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Class Explorer · Gastrointestinal

Proton pump inhibitors

Irreversible H+/K+-ATPase inhibition in active parietal cells: the deepest acid suppression available.

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Members

Also in this class: Pantoprazole (fewest interactions) · Esomeprazole · Lansoprazole · Rabeprazole. Full pages arrive as the library grows.

Compare the members

Omeprazole
CYP2C19 effect
Substrate + inhibitor
Distinguishing point
The clopidogrel-caution member

Shared across the class

Indications
GERD · Peptic ulcer disease · H. pylori regimens · NSAID gastroprotection
Adverse effects
Headache, GI upset · Rebound hypersecretion on stopping · Long-term associations (B12, magnesium, C. difficile, fractures)
Contraindications
Rilpivirine co-administration
Monitoring
The indication itself, at every renewal · Magnesium if long-term and symptomatic

What makes each agent different

  • Pantoprazole's weak CYP2C19 footprint makes it the default beside clopidogrel.
  • Efficacy differences are marginal; duration-of-need differences are everything.

A PPI without a stop date is a medication-review finding, not a maintenance plan.

Last reviewed 2026-08-15 · Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed.