Can proton pump inhibitors (PPIs) be used long-term?

Proton pump inhibitors (PPIs) should only be used for a couple of months, maximum, before gradually tapering off to prevent acid rebound. Long-term use has been associated with an increased risk of osteoporosis-related fractures of the hip and spine, pneumonia, kidney disease, Clostridium difficile-associated diarrhea, and vitamin B12, magnesium, or iron deficiency.

PPI side effects may include a headache, constipation or diarrhea, flatulence, or nausea. PPIs can also interact with some other drugs, such as clopidogrel (Plavix), or affect the absorption of certain drugs, such as iron salts, ketoconazole, and vitamin B12.

PPIs suppress gastric acid secretion by shutting down the stomach proton pumps. This is the final stage of acid secretion which makes PPIs more effective than H2 blockers. PPIs take a bit longer than H2 blockers to start working.

Different brands of PPIs include dexlansoprazole (Dexilant), esomeprazole (Nexium), lansoprazole (Prevacid), and omeprazole (Prilosec), but generic forms are often cheaper. Over-the-counter versions are available, too.