About 25 percent of Americans have heartburn at least once a week. And 25 percent of those folks have it every day. Pharmacists across the country answer questions about acid-related medications 1.6 million times every month, a new survey found!
To help provide relief to heartburn sufferers, there’s a class of drugs called proton pump inhibitors (PPIs). You may have seen ads for Prilosec (omeprazole) or Prevacid (lansoprazole). These are examples of PPIs.
PPIs are available over-the-counter for self-care if you have frequent heartburn. The medication can also be given at higher doses by prescription for many other conditions.
PPIs are usually given for short courses (2 to 8 weeks) of treatment. PPIs should be taken 30-60 minutes before a meal for maximum benefit. Why? You need the medication in your system when your stomach starts making acid to digest a meal.
Usually PPIs are taken once daily. They’re least effective if taken at bedtime, so if you’re directed to take it twice daily, take it before your morning and evening meals.
Up to 70% of patients on PPIs continue to have nighttime acid symptoms. If that’s your situation, you may need a different medication like an H-2 blocker at bedtime. An H-2 example is Zantac (ranitidine).
Visit with your health care provider or pharmacist about the reason you take PPIs. If you have a condition that can cause esophageal damage, or you must take medication that has caused stomach bleeding, you may need PPIs for long-term protection.
The benefits of PPIs for these conditions outweigh the risks. But PPIs are often started to relieve a temporary problem such as stomach ulcers or frequent heartburn, or they may be started in the hospital while on bed rest. An issue can arise if the use of PPIs never stops.
Up to two-thirds of prescriptions for PPIs may be unnecessary. This increases costs and can lead to preventable side effects.
Stopping PPIs after you have used them longer than eight weeks can cause "rebound hypersecretion." That’s when the stomach overproduces acid. This effect can last up to three months and discourage people from stopping PPI use.
Unfortunately, people who had not had past problems with heartburn can suffer from this rebound acid overproduction after using PPIs for a long period and then stopping.
If it’s appropriate for you to stop using PPIs, first decrease to the lowest possible daily dose. Then decrease to every other day for at least a week. Ask your provider of pharmacist for more tips to comfortably end use of PPIs.
Although side effects from short-term use of PPIs are usually mild, we do have two main concerns with long-term use. Here are the risks and how you can manage them:
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