PPI drugs are a class of heartburn drugs that work by blocking the enzyme that creates stomach acid. Drugs in this class, also known as proton pump inhibitors, include Nexium (esomeprazole), Prevacid (lansoprazole), and Prilosec (omeprazole).

The drugs are used to treat heartburn, ulcers, and acid reflux. While some find them more effective than other heartburn medications, there is a question about whether it is safe to take PPIs long term.

Are PPIs common?

Washington University School of Medicine in St. Louis says that over 15 million people in the U.S. have prescriptions for PPIs. Additionally, the School of Medicine says that the drugs are available not only by prescription, but over the counter.  

As a result, many more people may be taking the drugs for long periods of time, without supervision by a doctor.

The Washington University School of Medicine in St. Louis says that PPIs are one of the most commonly used types of drugs in the country.

Is it safe to take PPIs long term?

Some experts worry about how popular PPIs are, particularly because many patients take PPIs long term.

A number of risks may be associated with the drugs, including risk for developing various diseases including stomach cancer, kidney problems, and heart problems. Unfortunately, research suggests that in some cases, these conditions may be fatal.

Research suggests that these risks may increase the longer a patient is on a PPI. Washington University School of Medicine in St. Louis reports that a study was published by the journal The BMJ which suggests that taking PPIs may be risky.

Senior author of the study, Ziyad Al-Aly MD, assistant professor at the Washington University School of Medicine in St. Louis says that “taking PPIs over many months or years is not safe, and now we have a clearer picture of the health conditions associated with long-term PPI use.

The study suggested that PPI death rates from kidney disease, upper gastrointestinal cancer, cardiovascular disease, and stomach cancer were higher than in patients given an H2 blocker, another form of heartburn medication.

However, experts stress that it has not been proven that PPIs cause these serious side effects — just that they may be linked. Dr. Lawrence Kim of the American Gastroenterological Association told Health 24 that “there’s insufficient evidence to conclude that these adverse outcomes are likely to be an effect of the PPI therapy.” 

Do patients need to take PPIs long term?

Part of the reason why this news about the risks of long-term PPI use is so concerning is that patients may not benefit from taking the drug long-term.

The study recently published reportedly suggested that over half of the patients taking PPIs were taking the drugs though they did not need to.

Medline explains that heartburn, one of the primary conditions that PPIs aim to treat, is caused when stomach acid backs up into the esophagus. Medline then goes on to explain that acid reflux can cause damage to the esophageal tissue, taking these drugs can allow that tissue to heal. 

According to Dr. Al-Aly, once the tissues heal, patients can switch to another heartburn medication like H2 blockers, which have fewer serious side effects, reports Health 24.