Side Effects of Proton Pump Inhibitors: The Good and Bad of These Medications

Side Effects of Proton Pump Inhibitors: The Good and Bad of These Medications
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What is a PPI?

Proton-pump inhibitors (PPI) are medications that stop the production of stomach acid by interfering with the “proton pump” action and enzymes of the stomach during the last phase of digestion. These medications are useful in treating conditions where stomach acid wreaks havoc in the digestive system as with gastric ulcers, GERD and ulcers in the esophagus. PPI’s are also prescribed with antibiotics to treat people who have been diagnosed with Heliobacter pylori infections.

Below are names of the most popular PPI drugs along with their generic equivalents. Most of these medications are delayed released and taken once a day for 24-hour relief. These are the most common side effects. If you should experience trouble breathing, extensive rash, chest pain and/or fast heart rate and severe abdominal pains, please contact your physician immediately.

  • Nexium (esomeprazole magnesium) - nausea, constipation or diarrhea, abdominal gas, headache or dry mouth

  • Prevacid (lansoprazole) - nausea, stomach pain, diarrhea or constipation and headache. This medication can now be found over-the-counter.

  • Prilosec (omeprazole) - nausea and/or vomiting, gas, diarrhea and stomach pain. This drug is now over-the-counter, however the generic omeprazole can still be ordered by prescription.

  • Zegrid (omeprazole and sodium bicarbonate) - this is a combination drug consisting of omeprazole (like Prilosec) and sodium bicarbonate. The omeprazole is the PPI and the sodium bicarbonate is an antacid that works by raising the pH of your stomach so the PPI is absorbed. Side effects may include diarrhea or constipation, headache, stomach pain, white patches or sore in the mouth or mild fever. Check with your doctor if you are on a salt-restricted diet as sodium bicarbonate is a form of salt. This drug is sold over-the-counter.

  • Protonix (pantoprazole sodium) - diarrhea, nausea and/or vomiting, stomach pain and headache

  • Aciphex (rabeprazole sodium) - diarrhea and headache

  • Dexilant (dexlansoprazole) - nausea and/or vomiting, diarrhea, gas, stomach pain and upper respiratory infections

PPI medications should be taken before a meal, preferably breakfast. Check with your physician for any other dosage instructions.

Drug Interactions

It is important to check with your physician or pharmacist about other drugs you are taking to make sure there are no interactions when prescribed a proton-pump inhibitor. Here are a few interactions to note.

  • PPI drugs may increase the effects of medications like benzodiazapines, warfarin and phenytoin.

  • Combining PPI medications with clarithromycin may increase the blood levels of both drugs.

  • Sucralfate (Carafate) may interfere with the absorption of PPI medications. They need to be spaced apart.

  • Proton-pump inhibitors may interfere with the absorption of iron, ampicillin, ketoconazole, digoxin and itraconazole.

  • Combining a PPI medication with aspirin may increase stomach side effects.

During endoscopic exams many gastroenterologists have been finding polyps in some patients. Most are benign and are called fundic gland polyps and are small in size. Physicians usually remove any larger polyps to be pathologically observed, however since most are benign the others are left intact. It has been noted in clinical studies that long-term use of proton pump inhibitors is a factor that may cause fundic gland polyps in patients.

The Bottom Line…

The use of PPI medications has relieved pain in many patients who suffer with GERD, ulcers and gastritis. Be an informed consumer and discuss the side effects of proton-pump inhibitors with your doctor when prescribed. There are several different PPI drugs, although most work in the same way. It is a matter of trial and error to find the one that helps relieve your symptoms the most.


Drug Side Effects - (look up each drug individually)

Proton Pump Inhibitors -

Proton Pump Inhibitors: An Update -

Stomach Polyps -

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