Patient advice regarding
long term use of Proton
Pump Inhibitors (PPIs)
Information for you
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PPIs describes a range of drugs used to reduce acid
production in the stomach.
There are several different PPIs which all act in a
similar way. These include:
• Omeprazole
• Lansoprazole
• Pantoprazole
• Esomeprazole
• Rabeprazole
You may be prescribed one of these drugs by your
doctor if you have:
• reflux
• dyspepsia (indigestion/ heartburn)
• an ulcer or inflammation in your stomach or
duodenum (just after the exit from your stomach)
or oesophagus (gullet) or are found to have a bug
in your stomach called Helicobacter Pylori.
In most cases the medicine will be stopped after the
prescribed course has been completed.
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There are times where it is recommended that this
medicine is taken long term. This includes people
who are on other medicines which may cause ulcers,
have severe oesophageal (gullet) inflammation or
who have a condition called Barretts oesophagus.
Risks of taking PPI’s in the long term
Some people find that their heartburn or indigestion
symptoms cannot be controlled without them and
need to continue taking them for long periods. If this
is the case your doctor will advise on things you can
do to try to improve your symptoms such as:
Most people can take PPI’s for long periods of time
without affecting their health, although there is some
disputed evidence that there may be increased risk of
the following:
• avoiding fatty foods, alcohol and caffeine
• stopping smoking
• avoiding eating late at night
• losing weight
• sleeping with bolstered pillows.
Your doctor will review your need to continue on
the medicine at regular intervals and will prescribe
the lowest dose which provides control of your
symptoms.
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PPI’s are generally very safe although can have side
effects (the details of which are in the information
leaflet within the packet).
1.Gastro intestinal infection with a bacterium called
Clostridium Difficile (C. Diff). Elderly people and
those taking antibiotics are more at risk.
2.Bone fractures. Those with an existing increased
risk of fractures are most at risk. This includes
the elderly, those people with osteoporosis, post
menopausal women and smoking.
3.In very rare cases, PPI’s may cause kidney
damage. This is usually reversible, but may cause
permanent damage if not treated early.
4.Disturbance in levels of magnesium, calcium and
sodium in the blood. Symptoms include fatigue,
dizziness, and if the disturbance is severe enough,
convulsions and irregular heart beat. People
who are also taking diuretics (water tablets) and
digoxin are more at risk.
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5.Worsening of symptoms once a PPI is stopped.
This may last a couple of months and your doctor
may prescribe you an antacid to take during this
time or reduce the dose gradually.
Notes
If your doctor feels you are particularly at risk of
any of the above then a different treatment for
your symptoms may be suggested. If you have a
condition where it is recommended that a PPI is
taken long term, then your doctor will prescribe it
on the basis that the benefit will outweigh any risk.
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Last reviewed: February 2017
Leaflet reference: MIS17-029-CC/PIL17-0251