Microsoft word - 230307-ppi issues _pt handout__update__3-15-11__ta_.doc

What You Should Know About Proton Pump Inhibitors
What are proton pump inhibitors?
Proton pump inhibitors (PPIs) work by lowering the amount of acid in the stomach. PPIs treat conditions caused by too much stomach acid. Some of these conditions are heartburn or gastroesophageal reflux disease (GERD) and ulcers. These are the PPIs available in the U.S. and Canada (“*” indicates product available in U.S. only): Omeprazole (Prilosec, Prilosec OTC, Losec) Rabeprazole (Aciphex, Pariet) Omeprazole/Sodium Bicarb (Zegerid, Zegerid OTC)* Lansoprazole (Prevacid, Prevacid 24HR) Pantoprazole (Protonix, Pantoloc, Tecta) (Prilosec OTC, Prevacid 24HR, and Zegerid OTC can be bought over-the-counter in the U.S. All others need a prescription.) How should I take a PPI?
If you take a PPI once a day, take it 30 to 60 minutes before breakfast. If you take it twice a day, take the second dose 30 to 60 minutes before dinner. Your stomach makes acid when you eat. Taking the PPI before you eat stops extra acid from being made. The PPI also works better. Some people also take an antacid or an H2-blocker. H2-blockers are medicines like famotidine (Pepcid), cimetidine (Tagamet), ranitidine (Zantac), or nizatidine (Axid). If you take a PPI and one of these medicines, take the PPI 30 to 60 minutes before a meal. Take the other medicine at a different time of the day. They don’t work as well when taken at the same time. Take the H2-blocker at bedtime if you have symptoms at night. Can I take a PPI with other medicines?
PPIs may reduce the amount of calcium you absorb. There’s a very small chance this could weaken your bones and cause them to break more easily. This is more likely if you are over 50, take a high dose, or use a PPI for a year or more. To be safe, make sure you get enough calcium and vitamin D in your diet and from supplements. Calcium citrate is the best supplement for people taking PPIs. If you take a PPI for more than a year, your body could be low in vitamin B12 and magnesium. Take a multivitamin every day to help prevent this. Some drugs need acid in the stomach to work. Ask your pharmacist if your PPI affects other How often should I take a PPI?
You might be able to take your PPI only when you have symptoms of heartburn or mild GERD. But it can take days for complete relief. Check with your prescriber to see if this is an option for you. For ulcers and other more serious conditions, you must take your PPI as prescribed. How do I stop taking a PPI?
Your prescriber will tell you when to stop your PPI. If you stop your PPI all at once, you might have heartburn symptoms. To avoid this, your prescriber may have you slowly decrease your PPI use over a week or more. During this time, an H2-blocker or antacid can be used if you have symptoms. What else can I do to help prevent heartburn?
Don’t eat two to three hours before bedtime Raise the head of your bed four to six inches [March 2011]
Pharmacist’s Letter / Prescriber’s Letter to give to their patients. Copyright 2011 by Therapeutic Research Center www.pharmacistsletter.com ~ www.prescribersletter.com

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