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Lansoprazole may trigger or exacerbate restless legs syndrome and periodic limb movement disorder in hemodialysis patients

A 76-year-old hemodialysis patient developed dopaminergic-refractory RLS/PLMD after starting lansoprazole 15 mg/day. Symptoms nearly completely resolved within 14 days of lansoprazole withdrawal, with RLS-6 score dropping from 28 to 4, and a Naranjo score of 5 indicating a probable adverse drug reaction.

Last updated: Aug 26, 2026•0 RCTs•📖 Read as article →

Evidence Score

Evidence Score34/100
Human RCT☆☆☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Lansoprazole as a possible trigger of restless legs syndrome with suspected periodic limb movement disorder in a hemodialysis patient: a case report.

observational

Nakata H, Nishiwaki K · CEN case reports (2026)

Participants: N/A
Duration: 14 days (post-withdrawal follow-up)
Intervention: Withdrawal of lansoprazole 15 mg/day and transition to vonoprazan
Outcome: RLS/PLMD symptom severity measured by RLS-6 score
Effect Size: N/A (single case report)
Population: A 76-year-old female hemodialysis patient with end-stage renal disease due to diabetic nephropathy

Result:

PubMed: 41999568DOI: 10.1007/s13730-026-01099-1

Mechanism Graph

Lansoprazole may alter iron absorption or metabolism in susceptible patients
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Iron deficiency or dysregulation can affect dopaminergic function
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Dopaminergic dysfunction contributes to RLS/PLMD pathophysiology
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Result: Lansoprazole withdrawal leads to symptom improvement

Limitations

  • ⚠Single case report with no control group, limiting generalizability
  • ⚠Confounding from prior discontinuation of methyldopa, which may have contributed partial improvement

Frequently Asked Questions

What is the Naranjo score and what does a score of 5 mean?▼

The Naranjo scale assesses the probability of an adverse drug reaction. A score of 5 indicates a 'probable' adverse drug reaction.

Why might lansoprazole trigger RLS in hemodialysis patients?▼

PPIs like lansoprazole can impair iron absorption, and iron deficiency is a known trigger for RLS. Hemodialysis patients are already at risk for iron deficiency.

How quickly did symptoms improve after stopping lansoprazole?▼

Symptoms showed near-complete resolution within 14 days of lansoprazole withdrawal.

Is this effect specific to lansoprazole or all PPIs?▼

This case specifically implicates lansoprazole, but the authors suggest clinicians should reassess PPI necessity in general for atypical or refractory RLS/PLMD.

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References

  1. 1.Nakata H, Nishiwaki K. "Lansoprazole as a possible trigger of restless legs syndrome with suspected periodic limb movement disorder in a hemodialysis patient: a case report.." CEN case reports, 2026. PMID: 41999568 DOI: 10.1007/s13730-026-01099-1
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.