Proton Pump Inhibitors (PPIs) are medications which reduce the production of acid by blocking the enzyme in the wall of the stomach which produces acid (necessary for the digestion of food in the stomach).  However, excess production of this acid is associated with the formation of most ulcers in the oesophagus, stomach, and duodenum and causing Gastroesophageal Reflux Disease (also known as GERD).  It may also be used in combination with antibiotics to treat Helicobacter Pylori (H. Pylori) a bacteria which is associated with gastric ulcers.

Formulations of PPI available include:

• Lansoprazole (Prevacid)
• Rabeprazole (Pariet)
• Pantoprazole (Controloc)
• Esomeprazole (Nexium)
• Dexlansoprazole (Dexilant)

Suggested PPI regime

Your doctor will recommend the medication schedule based on your condition.  Remember than everyone’s condition is different so avoid self medication.  Here is a general guide when taking PPIs; 

• Should be taken 30-60 minutes before meals
• Should NOT be taken long term
• Should NOT be taken with H2 antagonists
• Can be taken with adjuvant therapy such as antacids or alginates
• Aim for lowest effective dose
• Beware of long term overuse

Condition	Frequency	Duration
GERD at diagnosis	Once daily	4-8 weeks
Maintenance GERD	Once daily	As directed
Symptomatic GERD	Once daily	4 weeks & thereafter on demand
Gastric Ulcer	Once daily	8 weeks
H Pylori Eradication	Twice daily	7-14 days

Side effects

There are side effects with any medication and as such it is important to use the lowest doses and shortest duration of treatment necessary for the condition being treated.  Long term use can be associated with increased risk of fractures, kidney disease, pneumonia and Vitamin B12 deficiency.  The most common side effects (usually mild and therefore easily tolerated) of PPIs are:

• Headache
• Diarrhoea or constipation
• Flatulence
• Nausea or vomiting
• Rashes

Discuss the treatment regime with your doctor or pharmacist to use your medication safely. AVOID self-medication

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