Fillers POEM

Many taking twice daily proton pump inhibitors can step down

BMJ 2004; 328 doi: (Published 29 January 2004) Cite this as: BMJ 2004;328:0-f

Question Do patients taking high doses of a proton pump inhibitor really need it?

Synopsis It's bad enough that many physicians routinely recommend an expensive proton pump inhibitor (PPI) for any patient with reflux, instead of initially trying an adequate dose of a histamine-2 antagonist (150-300 mg twice a day). Many patients also are bumped up to taking the drug twice a day because they have a little breakthrough discomfort. Although some people need more than the standard dose once …

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