Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
What are proton pump inhibitors (PPIs) and how do they work?
inhibitors reduce the production of acid by blocking the enzyme in the wall of
the stomach that produces acid. The reduction of acid
prevents ulcers and allows
any ulcers that exist in the esophagus, stomach, and duodenum to heal.
For what conditions are proton pump inhibitors (PPIs) used?
Proton pump inhibitors are used for the prevention and treatment of
acid-related conditions such as:
Are there differences among proton pump inhibitors (PPIs)?
Proton pump inhibitors are very similar in action and there is no
evidence that one is more effective than another. They differ in how they are
broken-down by the liver and their drug interactions. The effects of some PPIs
may last longer and they, therefore, may be taken less frequently.
What are the side effects of proton pump inhibitors (PPIs)?
The most common side effects of proton pump inhibitors are:
Nevertheless, proton pump inhibitors generally are well tolerated.
High doses and long-term use (1 year or longer) may increase the risk of
osteoporosis-related fractures of the hip, wrist, or spine. Therefore, it is important to use the lowest doses and shortest duration of treatment necessary for the condition being treated.
With which drugs do proton pump inhibitors (PPIs) interact?
Proton pump inhibitors interact
with few drugs. The absorption into
the body of some drugs is affected by the presence of acid in the stomach, and
because PPIs reduce acid in the stomach, they may affect the absorption of these
drugs. Specifically, PPIs reduce the absorption and concentration in the blood
of ketoconazole (Nizoral) and increase the absorption and concentration of
digoxin (Lanoxin). This may lead to reduced effectiveness of ketoconazole and an
increase in digoxin toxicity.
Proton pump inhibitors can reduce the break-down of some drugs by
the liver and lead to an increase in their concentration in the blood.
Omeprazole (Prilosec) is more likely than the other PPIs to reduce the break-down of drugs
by the liver. For example, omeprazole (Prilosec) may increase the concentration in the
blood of diazepam (Valium), warfarin (Coumadin) and phenytoin (Dilantin).
Which proton pump inhibitors (PPIs) are approved in the United States?