Proton Pump Inhibitors (PPIs) review and step-down (Guidelines)



Patient advice for stopping a Proton Pump Inhibitor (PPI)

Your GP will advise you how your PPI should be stopped. This is likely to be in 4 stages:

  1. If you are on a high dose (more than 20mg) you will reduce to a lower dose for one month. This will be reduced again until you are taking the lowest dose of your PPI.
  2. You should then take the low-dose PPI on alternate days for one month. If you have any indigestion or heartburn on the non-medicine days, your GP will give you Peptac®. Peptac® is an antacid: it neutralises the acid but doesn’t interfere with acid production.
  3. You should then reduce the dose again to take the PPI once or twice a week for one month, again using Peptac® if needed.
  4. Finally, you should stop the PPI. Any symptoms of indigestion or heartburn should clear up within two weeks of stopping the PPI as the level of stomach acid returns to normal. If you still have symptoms after three weeks, consult your doctor.

Editorial Information

Last reviewed: 30/06/2018

Next review date: 30/06/2020

Author(s): Gastroenterology.

Approved By: TAM subgroup of ADTC

Document Id: TAM213