Preventing adverse effects of long-term PPI therapy

How to prevent the potential adverse effects of long-term treatment with proton pump inhibitors (PPIs)?

Paul Moayyedi, MB ChB, PhD: I do not think that there is any convincing evidence of a long-term risk, so I do not think they really need preventing. But like any medication, it should only be used when it is indicated, and these drugs are often overused. It should be used at the lowest dose that controls patients’ symptoms for the shortest duration that they need.

I often give PPIs on an as-needed basis, and if the patient needs them less and less, they will eventually stop them. That is probably the best way to deprescribe PPIs.