rabeprazole, esomeprazole, omeprazole, lansoprazole, dexlansoprazole, pantoprazole
-gastroesophageal reflux disease
-peptic ulcer disease
-gastroprotection from NSAIDs or blood thinners
Role in Therapy:
-effective medications for acid reduction and stomach protection
-taken once daily 30 minutes before meal (usually before breakfast) and can be increased to twice daily. Taper dose slowly if taken for a long time to avoid rebound acid secretion.
-usually well tolerated, but can cause nausea, diarrhea and headache.
-reduced acidity may result in increased risk for fractures, anemia and infections (C.difficile)
Mostly through reduced absorption via reduced acidic environment:
-May reduce magnesium, vitamin B12, calcium and iron absorption
-Oral bisphosphonates - may put patients at risk for fractures
-Methotrexate (at high chemotherapy doses) - decreased clearance of methotrexate at the kidney level
-Omeprazole: a CYP2C19 inhibitor which can reduce the conversion of clopidogrel into its active metabolite
-Other various drugs which require acidic environment for optimal absorption