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Proton pump inhibitors

Show Alternative Names
PPIs

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 duodenal or stomach (gastric) 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), also available over-the-counter (without a prescription)
  • Lansoprazole (Prevacid), also available over-the-counter (without a prescription)
  • Rabeprazole (AcipHex)
  • Pantoprazole (Protonix)
  • Dexlansoprazole (Dexilant)
  • Zegerid (omeprazole with sodium bicarbonate), also available over-the-counter (without a prescription)

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 without a prescription. Talk to your health care provider 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 2 or 3 other medicines for up to 2 weeks. Or your provider may ask you to take these drugs for 8 weeks.

If your provider prescribes these medicines for you:

  • Take all of your medicines as you are told.
  • Try to take them at the same time each day.
  • Do not stop taking your medicines without talking with your provider first. Follow up with your provider regularly.
  • Plan ahead so that you do not run out of medicine. Make sure you have enough with you when you travel.

Side Effects

Side effects from PPIs are rare. You may have a headache, diarrhea, constipation, nausea, or itching. Ask your provider about possible concerns with long-term use, such as infections and bone fractures.

If you are breastfeeding or pregnant, talk to your provider before taking these medicines.

Tell your provider if you are also taking other medicines. PPIs may change the way certain medicines work, including some anti-seizure medicines and blood thinners such as warfarin or clopidogrel (Plavix).

When to Call the Doctor

Call your provider if:

  • You are having side effects from these medicines
  • You are having other unusual symptoms
  • Your symptoms are not improving
Review Date: 5/3/2023

Reviewed By

Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

References

Aronson JK. Proton pump inhibitors. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Walthman, MA: Elsevier; 2016:1040-1045.

Katz PO, Dunbar KB, Schnoll-Sussman FH, Greer KB, Yadlapati R, Spechler SJ. ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2022;117(1):27-56. PMID: 34807007 www.ncbi.nlm.nih.gov/pmc/articles/PMC8754510/.

Kuipers EJ, Blaser MJ. Acid peptic disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 130.

Richter JE, Vaezi MF. Gastroesophageal reflux disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 46.

Disclaimer

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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Gastroesophageal reflux disease

Gastroesophageal reflux disease

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Gastroesophageal reflux disease - Animation

Do you feel a burning in your chest not long after you eat or lie down? If so, you may have Gastroesophageal reflux disease, or GERD.

When we swallow food, it travels down our esophagus into the stomach, where it's greeted by a rush of Hydrochloric acid in the stomach to begin digestion. This acid is so powerful, it could eat the paint right off your car!

Fortunately, there's a band of muscle between the stomach and the esophagus - called the Lower Esophageal Sphincter or L-E-S, that clamps down to prevent the stomach contents from moving or "refluxing" upward and burning the lining of the esophagus. If that band of muscle does not adequately clamp down, this backwash causes the irritation and burning that's known as heartburn or GERD.

Maintaining good tight L-E-S muscle tone is the key to preventing this condition.

Causes of GERD include: being overweight, smoking, and drinking too much alcohol. Certain foods, like chocolate and peppermint and if you're a woman, pregnancy can bring on GERD

To determine if you have GERD, your doctor may request an upper endoscopy exam to look into your esophagus and stomach to diagnose reflux. Other tests can measure the acid and amount of pressure in your esophagus, or if you have blood in your stool.

If you do have GERD, lifestyle changes can help. First, avoid foods that cause problems for you and avoid eating large meals. If you're a little on the heavy side, try to lose some weight. Since most GERD symptoms are experienced lying down in bed, let gravity help. Elevating the head of your bed 4-6 inches using blocks of wood may help.

If symptoms continue, see your doctor or a Gastroenterologist for evaluation and an upper endoscopy exam. Your doctor may suggest you take over-the-counter antacids or may prescribe stronger medications.

Call your doctor if you are bleeding, feel like you are choking, have trouble-swallowing, or experience sudden weight loss.

The good news is most people who have GERD do not need surgery. For the worst cases, surgeons may perform a laparoscopic procedure to tighten a weak L-E-S muscle.

If you have occasional heartburn, antacid tablets can be used as needed. However! If you're having heartburn more than 3-4 times a week, see your doctor & take the prescribed medication to prevent this condition.

 

Gastroesophageal reflux disease - Animation

Do you feel a burning in your chest not long after you eat or lie down? If so, you may have Gastroesophageal reflux disease, or GERD.

When we swallow food, it travels down our esophagus into the stomach, where it's greeted by a rush of Hydrochloric acid in the stomach to begin digestion. This acid is so powerful, it could eat the paint right off your car!

Fortunately, there's a band of muscle between the stomach and the esophagus - called the Lower Esophageal Sphincter or L-E-S, that clamps down to prevent the stomach contents from moving or "refluxing" upward and burning the lining of the esophagus. If that band of muscle does not adequately clamp down, this backwash causes the irritation and burning that's known as heartburn or GERD.

Maintaining good tight L-E-S muscle tone is the key to preventing this condition.

Causes of GERD include: being overweight, smoking, and drinking too much alcohol. Certain foods, like chocolate and peppermint and if you're a woman, pregnancy can bring on GERD

To determine if you have GERD, your doctor may request an upper endoscopy exam to look into your esophagus and stomach to diagnose reflux. Other tests can measure the acid and amount of pressure in your esophagus, or if you have blood in your stool.

If you do have GERD, lifestyle changes can help. First, avoid foods that cause problems for you and avoid eating large meals. If you're a little on the heavy side, try to lose some weight. Since most GERD symptoms are experienced lying down in bed, let gravity help. Elevating the head of your bed 4-6 inches using blocks of wood may help.

If symptoms continue, see your doctor or a Gastroenterologist for evaluation and an upper endoscopy exam. Your doctor may suggest you take over-the-counter antacids or may prescribe stronger medications.

Call your doctor if you are bleeding, feel like you are choking, have trouble-swallowing, or experience sudden weight loss.

The good news is most people who have GERD do not need surgery. For the worst cases, surgeons may perform a laparoscopic procedure to tighten a weak L-E-S muscle.

If you have occasional heartburn, antacid tablets can be used as needed. However! If you're having heartburn more than 3-4 times a week, see your doctor & take the prescribed medication to prevent this condition.

 
 
 
 

 

 
 
 
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