Proton pump inhibitors (PPIs) for peptic ulcer disease

Examples

Generic Name	Brand Name
esomeprazole magnesium	Nexium
lansoprazole	Prevacid
omeprazole	Prilosec, Prilosec OTC
pantoprazole sodium	Protonix
rabeprazole sodium	Aciphex

Proton pump inhibitors (PPIs) are usually taken one time a day. They are sometimes taken two times a day if a stronger dose is needed.

How It Works

Proton pump inhibitors (PPIs) greatly reduce the amount of acid produced by the stomach, which in turn reduces irritation of the stomach lining and allows an ulcer to heal.

When used with antibiotics, PPIs also help treat Helicobacter pylori (H. pylori) infection.

Why It Is Used

Proton pump inhibitors are used to treat ulcers. They provide short-term (2 to 8 weeks) treatment for ulcers in the stomach and in the upper small intestine. They also are used to treat gastroesophageal reflux disease (GERD).

How Well It Works

Proton pump inhibitors (PPIs) can block more than 90% of stomach acid production. They are more effective than H2 blockers. After 4 weeks of treatment, ulcers are more likely to have healed when using PPIs than when using H2 blockers or antacids.

Most ulcers heal within 4 weeks, although some people may need up to 4 more weeks of treatment to complete healing. Rarely, large ulcers need even longer treatment.

Side Effects

These medicines generally are well-tolerated. Headache and diarrhea are the most frequent side effects. These medicines may interfere slightly with the actions of warfarin (Coumadin) and phenytoin (Dilantin). Tell your doctor about all the medicines you are taking.

Proton pump inhibitors may have some more serious side effects:

• They may reduce the amount of calcium your body absorbs. This may be associated with an increased risk of broken bones.¹
• They may make it more likely that you will get certain infections.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Proton pump inhibitors (PPIs) usually cost more than H2 blockers.

Some doctors may have concerns about the risk of using PPIs to reduce stomach acid production for a long time. But omeprazole has been used by some people for up to 10 years with no sign that the medicine causes serious health problems. Proton pump inhibitors are approved for long-term use in Canada, Europe, and the United States.

You can get omeprazole without a prescription (over-the-counter or OTC). If you use Prilosec OTC to help with your symptoms for more than 10 to 14 days at a time, or if your symptoms are very bad, be sure to see your doctor.

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Author:	Monica Rhodes	Last Updated: January 7, 2008
Medical Review:	Kathleen Romito, MD - Family Medicine Andrew H. Soll, MD - Gastroenterology
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