Proton-Pump Inhibitors

For some people, H2 - blockers, even at high dose, are inadequate to control acid reflux symptoms. In particular, if an upper endoscopy is performed and shows that the person has esophagitis, then the most powerful anti-acid medications, the proton-pump inhibitors, are usually prescribed. The proton-pump inhibitors have been shown to provide better acid suppression, and better and faster-onset symptom control, in severe, H2 - blocker-resistant case of acid reflux. In addition, they are more effective and faster a healing acid reflux related esophagitis than H2 - blockers. Proton-pump inhibitors are only available with a prescription.

The five FDA-approved proton-pump inhibitors and their standard doses are:
  • lansoprazole (Prevacid), 30 mg once a day
  • omeprazole (Prilosec), 20 mg once a day
  • pantoprazole (Protonix), 40 mg once a day
  • rabeprazole (Aciphex), 20 mg once a day
  • esomeprazole (Nexium), 40 mg once a day
For acid relux or acid relux esophagitis, the usual does is one tablet or capsule taken once daily. As with H2 - blockers, for people whose acid reflux is not well controlled on the standard dose, or whose associated esophagitis does not heal well, the dose of the proton-pump inhibitors can be doubled or even tripled, usually by increasing the number of times each day the standard dose is taken from once a day to two or three times a day.

Side effect on proton-pump inhibitors
The proton-pump inhibitors are generally well tolerated. The most common side effects are headache, dizziness, diarrhea, constipation, fatigue, and abdominal discomfort, but none of these individual symptoms occurs in more than 3 percent of people taking proton-pump inhibitors daily.