Proton pump inhibitors (PPIs) are medications used to decrease the acidity of the stomach and upper small intestine. They are used to treat gastroesophageal reflux disease (heartburn) and ulcers and in the eradication of a bacteria associated with these disorders. Since their effectiveness is similar, choice of one over another is often made based on cost.
The first proton pump inhibitor, omeprazole, was introduced in 1989. It is marketed under the brand names Prilosec or Zegerid, which is omeprazole plus sodium bicarbonate. Omeprazole is also available generically. It comes in 10, 20 and 40 mg capsules. Prilosec OTC is available without a prescription. This medicine is usually administered once daily for up to eight weeks depending on the condition being treated, or it can be taken on an as needed basis for symptom control. It is approved for children as young as age one. Possible side effects include headache, dizziness, rash, diarrhea, nausea or vomiting, and alteration in taste.
Lansoprazole comes in 15 and 30 mg doses. It may be better known by the brand name Prevacid. It is also available as a generic drug. It can be given intravenously and also comes in an orally-disintegrating tablet. It is generally taken on a daily basis for up to eight weeks. FDA approval for use in children down to age one has been obtained. The more frequent adverse reactions are fatigue, dizziness, headache, abdominal pain, diarrhea, nausea and increased appetite.
Rabeprazole is available as the brand name drug Aciphex or in generic versions. It comes in 20 mg tablets and is usually taken once daily. It is approved for use in those over age twelve for up to 16 weeks. The most frequent side effect is headache.
Pantoprazole is available by the brand name Protonix or in a generic drug. It is available in 20 or 40 mg extended-release tabs or can be given intravenously. It can be taken for up to 16 weeks, commonly once a day, but is not approved for use in children. Side effects are uncommon but it could cause a rash, headache or diarrhea.
Nexium is the brand name of esomeprazole and is not available in a generic, as of 2009. It comes in 20 and 40 mg caps. It can also be given intravenously. The oral form is most often taken one time a day for four to eight weeks, but a repeat four- to eight-week course is FDA approved, as is use in children down to age one. The most likely side effects are headache, dizziness, rash, diarrhea, nausea or vomiting, and change in taste.
Dexlansoprazole, known by its brand name Kapidex, received FDA approval in early 2009. It is supplied in 30 mg and 60 mg caps that are administered once daily. It is not recommended for children, but adults may take it for up to six months for some conditions. It may be associated with stomach upset, abdominal pain or upper respiratory infections, but is generally well tolerated.