Proton pump inhibitors (PPIs) are medications used to relieve the symptoms of acid reflux, or gastroesophageal reflux disease (GERD), to treat a peptic or stomach ulcer or to treat damage to the lower esophagus caused by acid reflux. They work by reducing the amount of stomach acid produced by glands in the lining of the stomach.
GERD and acid reflux have been observed in up to 90 percent of people with pulmonary fibrosis (PF). GERD can lead to aspiration and microaspiration, which may cause pneumonitis, which in turn can worsen pulmonary fibrosis. PPIs may help decrease this risk associated with aspiration.
The American Thoracic Society guidelines suggest the use of regular antacid treatment for people with pulmonary fibrosis, as this places a higher value on improved lung function and survival and the low cost of therapy, and a lower value on the potential increased risk for pneumonia with antacid therapy.
There is a need for more studies to compare antacid treatments with placebo in people with pulmonary fibrosis and also on the drug interaction of PPIs with other pulmonary fibrosis treatments.
Although there are different brands of PPIs, most of them work equally as well. Their side effects vary from drug to drug:
- Omeprazole (brand name Prilosec);
- Esomeprazole (brand name Nexium);
- Lansoprazole (brand name Prevacid),;
- Rabeprazole (brand name AcipHex);
- Pantoprazole (brand name Protonix);
- Dexlansoprazole (brand name Dexilant);
- Zegerid (omeprazole with sodium bicarbonate).
These medicines are taken by mouth, as tablets or capsules, 30 minutes before the first meal of the day.
Common side effects are rare, but may include headache, diarrhea, constipation, nausea or itching.
Some brands of PPIs may be bought without a prescription, but it is important to talk to a doctor if these symptoms don’t go away, especially when related to a condition such as pulmonary fibrosis.