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Proton Pump Inhibitors (PPIs)


Updated May 18, 2014

Proton pump inhibitors (PPIs) are a group of medications that decreases the amount of acid in the stomach and intestines. Doctors prescribe PPIs to treat people with GERD, ulcers in the stomach or intestine, or other digestive disorders that may cause excess stomach acid.

How do proton pump inhibitors work?

Your stomach produces acid to help break down food so it is easier to digest. In certain circumstances, this acid can irritate the lining of your stomach and duodenum (the upper part of your small intestine), causing indigestion and even ulcers.

The proton pump inhibitors work by completely blocking the production of stomach acid. They do this by inhibiting (shutting down) a system in the stomach known as the proton pump.

What is a proton pump?

The proton pump is a molecule in certain cells of the stomach. It "pumps" acid into the stomach. It takes a non-acidic potassium ion out of the stomach and replaces it with an acidic hydrogen ion. This hydrogen ion is what makes things acidic. By putting more hydrogen ions into your stomach, the pump makes the contents of your stomach more acidic. But by stopping the action of the pump, acid secretion into the stomach is stopped.

What are PPIs used for?

Proton pump inhibitors are used in the treatment of GERD, stomach and duodenal ulcers, erosive esophagitis, and Zollinger-Ellison syndrome. Doctors may prescribe using PPIs alone, or in combination with antacids. PPIs may also be used in combination with certain antibiotics (e.g. amoxycillin and clarithromycin) when treating Helicobacter pylori (H. pylori) infection (a bacterial infection of the stomach), which is thought to be one of the main causes of recurring stomach ulcers.

Are there differences among PPIs?

PPIs are similar in how they work, and there is no evidence that one is more effective than another. However, they differ in how they are broken down by the liver and how they interact with other medications. Also, the effects of some PPIs may last longer than others, and may be taken less frequently.

What are the different types of PPIs?

PPIs include:
  • Aciphex (raberprazole)
  • Dexilant (dexlansoprazole)
  • Nexium (esomeprazole)
  • Prevacid (lansoprazole)
  • Prilosec (omeprazole)
  • Protonix (pantoprazole)
Prilosec is also available in over-the-counter form as Prilosec OTC.

How are PPIs different from H2 Blockers?

Both PPIs and H2 Blockers suppress gastric acid secretion. They are different, however, in how they do this. While PPIs shut down the proton pumps in the stomach, H2 Blockers work by blocking the histamine receptors in acid producing cells in the stomach.

PPIs have a delayed onset of action, while H2 blockers begin working within an hour. PPIs work for a longer period of time; most up to 24 hours and the effects may last up to three days. H2 Blockers, however, usually only work up to 12 hours.


For more information about the individual Proton Pump Inhibitor medications, please check out the resources below.

Aciphex is prescribed to treat peptic and esophageal ulcers, GERD, and erosive esophagitis.

Dexilant is is prescribed to treat GERD and erosive esophagitis.

Nexium is prescribed to treat peptic ulcers, GERD, erosive esophagitis, and Zollinger-Ellison Syndrome.

Prevacid is prescribed to treat and prevent peptic ulcers, erosive esophagitis GERD, and Zollinger-Ellison Syndrome.

Prilosec is prescribed to treat peptic ulcers, GERD, and erosive esophagitis.

Protonix is prescribed to treat damage to the erosive esophagitis and Zollinger-Ellison Syndrome.



"Pharmacodynamic Aspects of Hz-Blockers versus proton Pump Inhibitors." U.S. Food and Drug Administration. 14 Mar 2007

"Understanding Some of the Medications Often Prescribed for GERD & Ulcers." Common GI Problems: Volume 1. American College of Gastroenterology. 14 Mar 2007

Nicholas J. Talley, M.D., Ph.D., F.A.C.G.,1 Nimish Vakil, M.D., F.A.C.G., "Guidelines for the Management of Dyspepsia." doi: 10.1111/j.1572-0241.2005.00225.x. American College of Gastroenterology. 14 Mar 2007

Frank L. Lanza, M.D., F.A.C.G., "A Guideline for the Treatment and Prevention of NSAID-Induced Ulcers." Vol. 93, No. 11, 1998. American College of Gastroenterology 14 Mar 2007

Colin W. Howden, M.D., F.A.C.G., and Richard H. Hunt, F.R.C.P., F.A.C.G., "Guidelines for the Management of Helicobacter pylori Infection." Vol. 93, No. 12, 1998. American College of Gastroenterology. 14 Mar 2007

Kenneth R. DeVault M.D., F.A.C.G., and Donald O. Castell M.D., M.A.C.G., "Updated Guidelines for the Diagnosis and Treatment of Gastroesophageal Reflux Disease." doi: 10.1111/j.1572-0241.2005.41217.x. American College of Gastroenterology. 14 Mar 2007

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