Institute review to evaluate continuous use of Proton Pump Inhibitors

PROTON Pump Inhibitors referred to as PPIs are a very popular class of drugs because of its high efficacy to reduce acid production in gastrointestinal ailments.

According to the U.S. Pharmacists in the December 2019 edition, over 25 per cent of the world’s population is affected by some acid-related condition that translates to PPI sales worldwide of US$11B annually.

Prior to COVID-19, PPIs were ranked as the third most dispensed drug in New Zealand and in the top 10 in other parts of the world.

Proton Pump Inhibitors are indicated for GERD (gastro-esophageal reflux disease), esophagitis, peptic ulcer, gastric bleeding associated with long term use of NSAID (non-steroidal anti-inflammatory drugs) and blood thinners especially in the elderly and also as an adjunct treatment in H. Pylori infections.

In Guyana those proton pump inhibitors which are available are omeprazole (Lomac), pantoprazole, esomeprazole (Nexium) and lansoprazole. This category of drugs has been approved since 1989 by the FDA (Foods and Drugs Authority) with specific dosage and duration protocols established for its optimum use in mild, moderate and severe disease classification. However, by

2003, the FDA approved OTC (Over the Counter) versions of omeprazole and lansoprazole called Prilosec and Prevacid respectively, which are available to the general public without a prescrip- tion.

This meant that now these products were readily available to the general public who may not be equipped with the knowledge of its consequential long-term effects, side effects and contraindications due to its indiscriminate use.

Apart from the increasing pill burden and its associated unnecessary additional costs, there have been incidences from observational studies which are cause for concerns.

The Brazilian Journal of Nephrology highlighted a study done in 2017,

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