Proton pump inhibitors (PPIs) are a type of medication that reduces how much acid your stomach produces. Doctors prescribe PPIs to treat stomach ulcers and symptoms of chronic acid reflux, also known as gastroesophageal reflux disease (GERD). They are available over-the-counter (OTC) and on prescription as both generic and name brand medications including esomeprazole (Nexium), lansoprazole (Prevacid), and omeprazole (Prilosec).
Proton pump inhibitors (PPIs) are a class of drugs that help relieve heartburn caused by acid reflux and stomach ulcers. These medications treat heartburn by reducing how much acid your stomach makes.
Stomach acid is vital for breaking down food so your body can digest it. But too much stomach acid or acid that flows in the wrong direction can irritate the lining of the food pipe, cause discomfort, and lead to the development of ulcers.
PPIs help with issues relating to chronic or ongoing excess stomach acid. Several types of drugs, including histamine blockers and antacids, also reduce how much stomach acid you make. PPIs take more time to start working, but they also have longer-lasting effects. If you’re seeking quicker relief from heartburn, antacids or H2s are more effective.
PPIs help to manage gastroesophageal reflux disease (GERD), prevent and treat stomach and duodenum ulcers, and also reduce the symptoms of Zollinger-Ellison Syndrome, a rare chronic condition that causes tumors linked to acid production. They may also support the treatment of some bacterial infections.
Gastroesophageal Reflux Disease (GERD)
People with gastroesophageal reflux disease (GERD) might experience ongoing discomfort because a special valve meant to keep stomach acid and food particles from flowing back into the food pipe, or esophagus, doesn't function properly. As a result, stomach acid flows back into the esophagus (food pipe) — a process known as reflux, which causes symptoms like heartburn, irritation, chest pain, and coughing. Occasional reflux is normal and may not even cause symptoms, but GERD is a chronic disease that causes more frequent reflux with more severe symptoms.
Peptic and Duodenal Ulcers
Ulcers can result when stomach acid damages the inner lining of the stomach. This may be as a complication of GERD or as a side effect of taking nonsteroidal anti-inflammatory drugs (NSAIDs). They can lead to dull, burning pain, bloating, heartburn, or nausea. PPIs can prevent ulcers if another treatment, such as NSAIDs, increases a person's ulcer risk. They can also treat existing ulcers.
Zollinger-Ellison Syndrome
This rare condition causes tumors called gastrinomas to develop in the digestive system. These tumors grow in the gut or pancreas and release a hormone called gastrin, which triggers the release of excess stomach acids. PPIs work against the acid-producing effects of Zollinger-Ellison syndrome, giving the gut and stomach tissue space to heal and preventing ulcers.
H. pylori Infection
H. pylori is a bacteria that can cause digestive problems and nausea when it infects the stomach. Doctors treat H. pylori with antibiotics but might prescribe PPIs alongside it.
PPIs are available over-the-counter (OTC) and with a prescription. They are available in forms such as:
Intravenous (IV) injections or infusions
Oral pills
Capsules
Some brands of PPIs allow you to mix the powder in the capsule with applesauce and consume the mixture if you don’t feel comfortable or able to swallow pills.
These oral forms may take several days to take full effect.
The following PPis are available as intravenous (IV) injections or infusions:
esomeprazole
pantoprazole
lansoprazole
PPIs Available OTC and With Prescription
esomeprazole (Nexium)
lansoprazole (Prevacid)
omeprazole (Prilosec)
omeprazole/sodium bicarbonate (Zegerid)
Exclusively Prescription PPIs
dexlansoprazole (Dexilant)
pantoprazole (Protonix)
rabeprazole (AcipHex)
PPIs help people with gastroesophegal reflux (GER) and gastroesophegal reflux disease (GERD) by blocking the activity of the “proton pump,” an enzyme in your stomach that releases stomach acid. Even if the valve above the stomach doesn't close all the way, less acid flows into your food pipe and irritates its lining. PPIs don’t stop all of your stomach acid, as you still need enough to break down food, but they help you produce around 65 percent less after taking them for five days.
Some brands of PPI work best when you to take them 30–60 minutes before mealtimes on an empty stomach. This allows the medication to take effect before food triggers stomach acid production in your stomach.
PPIs don’t often cause side effects. To be safe, physicians usually recommend taking PPIs for the shortest possible time so that symptoms improve without risking side effects. But long-term (or chronic) use of PPIs can increase your risk of experiencing side effects.
Avoid using PPIs if you know that you have a hypersensitivity to any of the ingredients found in the medication. Taking PPIs for a long time may increase your risk of developing serious health problems:
Bone fracture in patients with osteoporosis, as PPIs might make it harder for your body to absorb calcium — a mineral with close links to bone strength.
A doctor may need to apply caution when you take PPIs along with the following:
Some antifungal agents, such as ketoconazole — a doctor may recommend other antifungals that your gut can digest well with less acid
Digoxin, which PPIs may help the gut absorb faster, leading to more severe side effects
Diazepam (valium), warfarin (Coumadin), and phenytoin (Dilantin), which the body can’t clear as effectively, meaning they stay in the body longer than usual
Avoid using omeprazole if you're already taking:
Viracept (nelfinavir), which the U.S. Food and Drug Administration (FDA) advises you shouldn’t take alongside drugs like PPIs that depend on an enzyme called CYP3A to leave the body
Drugs that contain rilpivirine, as PPIs may reduce the body’s ability to absorb them.
Proton pump inhibitors (PPIs) help lower stomach acid production, mainly treating conditions like GERD and peptic ulcers.
While they can be effective in managing symptoms, sometimes PPIs might cause side effects like headache or stomach pain.
If you're experiencing heartburn, using PPIs for the shortest duration necessary might help manage your discomfort while minimizing potential risks.
