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Severe Intestinal Malabsorption Linked with Olmesartan (Benicar)


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.

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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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3 Responses:

 
wonders
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said this on
19 Sep 2016 4:53:25 PM PDT
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!

 
Diane
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said this on
20 Sep 2016 1:56:39 PM PDT
Excellent Information!

 
Sharon
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said this on
28 Dec 2016 9:45:31 AM PDT
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. rnrnAt 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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So just to clarify had not consumed any gluten for about 4 days before testing. I was assured by my allergist that it wouldn't affect the test. But what was alarming was that she retested my food allergies (my most recent reaction was two weeks ago) and every food allergy I have came back negative. I don't understand how that is possible. These food allergies developed when I was 20 and I am almost 24 now.

Thanks! You too! I have learned from this experience to take charge of my own health. It's nice at least that we can try the gluten-free treatment without a firm diagnosis or a doctor confirming the disease. I've also felt some of the gluten withdrawal symptoms, and my stomach pain ebbs and flows, but I'm determined to stick with the gluten-free diet to see what a difference it makes. Gemini, thank you! This was really validating and useful for me to hear. I've felt so confused through this process and just want some answers. If the biopsy results do come back negative, I'm going to follow your advice and do the gluten-free diet with repeat blood testing after a while. If they come back positive, well, then I'll have my answer. I'm supposed to get them back next week.

I have celiac and eosinaphalic esophagitis. I was put on a steroid inhaler recently. I use it like an inhaler but swallow the air instead of breathing it in. You may want to look into EOE and it's relationship to celiac. Just a thought. My swallowing and celiac seem to be related.

You have eat gluten every single day until after testing. And the celiac blood test is supposed to be done as well.

If I was the big guy, there's no way I would have to wait 3 and a half weeks for a test lol. My GI doc never recommended the antibody test. He said doing it with the scope was the only sure way to know. Does anybody know if I should eat a little gluten the day before my test to see if I will get an accurate enough test? Or will it not matter, once the damage is done it's done?