What are Proton Pump Inhibitors?

Proton pump inhibitors (PPIs) may also be called antacids, though they are a specific type of antacid that aids in blocking stomach cells from producing acid in the form of hydrogen ions. Not all antacids are the same, and PPIs are often compared to another type of acid reducer called the H2 blocker. H2 blockers interfere with a different mechanism and reduce histamine response that signals the stomach to produce more acid. H2 blockers are usually more effective short-term, and shorter acting, but they need to be taken with greater frequency. PPIs, in contrast, tend to work more effectively for longer periods of time, but may need to be taken for several days before they begin to work well.

Either an H2 blocker or a PPI might be used to treat gastroesophageal reflux disease (GERD), but PPIs are recommended for conditions like acid damage of the esophagus or for ulcers. Another indication to use proton pump inhibitors is when a person has Zollinger-Ellison syndrome. This causes acid overproduction from tumor formation.

There are several proton pump inhibitors available and a number of them require a doctor’s prescription. The medication omeprazole, known by the brand-name Prilosec®, is obtainable over the counter in many regions. Other PPIs include lansoprazole (Prevacid®), pantoprazole (Protonix®), dexlansoprazole (Kapidex®), raberprazole (Aciphex®), and esomeprazole (Nexium®). Some of these medicines are heavily advertised and very familiar to consumers.

Familiarity doesn’t mean superiority, and most drugs in this class are thought equally effective. There may be reasons why doctors prefer to prescribe one of the proton pump inhibitors over others. Such reasons could include the medical history of the patient and the different medicines taken or conditions present that might make a specific drug a better choice. For instance, someone who routinely takes Valium® or warfarin might avoid Prilosec® because it elevates the blood levels of these medications. Alternately, dosing of Valium® or warfarin could change to accommodate these taking Prilosec® too.

Since each of the proton pump inhibitors is slightly different, expected side effects are difficult to discuss. On the whole, people who take PPIs may experience, to small or large degree, conditions like diarrhea, constipation or other stomach upset such as nausea. Another common side effect of PPIs is headache. Many people do not report side effects from use of PPIs or they find early side effects disappear with continued use.

Many times doctors intend people to take PPIs on a long-term basis to address ongoing conditions. Another advantage these drugs have over H2 inhibitors in treating chronic problems is that they often can be taken once a day instead of twice a day or more. They really aren’t generally intended to treat the occasional bout of heartburn, though, and won’t effectively halt an active case of heartburn. Instead an H2 inhibitor or other antacid would be advised. Should incidence of heartburn be frequent and chronic, people might want to consider discussing the potential benefits of proton pump inhibitors with their physicians.