Adverse Effects of Proton Pump Inhibitors

Headache is one of the most frequently reported adverse events in clinical trials where PPIs have been examined (frequency 1.3-8.8%). Patients with headache also had a significant incidence of diarrhea, nausea, and dizziness. A discontinuation of PPI therapy resulted in a cessation or reduction of the headache in 80.0% (20 of 25) (156).

Possible risks of prolonged treatment with PPIs had been thought to include hypergas-trinemia (157), atrophic gastritis, and enteric infections. However, no data have established any true risk to patients, despite many years

Table 3.6 An Overview of the Clinically Marketed PPI Inhibitors; Affinity, Clinical Pharmacology, and Pharmacokinetic Profile

Drug

In Vitro

Clinical Pharmacology: Effect on Gastric Acid Secretion

Oral

Absorption

Plasma Half-Life (h)

Volume of Distribution (Lkg"1)

Plasma Protein Binding

Excretion

Metabolism

Omeprazole

Pantoprazole 8.6 (208)

Lansoprazole 9 (208)

Rabeprazole

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