Heartburn Meds May Often Be Taken for Too Long, at Too-High Doses

FRIDAY Feb. 22, 2013 -- U.S. veterans with chronic heartburn are often prescribed higher-than-recommended doses of medicines to control the condition and many are kept on the drugs far too long, according to a new study.

Researchers looked at 1,600 veterans who were diagnosed with chronic heartburn -- also known as gastroesophageal reflux disease (GERD) -- and prescribed a type of drug called a "proton pump inhibitor," such as Prilosec (omeprazole).

GERD arises when the ring of muscle between the esophagus and stomach fails to close properly, allowing stomach acids to splash up into the esophagus. The main symptom is chronic heartburn.

These drugs -- which also include Prevacid (lansoprazole) and Nexium (esomeprazole) -- are among the most widely used drugs in the United States and provide relief for many patients with chronic heartburn. However, proper prescribing is required to avoid prolonged and unnecessary use, according to study first author Dr. Andrew Gawron, a fellow in the gastroenterology division and the Center for Healthcare Studies at Northwestern University Feinberg School of Medicine, in Chicago.

He and his colleagues found that most of the veterans in the study received more than a three-month initial supply of proton pump inhibitor medication and that nearly one-quarter of them were given high doses.

Only a few of the patients who were started on a high dose of this kind of medication had reductions in dosing more than two years after their initial prescription, according to the study published Feb. 16 in the Journal of General Internal Medicine.

The researchers noted that it is recommended that proton pump inhibitors be prescribed at the lowest effective dose for the first four to eight weeks. If symptoms persist after eight weeks, doctors should try to find other potential causes of symptoms and different types of treatment.

"We should always have a reevaluation after an initial prescription and ask, 'Does this patient need to be on this medication?'" Gawron said in a university news release.

However, he said this study shows that "once these veterans are prescribed a [proton pump inhibitor], they are rarely taken off of it. Two years after their initial prescription, most are still on the drug."

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about GERD.

Posted: February 2013


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