- Prescribing Advice for GPs - https://www.prescriber.org.uk -

Proton Pump Inhibitors

Proton Pump Inhibitors (PPI) are very common drugs that are used to treat gastrointestinal conditions associated with excess stomach acid production. Currently there are five PPIs available, omeprazole, lansoprazole, pantoprazole, rabeprazole and esomeprazole.

A meta-analysis1 of 19 studies that directly compared PPIs with each another has assessed if there are any differences between these PPIs in the treatment of gastro-oesophageal reflux disease (GORD).

The analysis concluded that, for equivalent doses, there is no difference between PPIs in the treatment of GORD and therefore choice should be based firstly on cost and secondly on individual patient response.

Action: On the basis of cost the first choice PPI is currently omeprazole. If individual patients fail to respond to an adequate dose of omeprazole, lansoprazole is likely to be a good second choice based on cost and clinician experience of using this drug.


  1. Klok RM et al. Meta-analysis: comparing the efficacy of proton pump inhibitors in short-term use. Alimentary Pharmacology and Therapeutics 2003;17:1237-45