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Proton Pump Inhibitors

When you eat, food goes from your mouth to your stomach through your throat, or your esophagus (which is the tube from your mouth to your stomach). Gastro Esophageal Reflux Disease (GERD) is a condition where the food or liquid in your stomach leaks backward from the stomach, which can cause heartburn, irritation, and damage to the esophagus.

There are some things you can do to prevent these symptoms:

  • Avoid foods that cause problems.
  • Avoid drugs like aspirin, ibuprofen (like Advil or Motrin), or naproxen (like Aleve or Naprosyn).
  • Take Tylenol (acetaminophen) for pain.
  • Take your medicines with plenty of water.
  • When your doctor gives you a new drug, remember to ask if it will make your heartburn worse.

You can use over-the-counter antacids after meals and before bed, but they usually don’t last very long. However, common side effects of antacids include diarrhea or constipation.

GERD can also be treated by other over-the-counter and prescription drugs. They don’t work as fast as antacids, but they can also give you longer relief. Your pharmacist, doctor, or nurse can tell you how to take these drugs.

  • Proton Pump Inhibitors (PPIs) help your stomach make less acid.Note: The official labels for Prevacid (lansoprazole), Protonix (pantoprazole), Aciphex (rabeprazole), and Zegerid (omeprazole/sodium bicarbonate) say that “controlled studies do/did not extend beyond 12 months,” so they haven’t measured their effects when taken for more than a year.
  • H2 Blockers (antagonists) help your stomach release less acid.Note: You shouldn’t take more than one 14-day set of treatment every four months, unless your doctor tells you otherwise.

PPIs are usually used to treat heartburn and other symptoms of GERD after lifestyle changes and H2 blockers, like Pepcid of Zantac, have failed. PPIs work by blocking the “pump” that moves acid into the stomach, which lowers the amount of gastric acid.

PPIs also treat some stomach ulcers, like ulcers caused by bacteria (Helicobacter pylori) and ulcers from long-term use of NSAIDs (non-steroidal anti-inflammatory drugs), like aspirin and ibuprofen. They can also help heal irritation and inflammation of the esophagus (erosive esophagitis).

On the flip side, stomach acid is needed to absorb nutrients (especially vitamin B12), digest proteins, and get rid of pathogens, like viruses.

Also, in June 2010, the FDA issued a warning to patients and doctors that high doses or long-term use of PPIs can raise the risk of hip, wrist, and spine fractures. PPIs raise this risk because they block the absorption of calcium in the body. This forces your body to get the calcium it needs from your bones, which leads to weaker bones that break and fracture more easily.

Available Generic Alternative
Prilosec OTC
Zegerid Omeprazole/ sodium bicarbonate
Prevacid FasTab
Protonix Pantoprazole*
Aciphex Rabeprazole

*Available at the Tier 1 copayment without restriction

Note: All drugs sold in the United States are approved by the FDA, whether they are brand name or generic.

“Most people believe that if something costs more, it has to be better quality. In the case of generic drugs, this is not true,” says Gary Buehler, Director of the FDA’s Office of Generic Drugs. “The standards for quality are the same for brand name and generic products.”

In some cases, Health Alliance requires you try a generic drug before we will pay for a brand name drug. This is also called step-therapy, and it helps control your costs.

Health Alliance has a list of drugs that require this, and PPIs are on the Medicare Part D Formulary’s list. PPIs require a prior paid claim of one generic federal legend PPI within the past 180 days.

For all non-Medicare members, Health Alliance requires a documented trial and failure of omeprazole, pantoprazole, and lansoprazole for at least 14 days, OR intolerance to omeprazole, pantoprazole, and lansoprazole, AND an FDA-approved diagnosis.


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This information is meant to help you save money on your prescriptions. A generic option may not always be the best option, and your doctor will determine what is best for your situation.



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