How Should You Wean from a PPI?
Proton Pump Inhibitors (PPIs) are both popular and effective for acid reflux treatment. However, as with most medications, there can be both long-term benefits and risks. The ultimate goal of most medications is to reduce the amount you are taking down to the most effective dose. Taking only the medication you need will help you to save money and reduce the side effects.
If you are interested in reducing or discontinuing your PPI, the first thing you should do is to talk to your doctor (the one who prescribed your medication). He or she will know whether or not you are a good candidate to try to wean from your PPI. While there are risks to taking a PPI long term, GERD left untreated is a greater risk.
If your doctor thinks you may benefit from medication reduction, he or she might try several different approaches, including:
1. A Slow Step Down. Your doctor may slowly reduce the amount of medication you are taking over time. For example, if you are on a twice-daily dose, you may be asked to go down to a once-daily dose and then document how you respond to the change. If you respond well, then you may be asked to further step down the dose until the PPI is stopped or the symptoms return.
2. Taking a Different Medication. There are different reflux medications that are only used “on demand” when reflux symptoms are at their worst. PPIs are not a great choice to take just when reflux symptoms are present because PPIs take time to work. However, there are other reflux medications that do not take as long for symptom relief.
3. Lifestyle Changes. If you are interested in reducing your medication, your doctor may ask you to avoid certain foods that are reflux triggers for many. For example, foods that include caffeine, alcohol, or excessive spice should be avoided.