[What has the long clinical experience of PPIs taught us about their putative side effects?].

In addition to drug interactions (e.g. with clopidogrel), PPI therapy has been suggested to have--particularly in long term--undesirable effects on gastric epithelium, infection risk, bone strength, and vitamin and mineral levels in serum. Analyses of the literature indicate that existing data in this regard are based on studies that are susceptible to bias and confounding. Significant interaction between PPI therapy and clopidogrel is controversial. PPIs can be regarded as safe, and should not be denied to patients who are likely to benefit from them.