25 Years of Proton Pump Inhibitors: A Comprehensive Review

Daniel S Strand, Daejin Kim, David A Peura
Gut and Liver 2017 January 15, 11 (1): 27-37
Proton pump inhibitors (PPIs) were clinically introduced more than 25 years ago and have since proven to be invaluable, safe, and effective agents for the management of a variety of acid-related disorders. Although all members in this class act in a similar fashion, inhibiting active parietal cell acid secretion, there are slight differences among PPIs relating to their pharmacokinetic properties, metabolism, and Food and Drug Administration (FDA)-approved clinical indications. Nevertheless, each is effective in managing gastroesophageal reflux disease and uncomplicated or complicated peptic ulcer disease. Despite their overall efficacy, PPIs do have some limitations related to their short plasma half-lives and requirement for meal-associated dosing, which can lead to breakthrough symptoms in some individuals, especially at night. Longer-acting PPIs and technology to prolong conventional PPI activity have been developed to specifically address these limitations and may improve clinical outcomes.

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David Katz

Effective, yes. But against what? Most of their use does NOT fix anything, just suppress symptoms. Meantime, they decrease effective absorption of essential minerals, vitamins and proteins. Overutilized for the wrong reasons, for far too long.


Thorsten Stanley

What effect on the gut Microbiome?


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