Proton pump inhibitors
Proton pump inhibitors (PPIs) are medicines that work by reducing the amount of stomach acid made by glands in the lining of your stomach.
How PPIs help you
Proton pump inhibitors are used to:
- Relieve symptoms of acid reflux, or gastroesophageal reflux disease
(GERD). This is a condition in which food or liquid moves up from the stomach to the esophagus (the tube from the mouth to the stomach).
- Treat a peptic or stomach ulcer
- Treat damage to the lower esophagus caused by acid reflux.
Types of PPIs
There are many names and brands of PPIs. Most work equally as well. Side effects may vary from drug to drug.
- Omeprazole (Prilosec), also available over-the-counter (without a prescription)
- Esomeprazole (Nexium)
- Lansoprazole (Prevacid)
- Rabeprazole (AcipHex)
- Pantoprazole (Protonix)
- Dexlansoprazole (Kapidex)
Taking your PPIs
PPIs are taken by mouth. They are available as tablets or capsules. Commonly, these medicines are taken 30 minutes before the first meal of the day.
You can buy some brands of PPIs at the store without a prescription. Talk to your doctor if you find you have to take these medicines on most days. Some people who have acid reflux may need to take PPIs every day. Others may control symptoms with a PPI every other day.
If you have a peptic ulcer, your doctor may prescribe PPIs along with two or three other medicines for up to 2 weeks. Or your doctor may ask you to take these drugs for 8 weeks.
If your doctor prescribes these medicines for you:
- Take all of your medicines as your doctor tells you to.
- Try to take them at the same time each day.
- Do not stop taking your medicines without talking with your doctor first. Follow up with your doctor regularly.
- Plan ahead so that you do not run out of medicine. Make sure you have enough with you when you travel.
Side effects from PPIs are rare. You may have a headache, diarrhea, constipation, nausea, or itching. Ask your doctor about possible concerns with long-term use, such as infections and bone fractures.
If you are breastfeeding or pregnant, talk to your health care provider before taking these medicines.
Tell your doctor if you are also taking other medicines. PPIs may change the way certain drugs work, including some anti-seizure medicines and blood thinners such as warfarin or clopidogrel (Plavix).
When to call the doctor
Call your doctor if:
- You are having side effects from these medicines
- You are having other unusual symptoms
- Your symptoms are not improving
Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108:308-328.
Richter JE, Friedenberg FK. Gastroesophageal reflux disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Saunders Elsevier; 2010:chap 43.
George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.