Important Information About Long-Term Use
Proton Pump Inhibitors (PPIs) are medicines that reduce stomach acid and help treat conditions such as:
✔️ Acid reflux (heartburn)
✔️ Indigestion
✔️ Stomach ulcers
✔️ Barrett’s oesophagus
While short-term use is effective, taking PPIs for too long may lead to health risks.
Common PPIs in the UK
The most commonly prescribed PPIs in the UK include:
- Omeprazole (brand name: Losec)
- Lansoprazole (brand name: Zoton FasTabs)
- Esomeprazole (brand name: Nexium)
- Pantoprazole (brand name: Protonix)
- Rabeprazole (brand name: Pariet)
These medications work similarly but may have different strengths and formulations. Always follow your GP or pharmacist’s advice on which one to take.
What Are the Risks of Taking PPIs for Too Long?
🔸 Infections
PPIs reduce stomach acid, which helps kill harmful bacteria. Taking PPIs for a long time can increase the risk of:
✔️ Gut infections (Clostridium difficile), causing severe diarrhoea
✔️ Chest infections (pneumonia) (NHS, NICE, Cheshire & Merseyside NHS)
🔸 Bone Fractures
PPIs reduce calcium absorption, which may weaken bones and increase the risk of hip, wrist, or spine fractures, especially in older adults. (NHS, NICE)
🔸 Vitamin & Mineral Deficiencies
Long-term PPI use may reduce absorption of:
✔️ Vitamin B12 → Can lead to tiredness, tingling in hands/feet, and mouth ulcers
✔️ Magnesium → May cause muscle cramps and irregular heartbeats
✔️ Iron & Calcium → Can increase the risk of anaemia and osteoporosis (NHS, NICE, Cheshire & Merseyside NHS)
🔸 Rebound Acid Reflux
If you stop taking PPIs suddenly, your stomach may produce even more acid, leading to worse heartburn symptoms. This is called acid rebound. (NICE)
What Should You Do?
✔️ Review Your Medication Regularly
📌 If you’ve been taking a PPI for more than 4-8 weeks, speak to your GP or pharmacist for a review. (NICE CG184, Cheshire & Merseyside NHS)
✔️ Consider Reducing the Dose
📌 Your doctor may suggest lowering your dose gradually instead of stopping suddenly. (NHS, NICE)
✔️ Use PPIs for the Shortest Time Possible
📌 PPIs are usually recommended for 4 to 8 weeks. If symptoms persist, alternative treatments may be considered. (NICE CG184, Cheshire & Merseyside NHS)
✔️ Try Lifestyle Changes
Making small adjustments may help reduce symptoms naturally:
- Eat smaller meals
- Avoid spicy, fatty, or acidic foods
- Do not eat late at night
- Raise the head of your bed
- Lose weight if overweight
- Reduce caffeine and alcohol intake (NHS, Cheshire & Merseyside NHS)
Here’s a useful information video about heartburn symptoms and their causes
Need Advice?
📌 Speak to your GP, pharmacist, or healthcare provider before making any changes to your medication.
📌 More Information:
- NHS: Omeprazole Side Effects
- NICE CG184: Dyspepsia & Reflux Guidelines
- Cheshire & Merseyside NHS: Treatment of Indigestion with PPIs
This page is based on information from NHS, NICE, and Cheshire & Merseyside NHS guidelines.
