Page 1 of 4

View this article online at: patient.info/health/proton-pump-inhibitors

Proton Pump Inhibitors

Proton pump inhibitors (PPIs) reduce the amount of acid made by your stomach. They are
commonly used to treat acid reflux and ulcers of the stomach and part of the gut called the
duodenum. Most people who take a PPI do not develop any side-effects.

What are proton pump inhibitors (PPIs)?

PPIs are a group (class) of medicines that work on the cells that line the stomach, reducing the production of
acid. They include esomeprazole, lansoprazole, omeprazole, pantoprazole and rabeprazole, and have various
different brand names.

What conditions are proton pump inhibitors (PPIs) used to treat?

PPIs are commonly used:

To treat ulcers in the stomach and the part of the gut called the duodenum.
To reduce acid reflux which may cause heartburn or inflammation of the gullet (oesophagitis). These
conditions are sometimes called gastro-oesophageal reflux disease (GORD).
As one part of treatment to get rid of Helicobacter pylori - a germ (bacterium) found in the stomach,
which can cause ulcers.
To help prevent and treat ulcers associated with anti-inflammatory medicines called non-steroidal anti-
inflammatory drugs (NSAIDs).
In a rare condition called Zollinger-Ellison syndrome.
In other conditions where it is helpful to reduce acid in the stomach.

PPIs usually work very well to reduce stomach acid and to treat the above conditions. They have made a big
impact on the quality of life of many people with these conditions since they first became available in the 1980s.
They are commonly prescribed.

How do proton pump inhibitors (PPIs) work?

Your stomach normally produces acid to help with the digestion
of food and to kill germs (bacteria). This acid is corrosive so
your body produces a natural mucous barrier which protects
the lining of the stomach from being worn away (eroded).

In some people this barrier may have broken down allowing the
acid to damage the stomach, causing an ulcer. In others there
may be a problem with the muscular band at the top of the
stomach (the sphincter) that keeps the stomach tightly closed.
This may allow the acid to escape and irritate the gullet
(oesophagus). This is called 'acid reflux' which can cause
heartburn and/or inflammation of the gullet (oesophagitis).

PPIs stop cells in the lining of the stomach producing too much
acid. This can help to prevent ulcers from forming or assist the
healing process. By decreasing the amount of acid, they can
also help to reduce acid reflux-related symptoms such as
heartburn.
 Page 2 of 4
They are called 'proton pump inhibitors' because they work by
blocking (inhibiting) a chemical system called the hydrogen-
potassium adenosine triphosphatase enzyme system
(otherwise known as the 'proton pump'). This chemical system
is found in the cells in the stomach lining that make stomach acid.

Can I buy proton pump inhibitors (PPIs)?

Most of these medicines are prescription only. You can buy omeprazole and pantoprazole over-the-counter at
pharmacies. However, if you need to use this medicine for more than four weeks you should consult your doctor.

How do I take proton pump inhibitors (PPIs)?

Your doctor will advise you of the dose needed and how often you should take it. Some of these medicines need
to be taken in a certain way, such as on an empty stomach. Therefore, read the leaflet that comes with your
particular brand for further information.

How quickly do proton pump inhibitors (PPIs) work?

Generally, PPIs are well absorbed by the body and may provide quick relief for some problems. For example,
heartburn caused by acid reflux. However, if you are taking them for other reasons, such as to heal an ulcer, it
may take longer for the medicines to have an underlying effect.

How long is treatment needed?

This can vary depending on the reason you are taking a PPI. So, speak to your doctor for advice. For example, in
some cases your doctor may prescribe a PPI that you only take 'as required' to relieve your symptoms, rather
than every day. In some cases a regular dose taken each day is advised.

Will my symptoms return after treatment with a proton pump

inhibitor (PPI)?
It is possible that your symptoms might come back if you stop your medication. If this happens, see your doctor
again.

Who should not take proton pump inhibitors (PPIs)?

PPIs may not be suitable for some people - for example, people with certain liver problems. Breast-feeding or
pregnant mums should avoid them apart from omeprazole which is deemed to be safe. A full list of individuals
who should not take a PPI is included with the information leaflet that comes in the medicine packet. If you are
prescribed or buy a PPI, read this to be sure you are safe to take it.

What about side-effects?

Most people who take a PPI do not have any side-effects. However, side-effects occur in a small number of
users. The most common side-effects are:

Constipation
Diarrhoea
Wind (flatulence)
Headaches
Feeling sick (nausea)
Tummy (abdominal) pain
Being sick (vomiting)

For a full list of possible side-effects and cautions, see the leaflet that comes in the packet with your particular
brand.
 Page 3 of 4
In particular: tell your doctor if you are taking the blood-thinning medicine warfarin, or a medicine for epilepsy,
called phenytoin (Epanutin®), or medicines called digoxin, methotrexate or cilostazol. Taking a PPI can affect how
well these medicines work, or can even cause serious 'drug reactions'. Also, lansoprazole possibly affects how
well oral contraceptives might work. Discuss this with your doctor if it is relevant to you.

If you are taking antacids you should try to avoid taking them at the same time as you take your other medication,
including PPIs. This is because antacids can affect how well your medication is absorbed.

How to use the Yellow Card Scheme

If you think you have had a side-effect to one of your medicines you can report this on the Yellow Card Scheme.
You can do this online at the following web address: www.mhra.gov.uk/yellowcard.

The Yellow Card Scheme is used to make pharmacists, doctors and nurses aware of any new side-effects that
medicines or any other healthcare products may have caused. If you wish to report a side-effect, you will need to
provide basic information about:

The side-effect.
The name of the medicine which you think caused it.
The person who had the side-effect.
Your contact details as the reporter of the side-effect.

It is helpful if you have your medication - and/or the leaflet that came with it - with you while you fill out the report.

Other considerations when taking a proton pump inhibitor (PPI)

You should consult your doctor if your symptoms worsen, or if you experience any of the following problems
which can indicate a serious gut disorder:

Bring up (vomiting) blood. This may be obviously fresh blood, but altered blood in vomit can look like
ground coffee. Doctors call this 'coffee-ground vomit'.
Blood in your stools (faeces). This may be obvious blood, or it may just make your stools black.
Unintentional weight loss.
Difficulty swallowing, including food getting stuck in the gullet.
Persistent tummy (abdominal) pain or persistent vomiting.

Further reading & references

British National Formulary
The management of dyspepsia in primary care; MeReC Briefing, No 32, 2006

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical
conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its
accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions.
For details see our conditions.

Original Author: Current Version: Peer Reviewer:

Dr Tim Kenny Dr Laurence Knott Prof Cathy Jackson
Document ID: Last Checked: Next Review:
9012 (v4) 24/11/2014 23/11/2017

View this article online at: patient.info/health/proton-pump-inhibitors

Discuss Proton Pump Inhibitors and find more trusted resources at Patient.
 Page 4 of 4

© EMIS Group plc - all rights reserved.