Explain That Any Risk of Heart Attack With PPIs Is Very Small

Patients will ask whether PPIs increase the risk of heart attacks.

This is coming from recent analyses that suggest a possible link.

Tell patients not to be alarmed. Explain that any risk of heart attack is very small...plus this is only a weak ASSOCIATION and not PROOF.

But be aware of other risks linked to PPIs...Clostridium difficile diarrhea, hypomagnesemia, B12 deficiency, pneumonia, fractures, etc.

Suggest saving PPIs for when they're really needed...severe GERD, ulcers, erosive esophagitis, prevention of NSAID-induced ulcers, etc.

If possible, use them short-term... 10 to 14 days for H. pylori, 4 weeks for duodenal ulcers, and 8 weeks for erosive esophagitis.

Help patients avoid acid rebound when stopping a PPI after long-term use. Suggest lowering the dose gradually...then taking it every other day for at least a week. Suggest ADDING an H2-blocker or antacid if needed.

For mild GERD symptoms, stick with lifestyle changes (losing weight, etc)...plus an antacid or H2-blocker, which have fewer side effects.

Share our PL Patient Education Handout, What You Should Know About PPIs, to help counsel patients on PPI use.

• FAQ: Proton Pump Inhibitors: Appropriate Use and Safety Concerns
• Patient Education: What You Should Know About Proton Pump Inhibitors