The Timing and Dosage of Reflux Medication Matters
Proton pump inhibitors (PPIs) are acid-suppressive drugs that can provide sustained relief from symptoms of gastro-esophageal reflux disease (GERD). PPIs work by reducing the amount of acid in your stomach by blocking the enzyme in the stomach that produces acid. The common names of PPIs in the United States are Prilosec, Prevacid, Aciphex, Protonix, Nexium and Zegarid. While PPIs can work really well for some, about 20 – 30 percent of patients still report GERD symptoms even when taking a PPI. One of the ideas related to reflux medication that is being explored is whether it matters what time of the day the medication is taken.
Wilder-Smith and colleagues (2010) were the first to look at the effectiveness of the different dosages and timing of PPIs. They gave 30 volunteers with acid reflux disease different dosages of PPIs at different times of the day. They tried administering the medication before breakfast, before dinner, at bedtime and then several times a day to see if it mattered to symptom relief. They also modified the amount of medication they were giving the subjects. What they found was, at least in adults, increasing the dosage of the PPI medication (from 20 mg to 40 mg) improved the reflux symptoms. What they also found was that giving the medication in the morning before breakfast resulted in improved symptom relief throughout the day, but giving the medication before bedtime or once in the morning and once at night, improved nighttime symptom relief.
This information is important to know especially if you think your PPI medication is not working at the times you need it to work. If your reflux medication is not working well, you should talk to your doctor about the possibility of tailoring the dosage and timing to fit your symptoms.
This Sharepost is dedicated to Dr. Jeff Phillips and the late Dr. J. Stephen Latimer who were early pioneers in the understanding of reflux medication timing and dosage.