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Proton pump inhibitors in the treatment of dyspepsia

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

PPI doses relating to management of dyspepsia, oesophagitis and peptic ulcer disease

PPI

Full/Standard dose

Low dose (on demand dose)

Double dose

Esomeprazole

20 mg* once a day

Not available

40 mg*** once a day

Lansoprazole

30mg once a day

15mg per day

30 mg** twice a day

Omeprazole

20 mg once a day

10mg* per day

40 mg once a day

Pantoprazole

40 mg once a day

20mg per day

40mg twice a day

Rabeprazole

20mg once a day

10mg per day

20mg twice a day

  • * lower than the licensed starting dose for esomeprazole in GORD, which is 40 mg, but considered to be dose-equivalent to other PPIs. When undertaking meta-analysis of doserelated effects, NICE classed esomeprazole 20 mg as a full-dose equivalent to omeprazole 20 mg
  • **off-label dose for GORD
  • ***40 mg is recommended as a double dose of esomeprazole because the 20-mg dose is considered equivalent to omeprazole 20 mg.

PPI doses for severe oesophagitis

PPI

Full/Standard dose

Low dose (on demand dose)

Double dose/High dose

Esomeprazole

40 mg* once a day

20mg* once a day

40 mg* twice a day

Lansoprazole

30mg once a day

15mg per day

30 mg** twice a day

Omeprazole

40 mg* once a day

20mg* per day

40 mg* twice a day

Pantoprazole

40 mg once a day

20mg per day

40mg** twice a day

Rabeprazole

20mg once a day

10mg per day

20mg** twice a day

  • *dose, specifically for severe oesophagitis
  • ** Off-label dose for GORD.

PPI doses for H pylori eradication therapy

PPI

Dose (twice daily)

Esomeprazole

20mg

Lansoprazole

30mg

Omeprazole

20-40mg

Pantoprazole

40mg

Rabeprazole

20mg

Reference:


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