The document summarizes short-term side effects of PPIs (proton pump inhibitors), which are generally well tolerated. The most common side effects are headache, diarrhea, abdominal pain and nausea. Diarrhea appears to be related to acid suppression and the overall incidence is less than 5%, though it may be dosage and age related. PPIs are considered safe for short-term use and have similar safety profiles to H2 blockers. PPIs should be used cautiously in patients with liver disease.

1. PPI: Short – term side effects:
Dr.Muhsin Abubakir
MBChB- FICMS-Int Med- Kurdistan Board GEH.
Consultant gastroenterologist & hepatologist

2. PPI:Short-tem(<12 weeks)side-effectsPPI:Short-tem(<12 weeks)side-effects
 PPIs are generally well tolerated.PPIs are generally well tolerated.
 The frequency of adverse effects associated with PPIs is similar toThe frequency of adverse effects associated with PPIs is similar to
that of placebo, with an overall incidence of <5 percent.that of placebo, with an overall incidence of <5 percent.
 The type/frequency of adverse effects are similar to thoseThe type/frequency of adverse effects are similar to those
observed with histamine H2-receptor blockers.observed with histamine H2-receptor blockers.
 The most common adverse effects are headache, diarrhea,The most common adverse effects are headache, diarrhea,
abdominal pain, nausea.abdominal pain, nausea.
 Except for diarrhea, the adverse effects of PPIs do not appear to beExcept for diarrhea, the adverse effects of PPIs do not appear to be
related to age, dosage, or duration of treatment.related to age, dosage, or duration of treatment.
 The diarrhea seems to be related to the profound acidThe diarrhea seems to be related to the profound acid
suppression, which has been shown to alter the bacterial contentsuppression, which has been shown to alter the bacterial content
of the gut.of the gut.
 The overall incidence of diarrhea is < 5 % &this effect appears toThe overall incidence of diarrhea is < 5 % &this effect appears to
be dosage& age-related.be dosage& age-related.
 PPI is aslo linked to MC.PPI is aslo linked to MC.

3. PPI:Short-tem(<12 weeks)side-effectsPPI:Short-tem(<12 weeks)side-effects
 Short-term safety of the oldest agents, omeprazole &lansoprazole,Short-term safety of the oldest agents, omeprazole &lansoprazole,
has been well established.has been well established.
 The safety profiles of the newer agents, rabeprazole&The safety profiles of the newer agents, rabeprazole&
pantoprazole, are similar to those of the older agents.pantoprazole, are similar to those of the older agents.
 PPIs are only contraindicated if the patient has a known history ofPPIs are only contraindicated if the patient has a known history of
hypersensitivity to them.hypersensitivity to them.
 They should be used with caution in patients with severe hepaticThey should be used with caution in patients with severe hepatic
disease.disease.
 Omeprazole is a pregnancy category C agent; the others areOmeprazole is a pregnancy category C agent; the others are
pregnancy category B medications.pregnancy category B medications.
 PPIs are not recommended for use in breastfeeding mothersPPIs are not recommended for use in breastfeeding mothers