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| Safe use of Proton Pump Inhibitor (PPI) |
Since these drugs irreversibly bind to the proton
pump they have a sustained duration of acid inhibition which does not correlate
with the plasma elimination half-life of 1–2h. The apparent half-life is
approximately 48h. This prolonged duration of action allows once-daily dosing
of PPIs, although twice-daily dosing is recommended in some cases of erosive
oesophagitis or Barrett's oesophagus when a sustained gastric pH of greater
than 4.0 is required. All PPIs are most effective if taken about 30min before a
meal as they inhibit only actively secreting proton pumps. Meals are the main
stimulus to proton pump activity. The optimal dosing time is 30–60min before
the first meal of the day.
