Proton pump inhibitors (PPIs) for acid reflux

What are proton pump inhibitors (PPIs)?

PPIs are medicines that lower the production of acid in the stomach. They are used to treat acid reflux as well as other conditions such as ulcers. Medicine names that end in “prazole” are PPIs.

Some PPIs are:

  • omeprazole (Prilosec)
  • esomeprazole (Nexium)
  • pantoprazole (Protonix)

What are the risks of using a PPI?

Long-term use of PPI can be linked to a number of other health problems, such as:

  • Kidney injury
  • Osteoporosis and bone fractures
  • Dementia

Why is it so hard for people to stop taking PPIs?

If a PPI is stopped, people who have been taking it may find they have even worse acid reflux than before. This happens because the PPIs are good at shutting down acid production. When the PPI is stopped, there is nothing holding the stomach back from making acid. The stomach may make more acid than before. This is known as “rebound acid production.”

It may be better to switch over to a different medicine first instead of stopping all reflux medicines at once. That new medicine can then be weaned down in the future.

Are there any safer medicines to take instead of PPIs?

There is no such thing as a medicine that is 100 percent safe and free of side effects. H2 blockers are thought to be safer than PPIs for long-term use to treat acid reflux. H2 blockers can be over-the-counter or prescription medicines.

Some H2 blockers are:

  • Ranitidine (Zantac)
  • Famotidine (Pepcid) 
Last reviewed: 
October 2017

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