Proton pump inhibitors (PPIs) reduce the production of stomach acid by interfering with the mechanism that causes certain cells to produce this acid. They are available by prescription and are used to treat conditions such as peptic ulcers, gastroesophageal reflux disease (GERD), gastritis, indigestion and Zollinger-Ellison syndrome. One PPI (omeprazole) is available without a prescription.

Examples of PPIs include:

• esomeprazole (Nexium)
• lansoprazole (Prevacid)
• omeprazole (Prilosec)
• pantoprazole (Protonix)
• rabeprazole (Aciphex)

These medications provide effective, long-lasting treatment of symptoms and can be used safely for periods of 10 years or longer. They are taken once daily, generally in tablet or capsule form. An intravenous (I.V.) form of proton pump inhibitor medication is also available.

PPIs are well-tolerated by most patients. In some cases, they may cause side effects such as abdominal pain, diarrhea, flatulence, dry mouth, constipation, nausea and headache. 

Proton pump inhibitors (PPIs) are medications that reduce the production of stomach acid by stopping the mechanism inside cells that pumps acid to the stomach. These drugs are generally considered to be the most effective treatment for suppressing the production of stomach acid.

PPIs are available by prescription and are used to treat conditions such as peptic ulcers, gastroesophageal reflux disease (GERD), indigestion and Zollinger-Ellison syndrome (ZES). First introduced in the 1980s, they now are considered superior to H2 blockers in terms of reducing acid production. One PPI (omeprazole) is available in an over-the-counter form.

These medications can be extremely effective at treating some conditions. For example, PPIs are the preferred method of treating GERD or Zollinger-Ellison syndrome. In some cases, these drugs are used to treat severe forms of a disease. For instance, PPIs may be used to treat gastritis when other medications fail to resolve symptoms.

PPIs provide long-lasting treatment and can be used safely for periods of 10 years or longer. They are taken once daily, preferably in the morning on an empty stomach, in a tablet or capsule form. Patients who have difficulty swallowing tablets or capsules may be urged to sprinkle granules of the drug over a tablespoon of applesauce, pudding, yogurt or cottage cheese. An intravenous (I.V.) form of PPI medication is also available.

The biggest disadvantage associated with PPIs is that they tend to be more expensive than other, similar medications. However, this cost may be offset by the fact that PPIs usually require lower and less frequent dosing than drugs such as H2 blockers.

All PPIs work similarly to one another, and there is no evidence to support the use of one type over another. They do, however, differ in their drug interactions and how they are processed by the liver. In addition, some PPIs demonstrate longer lasting effects and therefore may be taken less frequently.

Types of PPIs include:

Proton pump inhibitors (PPIs) are used to treat several conditions that affect the digestive system. These include:

• Gastroesophageal reflux disease (GERD). A condition in which acidic food or liquid from the stomach backs up into the esophagus, which connects the mouth to the stomach. PPIs are considered to be the most effective medication for treating GERD.
  
  
• Peptic ulcers. Sores that develop in the lining of the stomach or duodenum, the first part of the small intestine. PPIs do not kill Helicobacter pylori, the bacterium that causes peptic ulcers. For this reason, antibiotics may also be used to treat peptic ulcers.
  
  
• Gastritis. Inflammation of the stomach lining. PPIs are used when the condition is severe enough to require the strongest medication available.
  
  
• Indigestion. A burning feeling or discomfort in the upper abdomen caused by many different factors, including diseases such as GERD and ulcers, as well as lifestyle activities such as eating too much or eating high-fat foods.
  
  
• Zollinger-Ellison syndrome. Rare condition that causes tumors to form in the pancreas and duodenum, or ulcers to form in the stomach or duodenum. PPIs are considered to be the most effective drug for treating this condition, and are used to both reduce production of stomach acid and to promote healing.

Patients should consult their physician before taking any additional prescriptions, over-the-counter medications, nutritional supplements or herbal medications.

Proton pump inhibitors (PPIs) significantly raise a patient’s gastric pH level, which may affect the body’s ability to absorb drugs such as:

• Certain antibiotics including amoxicillin, ampicillin, clarithromycin, and griseofulvin. PPIs may decrease the absorption of certain antibiotics. However, antibiotics are often prescribed for several days to weeks along with certain PPIs to treat the Helicobacter pylori bacteria which cause peptic ulcers.
  
  
• Antifungals such as itraconazole and ketoconazole.
  
  
• Iron supplements.
  
  
• Vitamin B.

Other drugs that may be affected by PPI use include:

• Diazepam (antianxiety drug)
• Digoxin (antirrhythmic heart drug)
• Phenytoin (anticonvulsant)
• Sucralfate (antiulcer medication)
• Theophylline (bronchodilator)
• Warfarin (anticoagulant)

Symptoms of overdose can be similar to the medication’s side effects, but are usually more severe. Overdose of proton pump inhibitors (PPIs) is rare. However, patients exhibiting any of these symptoms should contact their physician immediately:

• Confusion
• Drowsiness
• Blurred vision
• Rapid heartbeat (tachycardia)
• Vomiting
• Profuse perspiration (diaphoresis)

Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions related to proton pump inhibitors (PPIs):

1. Are PPIs the best treatment for my condition?
   
   
2. Are there any other medications you can recommend for me?
   
   
3. How do PPIs work to treat my condition?
   
   
4. Which PPI is most appropriate for my condition?
   
   
5. Is an over-the-counter PPI a good option for my condition?
   
   
6. How often do I need to take PPIs?
   
   
7. For how long will I need to take these drugs?
   
   
8. Which side effects, if any, should I immediately report to you?
   
   
9. Will the PPI interact with any other medications I’m currently taking?
   
   
10. I’m pregnant – does this prevent me from taking PPIs?