Most Common Prescription Medication Used to Treat GERD

Some Proton Pump Inhibitors Are Available Over-The-Counter

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The most common prescription medications used for the treatment of Gastroesophageal Reflux Disease (GERD) are proton pump inhibitors (PPIs). 

Proton pump inhibitors are acid reducers. Doctors prescribe PPIs to treat people with a number of conditions including:

    How PPIs Work

    One of the reasons why proton pump inhibitors are prescribed often is because they tend to successfully relieve heartburn.

    Your stomach produces acid to help break down food so it is easier to digest. In certain circumstances, this acid can irritate the lining of your stomach and duodenum (the medical name for the upper part of your small intestine) causing heartburn and even ulcers.

    The stomach contains a pump, called the gastric acid pump, which produces stomach acid. PPIs block the secretion of acid into the stomach by binding to these pumps. Decreasing the amount of stomach acid can help ulcers heal and reflux to subside.

    Available PPI Medications

    Here are the seven PPIs available, some over-the-counter and some by prescription only:

    • Aciphex (Rabeprazole)
    • Nexium (Esomeprazole)
    • Prevacid (Lansoprazole)—available over-the-counter
    • Prilosec (Omeprazole)—available over-the-counter
    • Protonix (Pantoprazole)
    • Dexilant (Dexlansoprazole)
    • Zegrid (omeprazole/sodium bicarbonate)—available over-the-counter

    PPIs In Treated GERD

    If your doctor recommends a PPI for managing GERD, it's likely that he had also recommended lifestyle changes like weight loss (if overweight or obese), elevating the head of your bed at night, and not eating for two to three hours prior to bedtime.

    PPIs are usually taken once daily 30 to 60 minutes prior to breakfast, and are taken for approximately eight weeks, at which point your doctor will re-evaluate how you are feeling. If you are improved, your doctor may decrease your dose or even stop your medication. With a partial response, your doctor may increase your dose to twice a day. If you are still not getting relief for your GERD, your doctor will most likely refer you to a specialist (a gastroenterologist) or re-evaluate the diagnosis.

    PPI therapy is not meant to be taken long-term, so the goal is to take it at the lowest dose for the shortest duration that can still ease your heartburn and prevent complications like ulcers. This is why close follow-up with your doctor is important—so a careful treatment plan can be devised and altered as needed.

    What You Should Know Before Taking PPIs

    In 2012, the FDA issued a warning to consumers that using PPIs may be associated with an increased risk of infections, like pneumonia, as well as diarrhea associated with Clostridium difficile. Infection with the bacterium Clostridium difficile causes watery stools, abdominal pain, and fever.

    In addition, PPIs have been associated with reduced calcium absorption and an increased risk of bone fractures (in people who took high doses of PPIs—meaning more than once a day and for a year or longer).

    It is also linked to reduced magnesium absorption in the gut, so your doctor may check your magnesium level periodically.

    A Word From Verywell

    It is very important to take any medications, including proton pump inhibitors, under the guidance of a doctor, even if it is available over-the-counter. This is to ensure that the proton pump inhibitor is taken correctly and for the right reason—a proper diagnosis is key, as there are a number of health problems that can mimic GERD.

    Sources:

    American College of Gastroenterology. (June 2008). Common GI Problems Volume 1: Understanding Some of the Medications Often Prescribed for GERD & Ulcers.

    Johnson, T. (June 2014). U.S. Food and Drug Administration: Use of Proto Pump Inhibitors and Risk of Bone Fractures in Adults.

    Katz, P.O., Gerson, L.B., Vela M.F. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013 Mar;108(3):308-28.

    Lanza, F.L., Chan, F.K., Quigley, E.M., Practice Parameters Committee of the American College of Gastroenterology. Guidelines for prevention of NSAID-related ulcer complications. Am J Gastroenterol. 2009 Mar;104(3):728-38.

    U.S. Food and Drug Administration. (February 2012).FDA Drug Safety Communication:Clostridium difficile-associated diarrhea can be associated with stomach acid drugs known as proton pump inhibitors (PPIs).

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