Proton Pump Inhibitors (PPI)

Treatment for gastroesophageal reflux disease (GERD) usually consists of three stages. The first two steps include taking drugs and making diet and lifestyle changes. Surgery is the third level. In very serious cases of GERD involving complications, surgery is usually used only as a last resort.

By changing how, when, and what they eat, most individuals will benefit from first-stage therapies. Diet and lifestyle changes alone, however, might not be productive for some. In such cases, doctors may prescribe the use of drugs that slow or stop the production of acid in the stomach.

One type of drug that can be used to suppress stomach acid and alleviate GERD symptoms is proton pump inhibitors (PPIs). H2 receptor blockers, such as famotidine (Pepcid AC) and cimetidine (Tagamet), are other drugs that can treat excess stomach acid. PPIs, however, are typically more effective than blockers of the H2 receptor and can relieve symptoms in most people who have GERD.

How Does It Work?

PPIs function by blocking and reducing stomach acid production. This allows time for any damaged esophageal tissue to recover. PPIs also help avoid heartburn, the sensation of burning that often accompanies GERD. Since even a small amount of acid can cause severe symptoms, PPIs are one of the most potent drugs to alleviate GERD symptoms.

Over a four to 12-week duration, PPIs help to decrease stomach acid. This period of time allows for the esophageal tissue to be fully healed. A PPI may take longer to relieve the symptoms than a blocker of the H2 receptor, which normally begins to reduce stomach acid within an hour. Symptom relief from PPIs, however, will normally last longer. So, for those with GERD, PPI medications tend to be most appropriate.

How PPIs Help You

Proton pump inhibitors are used to:

  • Relieve symptoms of acid reflux, or gastroesophageal reflux disease (GERD).

  • Treat a duodenal or stomach (gastric) ulcer.

  • Treat damage to the lower esophagus caused by acid reflux.

Types of PPI

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 PPI

PPIs are taken orally. As tablets or capsules, they are available. These medications are usually taken 30 minutes before the day's first meal.

At the pharmacy, you can buy some brands of PPIs without a prescription. If you find that you have to take these drugs most days, talk to your health care provider. Every day, some people who have acid reflux may need to take PPIs. Others will check symptoms any other day with a PPI.

Your doctor can prescribe PPIs along with 2 or 3 other medicines for up to 2 weeks if you have a peptic ulcer. Or you might be asked to take these medications for 8 weeks by your physician.

If these medicines are prescribed for you by your provider:

  • As you are told, take all of your medication.

  • Try to take them at the same time each day.

  • DO NOT quit taking your medication without first talking to your provider. Follow up frequently with your provider.

  • Plan in advance so you don't run out of medicine. Make sure that when you fly, you have enough with you.

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