Proton Pump Inhibitors: What They Are, How They Work, and What to Know

When your stomach makes too much acid, it can cause heartburn, ulcers, or damage to your esophagus. That’s where proton pump inhibitors, a class of medications that block the final step of acid production in the stomach lining. Also known as PPIs, they’re one of the most common treatments for chronic acid reflux and related conditions. Unlike antacids that just neutralize acid temporarily, PPIs shut down the acid-producing pumps in your stomach cells — and that’s why they work so well for long-term relief.

Common PPIs include omeprazole, esomeprazole (Nexium), lansoprazole, and pantoprazole. You’ll find them in both prescription and over-the-counter forms. They’re often prescribed for GERD, a condition where stomach acid flows back into the esophagus, causing irritation and pain, or for healing ulcers caused by H. pylori bacteria or NSAIDs. Some people take them daily for months or even years. But here’s the catch: long-term use isn’t harmless. Studies show it can lower magnesium levels, increase risk of bone fractures, and mess with gut bacteria. That’s why many doctors now recommend the lowest effective dose for the shortest time possible.

People often mix up PPIs with H2 blockers like famotidine (Pepcid) or ranitidine — but they’re not the same. H2 blockers reduce acid production too, but they don’t shut down the pumps the way PPIs do. That’s why PPIs are stronger and last longer. Still, if you’ve been using an OTC PPI for more than two weeks without relief, it’s time to talk to a doctor. Your symptoms might be something else — like a hiatal hernia, gallbladder issues, or even heart problems.

And if you’re taking other meds — like blood thinners, antidepressants, or antibiotics — PPIs can interfere. For example, omeprazole can make clopidogrel less effective. That’s why it’s so important to know what else you’re on. The posts below cover real cases: how PPIs interact with other drugs, what side effects people actually experience, and when switching to a different treatment makes more sense. You’ll also find comparisons between brand-name and generic versions, tips for reducing dependence, and what to do if you’ve been on them too long and want to stop safely.