Proton pump inhibitors (PPIs) for peptic ulcer disease

Examples

Generic Name	Brand Name
dexlansoprazole	Kapidex
esomeprazole	Nexium
lansoprazole	Prevacid
omeprazole	Prilosec, Zegerid
pantoprazole	Protonix
rabeprazole	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.

PPIs are also used to prevent ulcers and problems from ulcers (such as bleeding) in people who take NSAIDs long-term (for example, for arthritis).

How Well It Works

Proton pump inhibitors (PPIs) can block more than 90% of stomach acid production. These medicines work better than antacids or H2 blockers to prevent and treat ulcers.

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

These medicines have been shown to prevent ulcers and problems from ulcers (such as bleeding) in people who take NSAIDs long-term.¹

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 more serious side effects, too:

• They may reduce the amount of calcium your body absorbs. This may be linked to an increased risk of broken bones.²
• 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.

Proton pump inhibitors work best when they are taken 30 minutes before your first meal (for example, breakfast). If taking one pill before breakfast does not completely relieve your symptoms, talk to your doctor about taking another pill before dinner.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

Author:	Monica Rhodes	Last Updated: January 6, 2010
Medical Review:	Kathleen Romito, MD - Family Medicine Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology
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