Deprescribing Proton Pump Inhibitors

Excerpt

Therapeutics Letter 111 explores deprescribing of proton pump inhibitors. Conclusions: Many patients take PPIs well beyond the recommended course of treatment. This incurs inconvenience, costs and potential for harms. Do not prescribe or renew PPIs without a well-documented indication and therapeutic goal. Write the indication and duration of therapy in the directions, to ensure this appears on the prescription label. Consider deprescribing PPIs after 4 weeks of treatment when symptoms have resolved. Start with reduced dose or a longer interval, switching to on-demand dosing or discontinuation when successful. Patients capable of “chasing” a dose with water to facilitate stomach emptying can consider dose-splitting to save money. Informed patient consent and a strategy to deal with recurrent symptoms enhance success. For more information, consult the high-quality resources shown below.