Overview
Proton pump inhibitors (PPIs) are among the most widely used medications in gastroenterology. They work by blocking the proton pump (H⁺/K⁺-ATPase) in the stomach wall cells, effectively reducing acid production. This class includes omeprazole (Losec), pantoprazole (Protonix), esomeprazole (Nexium), lansoprazole (Prevacid), and rabeprazole (Aciphex). They are safe and effective when used with proper medical guidance.
Key Uses
Gastroesophageal reflux disease (GERD) — most common use
Gastric and duodenal ulcers (from H. pylori or NSAIDs)
Erosive esophagitis
Zollinger-Ellison syndrome (excess acid secretion)
Eosinophilic esophagitis (EoE) — as primary or adjunct therapy
Prevention of NSAID-induced gastric ulcers
H. pylori eradication — as part of dual or quadruple antibiotic protocol
How It Works
Irreversibly blocks the H⁺/K⁺-ATPase proton pump in stomach parietal cells
Reduces both basal and stimulated gastric acid secretion by up to 90%
Must be taken 30–60 minutes before a meal for optimal absorption and effectiveness
Available as oral tablets/capsules; some forms available for IV use in hospital
Standard dose: 20–40 mg once or twice daily depending on the condition
Do not crush enteric-coated tablets or capsules
Safety & Self-Care
Take 30–60 minutes before breakfast for best effectiveness
If twice-daily dosing, take first dose before breakfast and second before dinner
Review with your doctor periodically — do not take indefinitely without reassessment
If taking for more than a year, discuss checking B12 and magnesium levels
Do not stop abruptly after long-term use — gradual taper is better to avoid rebound heartburn
Long-term risks: B12 deficiency, low magnesium, possible bone density reduction, rare kidney inflammation, increased susceptibility to C. difficile infection
Omeprazole may reduce clopidogrel effectiveness — inform your doctor if you take both
Contact Your IMCC Team
Contact your IMCC team if symptoms do not improve after two weeks of treatment, symptoms recur after stopping, you experience muscle cramps or unusual heart palpitations (possible magnesium deficiency), changes in stool colour or blood in vomit, difficulty swallowing, or unexplained weight loss.
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