The introduction of proton pump inhibitors PPIs in the late s dramatically changed the treatment and outcome of gastroesophageal reflux disease. Commonly prescribed PPIs include omeprazole Prilosec , lansoprazole Prevacid , pantoprazole Protonix , rabeprazole Aciphex , dexlansoprazole Dexilant , and esomeprazole Nexium.
Because billions of dollars are spent on PPIs each year in the United States, it is important for retail clinicians to know how to use them correctly. PPIs are appropriate for most stomach acid—related pathologies. The onset of action of PPIs is much longer than the 1-hour onset of H 2 -receptor antagonists, such as famotidine Pepcid.
There are certain situations and reasons for taking each category of these medications, and each has different contraindications and interactions, as well. One medication metabolized into its active form through this pathway is clopidogrel Plavix , a very commonly used antiplatelet agent. PPIs have the potential to interact with a wide variety of medications due to alteration of the pH of the stomach, which can potentially change absorption, activation, and binding of medications. Multiple HIV medications such as nelfinavir Aricept and rilpivirine Edurant require acid for proper absorption, so they are not absorbed in therapeutic doses when given with PPIs.
Debate about whether PPIs alter absorption of vitamins and minerals has been ongoing for many years. Longterm treatment with a PPI decreases absorption of vitamin B 12 and iron, potentially leading to anemia, neurologic dysfunction, and other long-term complications. PPIs not only affect oral medications in a variety of ways, they also alter gut flora by increasing the pH of the stomach, allowing ingested bacteria to survive the usual harsh acid environment.
Results of many studies have shown a correlation between the use of PPIs and increased incidence of nosocomial and community-acquired pneumonia, as well as Clostridium difficile infection, especially when PPIs are co-administered with antibiotics.
What are the common medications that may affect the tone of the lower esophageal sphincter LES? What can I take to correct the problem?
Other than acetaminophen, patients taking medications for pain should do two things: First, take a full glass of water with these medications to wash them down. Second, do not lie down for minutes after taking these pills. I have serious heartburn several times during the day and night.
I have found that a teaspoonful of baking soda in a little water gives me fast relief. Is this harmful? I have been taking it for several months now. I look at three different situations where patients require relief from heartburn. Read more about H2 Blockers If you have infrequent, but predictable heartburn, taking an over the counter preparation will work fine.
Share this page. Share on facebook. Share on twitter. Share on linkedin. Share on email. Share on print. Topics of this article. Was this article helpful? Make a donation. Related Information. June 30, Research News. February 24, Personal Stories. International Foundation for Gastrointestinal Disorders. Our Other Sites. Learn about symptoms and treatment. Acid reflux happens when stomach acid backs up into your esophagus. Learn how to prevent and treat it with lifestyle changes, medications, or surgery….
Prilosec and Zantac both reduce acid levels in the stomach to relieve symptoms of acid reflux. Find out how these drugs are alike and different. Baking soda can temporarily relieve acid reflux. But it can also cause unintended side effects. Find out how much baking soda you should take for acid….
You can help normalize your overactive bladder naturally by avoiding artificial sweeteners, caffeine, and alcohol, losing weight, and performing…. Prokinetics such as bethanechol, cisapride, domperidone, and metoclopramide are treatments for GERD. They help strengthen the lower esophageal…. Numerous over-the-counter medications can help treat GERD, or heartburn.
Learn more about your options for treating GERD and when you should see a…. Gastroesophageal reflux disease GERD is a chronic condition that affects nearly 20 percent of American adults.
Learn the complications from GERD…. Health Conditions Discover Plan Connect. Nexium vs. Medically reviewed by Alan Carter, Pharm. Understanding your options Heartburn is difficult enough. Be sure you have a good reason to take the PPI, and take it for the shortest time possible.
PPIs interact with some common prescription drugs. This can increase the risk of heart attack and even death. If you take Plavix, talk to your doctor about whether you should take a PPI.
Both the prescription and over-the-counter versions of PPIs are usually more expensive than antacids and H2 blockers. If you are worried about cost, talk to your doctor. He or she can help you find the least expensive medicine that will work for you.
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