In many cases, a proton pump inhibitor (PPI) is initiated for a valid indication, in cases where the benefits outweigh the risks. During a hospital stay, PPIs may be started for stress ulcer prophylaxis or for patients who will receive certain treatments that increase the likelihood of high-risk gastrointestinal conditions. After the patient’s risk for stress ulcer returns to baseline the PPI should be stopped. In addition, patients who did not require a PPI before their hospital admission typically will not need to continue taking one of these drugs after the underlying reason for PPI therapy has been addressed.
Long-term adverse effects associated with the acid inhibition caused by PPIs are now emerging. Patients should talk to their healthcare team and only continue taking PPIs if the benefits truly outweigh the risks and to obtain advice on how to taper the dose towards discontinuation if warranted.
Sources:
Boghossian TA, et al. Deprescribing versus continuation of chronic proton pump inhibitor use in adults. Cochrane Database Syst Rev. 2017 Mar 16;3:CD011969. PMID:28301676.
Cochrane. Stopping or reducing vs continuing long-term proton-pump inhibitor use in adults. [Internet]. 2017 Mar 16. [Accessed 20 Dec 2018].
Deprescribing Guidelines and Algorithms. [Internet]. [Accessed 20 Dec 2018].
Kinoshita Y, et al. Advantages and Disadvantages of Long-term Proton Pump Inhibitor Use. J Neurogastroenterol Motil. 2018 Apr 30;24(2):182–196. PMID:29605975.
Therapeutics Initiative: Independent Healthcare Evidence. Deprescribing Proton Pump Inhibitors. [Internet]. 26 Jun 2018. [Accessed 20 Dec 2018].