremlin Bicêtre, France.

    The team set out to assess, in a nationwide patient cohort, the risk of hospitalization for intestinal malabsorption associated with olmesartan compared with other angiotensin receptor blockers (ARB) and ACE inhibitors (ACEIs). From the French National Health Insurance claim database, they included all adult patients initiating ARB or ACEI between 1 January 2007 and 31 December 2012, with no prior hospitalization for intestinal malabsorption, no serology testing for celiac disease, and no prescription for a gluten-free diet product. Their main endpoint was incidence of hospitalization with a discharge diagnosis of intestinal malabsorption.

    The team included 4,546,680 patients, for a total of 9,010,303 person-years, and observed 218 events. Compared with ACEI, the adjusted rate ratio of hospitalization with a discharge diagnosis of intestinal malabsorption was 2.49 (95% CI 1.73 to 3.57, p

    Average length of hospital stay for intestinal malabsorption was longer in the olmesartan group than in the other groups (p=0.02).

    Compared with ACEI, the adjusted rate ratio of hospitalization for celiac disease was 4.39 (95% CI 2.77 to 6.96, p<0.0001).

    These results show that olmesartan is assoc qiated with higher rates of hospitalization for intestinal malabsorption and celiac disease.

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    I spent 13 days in the hospital with severe diarrhea. I was tested with many tests. My gastroenterologist said that I definitely have celiac. However, my primary care doctor said that I did not have it. I think more doctors should study up on this subject, then fewer people would become sick! All because I was on Benicar!

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    In the original article on this issue by Dr. Murray at Mayo I was astounded that in 10 pages not one of his researchers thought to look at/question if the inactive ingredients as opposed to the active (medicine) ingredients was the cause of the symptoms. I queried Dr. Murray years ago about this and never received a response - most celiac specialists love to hear from patients and typically respond. At the time Benicar and generics of it contained wheat/gluten components, two types of iron oxides, and lactose in the inactive ingredients - all of which or in combination can lead to intestinal absorption even in those without celiac or NCGS.

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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