Many Australians use proton pump inhibitors (PPIs)—such as omeprazole, esomeprazole and pantoprazole—to manage symptoms of gastro-oesophageal reflux disease (GORD), often for extended periods of time. Common brand names include Losec, Nexium, and Somac.
Heartburn—which can be a symptom of GORD—is experienced by around one in five adults at least once each week. PPIs are among the most commonly prescribed medicines in general practice in Australia for treating symptoms of GORD.
NPS MedicineWise is encouraging people who take PPIs to have conversations with their doctor about whether stepping down (ie reducing) or stopping this treatment is appropriate for them.
Dr Jill Thistlethwaite, Medical Advisor, NPS MedicineWise, says, “GORD is diagnosed based on symptoms of reflux or heartburn that are occurring two or more times per week, or having a severe and significant impact on your life. People experiencing reflux may feel stomach acid coming up into their mouth, causing a sour, unpleasant taste. You may also have a burning chest pain or discomfort after eating, which can be a symptom of heartburn.
“As PPIs are prescribed frequently and are effective at reducing symptoms, some people may consider them as lifetime medicines. However, long-term regular PPI therapy is generally not necessary nor recommended for most people with GORD.
“After completing an initial course of daily PPI treatment, which is usually around four to eight weeks, many people can reduce and step down the amount of medicine they take and still maintain control of their symptoms. Up to 6 out of 10 people can also step down and stop taking PPIs without their symptoms returning.
“But it is really important you have a conversation with your doctor before stopping treatment to ensure this is done safely and effectively.
“In addition to talking to your doctor about whether you can reduce or stop taking PPIs, it can also be helpful to discuss possible lifestyle changes, such as losing weight, stopping smoking or reducing alcohol consumption, which could reduce symptoms or stop the need for future PPI treatment.”
The latest educational program from NPS MedicineWise—Starting, stepping down and stopping medicines—aims to equip people with evidence-based information about managing GORD, including resources to help support discussions with health professionals about safely and effectively reducing and stopping PPI treatment when appropriate. To find out more go to www.nps.org.au/ppis
For questions about medicines call Medicines Line (1300 MEDICINE or 1300 633 424), Monday to Friday, 9am to 5pm AEST (excluding NSW public holidays).