Up to 82% of long-term omeprazole use may be unnecessary, according to a new study discussed by gastroenterologists. The medication, a proton pump inhibitor (PPI), is widely prescribed for conditions such as heartburn, stomach ulcers, gastro-oesophageal reflux disease (GORD), severe reflux in children and the stomach infection Helicobacter pylori.
Study findings on long-term use
The study included 629 patients who had been using the drug for an average of nine years despite no medical justification for such long-term use. For participants on high doses, dosage was reduced to a baseline level over the course of a month. After a year, around 43% of participants had achieved the goal of sustained therapeutic success.
The study recommended three routes to getting more people off the medication when they no longer need it: only using the medication when needed, using a natural alternative to relieve symptoms, or using the medication intermittently. Rates of success were similar across the three approaches.
Expert warnings on stopping
The study was discussed at a conference of gastroenterologists in Barcelona. Raquel González told Clarin: “Many patients take omeprazole because they fail to follow other measures to prevent reflux, specifically, avoiding foods that irritate the esophagus and stomach. It’s simply easier to take medication to feel better, so they just keep doing it.”
Karina Leta said there “has been a noticeable increase in the overuse of these medications”. She added: “It is worth noting that these medications are highly effective. However, their use must be based on precise indications provided by a pediatric gastroenterologist and/or the child’s primary pediatrician.”
Rebound effect and next steps
Stopping the medication can trigger a temporary increase in stomach acid secretion, known as the “rebound effect.” Charlotte Parker-Lennox, prescribing pharmacist at LloydsPharmacy Online Doctor, told the Mirror: “This can sometimes make patients feel that they immediately need to restart the medication, even though some of the symptoms may be related to the body's adjustment after stopping treatment.”
She advised that patients on omeprazole for a long time should speak to their GP or pharmacist before stopping, as the dose may sometimes be reduced gradually to help minimise rebound symptoms. The study noted that the results do not mean every patient can halt their medication, nor that the remaining half experienced complications.
