Although contested, Marks (2008) said that PPIs are extremely alike when in action – with no evidence to indicate that one is more effective than another. He did say, however, that they differ in how they are degenerated by the liver and the drug interactions. The effects of some PPIs may also last longer and may therefore be taken less often. Side effects Despite being medication meant for healing diseases, PPIs does have some side effects like headaches, diarrhea, constipation, abdominal pain, nausea, and rashes.
In addition, Hayden (2006) said that these medications possibly will meddle to some extent with the actions of the anticoagulant warfarin (such as Coumadin or Panwarfin) and the antiepileptic phenytoin (such as Dilantin). These side effects, however, are reportedly very much tolerable. Drugs with which PPIs interact Marks (2009) said that PPIs interact with only a very few drugs. Proton pump inhibitors supposedly interact with few drugs.
The absorption into the body of some drugs is affected by the presence of acid in the stomach but since PPIs reduce acid in the stomach, they may affect the absorption of these drugs. Specifically, PPIs reduce the absorption and concentration in the blood of the antifungal drug ketoconazole (Nizoral) and increase the incorporation and concentration of the drug digoxin (Lanoxin). However, this may lead to the lessened effect of ketoconazole and an increase in the toxicity of digoxin.
Since PPIs can reduce the collapse of some drugs as done by the liver, it can cause an increase in its concentration in the blood. According to Marks (2009), the prescribed medication omeprazole (Prilosec) is more likely, than the other PPIs, to have the ability reduce the breakdown of drugs caused by the liver. PPIs as treatment for GERD In the drug treatment of GERD, people usually turn to proton pump inhibitors. Hayden (2006) said that PPIs are usually used for severe and long-lasting GERD symptoms like heartburn, most especially when these symptoms do not respond to the drugs H2 blockers.
A type of the magnesium salt omeprazole (Prilosec OTC) which does not require a prescription is reportedly available for treatment of frequent heartburn but using this for treatment of more serious ongoing conditions including GERD and peptic ulcers can only be prescribed by a doctor. Meanwhile, PPIs are also used to prevent symptoms from coming back after the esophagus is healed for maintenance – such that further complications from GERD are prevented. If a doctor finds a patient to have severe inflammation of the esophagus (also known as esophagitis), he or she is also most probably prescribed with PPIs.
People with Barrett’s esophagus – an abnormal change in the cells of the lower end of the esophagus supposedly caused by damage from chronic acid exposure – are also often treated with PPIs because these drugs are more effective in lowering the acid level of stomach juices. If combined with specific antibiotics, PPIs are also used in treating Helicopbacterpylori – a bacterium that, together with acid, causes ulcers of the stomach and the duodenum. These are also used in the prevention and treatment of acid-related conditions like ulcer and the Zollinger-Ellison syndrome.