Using Proton Pump Inhibitors (PPIs) to Treat Acid Reflux

Learn About Proton Pump Inhibitors: Benefits and Risks

My chest feels so painful
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You really enjoyed that spicy meal at the local Mexan restaurant, but the price you have to pay for it may make you decide never to go back. Heartburn, acid indigestion, sour stomach... Whatever you call it, that nagging discomfort that feels like your esophagus is dissolving from too much acid will make you reach for a bottle of pills faster than one can say "taco." 

Which medicine to take isn't as easy a decision, though, and understanding the benefits and risks of the numerous options can help you choose the right one.

Proton pump inhibitors (known by the brand names Protonix, Prilosec, Prevacid, Dexilent, Kapidex, Aciphex and Nexium) are a popular choice among patients and physicians. 

How Do Proton Pump Inhibitors Work?

Proton pump inhibitors (PPIs) block the enzyme in the wall of the stomach that produces acid, lowering the amount of acid in the environment. Acid is the culprit behind heartburn, and tamping down production of stomach acid can help ease the discomfort of this bothersome symptom.

There are other conditions as well in which treatment with a PPI can be beneficial. In people with chronic gastroesophageal reflux disease, or GERD, minimizing acid can help halt damage to the esophagus and promote healing. Physicians also recommend using PPIs to patients with peptic ulcer disease (as part of combination therapy with an antibiotic to eradicate H. Pylori), and hypersecretory disorders including Zollinger-Ellison syndrome.

Some PPIs are available over the counter, and some are available by prescription only. 

Special Precautions to Follow When Taking PPIs

While PPIs have been used for years and most patients tolerate them well, there are certain concerns about high-dose and long-term PPI use to pay attention to. For example, In 2012, the FDA issued a warning to consumers that using PPIs, such as Protonix, may be associated with an increased risk of diarrhea associated with Clostridium difficile (C-difficile).

This bacterium is marked by diarrhea that does not improve, as well as watery stools, abdominal pain, and fever. Contact your physician if you experience these symptoms, as C-difficile can cause more gastrointestinal issues.

In addition, long-term PPI use has been linked to an increased risk of fractures of the hip, wrist or spine related to osteoporosis. When take over long periods of time, PPIs can also inhibit absorbtion of important vitamins and minerals such as vitamin B12 and magnesium, which could lead to an increased risk of heart attacks.

In addition, before deciding to start treatment with a PPI: 

  • Tell your doctor and pharmacist if you are allergic to lansoprazole, omeprazole, pantoprazole, rabeprazole, or any other drugs.
  • Tell your doctor and pharmacist what prescription and nonprescription medications you are taking, vitamins and herbal products.

  • Tell your doctor if you have or have ever had liver disease.

  • Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking Protonix, call your doctor.

  • If you are having surgery, including dental surgery, tell the doctor or dentist that you are taking Protonix.

What If You Forget a Dose?

Consult your physician before taking a missed dose.

Your doctor will be able to determine if it is safe to do so, or if you should wait until your next scheduled dose. Do not take a double dose to make up for a missed one.

Possible Side Effects 

Although side effects from PPIs are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away:

If you experience any of the following symptoms, call your doctor immediately:

  • chest pain
  • difficulty breathing or swallowing
  • itching
  • weakness
  • rash or hives
  • severe skin rash with swelling and peeling
  • swollen face, lower legs, or ankles
  • vision changes
  • vomiting
  • yellowing of skin or eyes
  • fever
  • confusion
  • slow movements
  • speech problems
  • increased salivation
  • difficulty maintaining balance
  • ringing in the ears
  • sinus or upper respiratory tract infection


"Protonix FDA Advisory Committee Briefing Document." U.S. Food and Drug Administration. 11 Mar 2007.

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