Proton pump inhibitors (PPls); gastric (stomach) acid secretion inhibitors.

How The Drug Works

PPls reduce gastric acid secretion significantly and for a prolonged period by blocking the final step of acid production by the stomach lining.

Uses

For short-term treatment (8 weeks or less) of gastroesophageal reflux disease (GERD, the reflux of stomach contents into the food pipe, which can cause heartburn), and to maintain healing and reduce relapse rates of heartburn symptoms in patients with erosive or ulcerative GERD.

Esomeprazole, lansoprazole, omeprazole: For short-term treatment (4 to 8 weeks for esomeprazole and omeprazole; 8 weeks or less for lansoprazole) or to maintain healing of inflammation and erosion of the food pipe (erosive nsophilqitis).

Esomeprazole, lansoprazole, omeprazole, rabeprazole: In combination therapy with antibiotics for treatment and elimination of Helicobacter pylori infection and associated active duodenal ulcer and to reduce the risk of ulcer recurrence.

Lansoprazole: For short-term treatment (up to 12 weeks) to reduce the risk of NSAID-associated gastric ulcers.

Lansoprazole, Omeprazole: For short-term treatment (4 to 8 weeks for omeprazole; 8 weeks or less for lansoprazole) of active benign gastric ulcers; to treat and reduce the risk of gastric ulcers associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) (Iansoprazole only).

Lansoprazole, Omeprazole, Pantoprazole, Rabeprazole: For long-term treatment of hypersecretory (increased acid secretion) conditions (eg, Zollinger-Ellison syndrome).

Lansoprazole, Omeprazole, Rabeprazole: For short-term treatment (4 to 8 weeks for omeprazole; 4 weeks or less for lansoprazole, rabeprazole) of active duodenal ulcers; to maintain healing of duodenal ulcers (Iansoprazole only).

Other Uses: These agents may increase the effectiveness of pancreatic enzyme replacements used to treat the "fatty stools" of patients with cystic fibrosis. Omeprazole has been prescribed to treat laryngitis.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits out weigh the possible risks to the fetus.

Breastfeeding: It is not known if proton pump inhibitors are excreted in breast milk. Because of the potential for serious adverse reactions in nursing infants from PPI, decide whether to discontinue nursing or the drug, taking into account the importance of the drug to the mother. Consult your doctor before you begin breastfeeding.

Children: Omeprazole can be used in children 2 years of age and older.

Safety and effectiveness of other agents have not been established.

Drug Interactions

Tell your doctor or pharmacist if you are taking or planning to take any over ­ the-counter or prescription medications or dietary supplements with these drugs. Drug doses may need to be modified or a different drug prescribed. The following drugs and drug classes interact with these drugs:

Ampicillin (eg, Principen)

Clarithromycin (eg, Biaxin)

Benzodiazepines (eg, diazepam)

Cyclosporine (eg, Neora/)

Disulfiram (eg, Antabusn)

Iron salts (eg, ferrous sulfate)

Phenytoin (eg, Dilantin)

Sucralfate (eg, Carafate)

Side Effects

Every drug is capable of producing side effects. Many patients experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Diarrhea; nausea; vomiting; stomach pain; constipation; gas; belching.

Nervous System: Dizziness; headache; weakness.

Other: Rash; back pain; upper respiratory tract infection; cough; high blood sugar.

Guidelines for Use

Dosage is individualized. Take exactly as prescribed.

Do not stop takingor change the dose, unless instructed by your doctor.

Usually taken once daily, at least 1 hour before a meal. Dosages and dosing regimens may vary depending on condition being treated.

Take rabeprazole after the morning meal when treating duodenal ulcers.

Take pantoprazole with or without regard to food.

These medicine must be taken daily to be effective in treating and preventing acid-related gastrointestinal diseases. Do not take on an "as needed" basis.

Antacids may be used as needed with these medicines.

Do not chew, crush, or split capsules or tablets. Swallow whole. If you have difficulty swallowing esomeprazole, omeprazole, or lansoprazole capsules, they maybe opened, sprinkled on 1 tablespoon of apple sauce, Ensure pudding, cottage cheese, yogurt, or strained pears, and swallowed immediately without chewing the granules. Lansoprazole capsules can also be emptied into a small glass of either orange or tomato juice (60 ml; approximately 2 oz), mixed briefly, and swallowed immediately. To ensure complete ingestion, rinse the glass with 4 or more oz of juice and swallow the cOntents immediately.

Orally-disintegrating tablets - Place tablet on the tongue. Allow to melt with or without water until particles can be swallowed.

Lansoafazole suspension - Empty the packet contents into a container with 2 tablespoons (30 ml) of water. Do not use other liquids or foods. Stir well and drink immediately. More water can be added if material remains in the container; drink immediately.

If a dose is missed, take it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless instructed by your doctor. If more than one dose is missed, or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.

Inform your doctor if you are pregnant, become pregnant, plan on becoming pregnant, or are breastfeeding.

PPls should be taken at least 30 minutes prior to taking sucralfate.

Store at controlled room temperature (59° to 86°F) in a tightly closed container. Protect from light and moisture.