Which medications in the drug class Proton Pump Inhibitors are used in the treatment of Gastroesophageal Reflux Disease?

Updated: May 23, 2019
  • Author: Marco G Patti, MD; Chief Editor: BS Anand, MD  more...
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Answer

Proton Pump Inhibitors

Proton pump inhibitors (PPIs) inhibit gastric acid secretion by inhibition of the H+/K+ ATPase enzyme system in the gastric parietal cells. These agents are used in cases of severe esophagitis and in patients whose conditions do not respond to H2 receptor antagonist therapy. Options include omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), and esomeprazole (Nexium).

PPIs are the most powerful medications available for treating GERD. These agents should be used only when this condition has been objectively documented. They have few adverse effects. However, data have shown that PPIs can interfere with calcium homeostasis and aggravate cardiac conduction defects. Long-term use of these agents has also been associated with bone fractures in postmenopausal women, chronic renal disease, acute renal disease, community-acquired pneumonia, and Clostridium difficile intestinal infection. [29, 30]

Omeprazole (Prilosec)

Omeprazole is used for up to 4 weeks to treat and relieve the symptoms of active duodenal ulcers. It may be used for up to 8 weeks to treat all grades of erosive esophagitis.

Lansoprazole (Prevacid)

Lansoprazole inhibits gastric acid secretion. It is used for up to 8 weeks to treat all grades of erosive esophagitis.

Rabeprazole (Aciphex)

Rabeprazole is for short-term (4- to 8-wk) treatment and relief of symptomatic erosive or ulcerative GERD. In patients who are not healed after 8 weeks, consider an additional 8-wk course.

Esomeprazole (Nexium)

Esomeprazole is an S-isomer of omeprazole. It inhibits gastric acid secretion by inhibiting the H+/K+-ATPase enzyme system at the secretory surface of gastric parietal cells.

Pantoprazole (Protonix)

Pantoprazole suppresses gastric acid secretion by specifically inhibiting the H+/K+-ATPase enzyme system at the secretory surface of gastric parietal cells. Use of the intravenous preparation has only been studied for short-term use (ie, 7-10 d).


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