Stop the PPI to Lower COVID-19 Risk?

Charles P. Vega, MD

Disclosures

August 19, 2020

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Welcome to Cases in Deprescribing. In this series, I present a clinical scenario drawn from my own practice. I will share with you what I plan to do, but I am more interested in crowdsourcing a response from all of you to collectively determine best practice.

Please answer the polling question and contribute to the comments section with your own thoughts, particularly if you disagree with me.

Virginia (not her real name) is a 60-year-old woman with a 10-year history of gastroesophageal reflux disease (GERD). She began treating herself with over-the-counter antacids but found that they were not effective. Her previous primary care physician placed her on a daily dose of a proton pump inhibitor (PPI). Her symptoms improved and so, when she remembered, she continued on a daily dose for years. Last year, she noticed more burning in her chest and throat at night, and her PPI frequency was increased to twice daily, which relieved her discomfort.

Virginia's medical history includes obesity (body mass index: 38 kg/m2), type 2 diabetes with nephropathy, knee osteoarthritis, hypertension, and gout. Her medications include omeprazole 40 mg twice daily; metformin 1000 mg twice daily; glipizide 5 mg twice daily; benazepril 40 mg daily; allopurinol 200 mg daily; and naproxen 500 mg twice daily as needed for pain. She doesn't smoke, and she drinks about one alcoholic beverage per month.

This week, Virginia asked for an urgent telehealth visit, saying she's heard that "these heartburn drugs can give you COVID-19." Although she acknowledges that the medication has helped her symptoms, she wants to stop if the drug might increase her risk for COVID-19.

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