Patient advice regarding long term use of Proton Pump Inhibitors (PPIs)

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Buddy Burns
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Patient advice regarding long term use of Proton Pump Inhibitors (PPIs) Information for you Follow us on Twitter @NHSaaa Find

1 Patient advice regarding long term use of Proton Pump Inhibitors (PPIs) Information for you Follow us on Find us on Facebook at Visit our website: All our publications are available in other formats

2 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. 2 3

3 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. 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: 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. Risks of taking PPI s in the long term PPI s are generally very safe although can have side effects (the details of which are in the information leaflet within the packet). 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: 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. 4 5

4 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. 6 7

5 All of our publications are available in different languages, larger print, braille (English only), audio tape or another format of your choice. Tha gach sgrìobhainn againn rim faotainn ann an diofar chànanan, clò nas motha, Braille (Beurla a-mhàin), teip claistinn no riochd eile a tha sibh airson a thaghadh Tell us what you think... If you would like to comment on any issues raised by this document, please complete this form and return it to: Communications Department, 28 Lister Street, University Hospital Crosshouse, Crosshouse KA2 0BB. You can also us at: comms@aaaht.scot.nhs.uk. If you provide your contact details, we will acknowledge your comments and pass them to the appropriate departments for a response. Name Address Comment Last reviewed: February 2017 Leaflet reference: MIS CC/PIL

Mirror Therapy. Complex Regional Pain Syndrome (CRPS) Information for you. Follow us on Find us on Facebook at

Mirror Therapy. Complex Regional Pain Syndrome (CRPS) Information for you. Follow us on Find us on Facebook at Pain Management Physiotherapy Service Complex Regional Pain Syndrome (CRPS) Mirror Therapy Information for you Follow us on Twitter @NHSaaa Find us on Facebook at www.facebook.com/nhsaaa Visit our website: