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Best time to take PPI's

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  • Best time to take PPI's


    Just had a quick question. When have most of you noticed is the best time to take your PPI's ?? If twice daily when and how often before bed ??? Also, please list the PPI you are taking and when you find it best to take them. I am taking Nexium 40mg twice daily currently and I do notice that it works better some days than other, and I am wondering if it is due to the time I am taking it.

    Also, one other question. Say patient 1 is on 40mg of a PPI once a day and patient 2 in on 20mg of a PPI twice a day. Is it more beneficial to take the 20mg twice a day since the medication will last longer than taking a stronger 40mg once a day ?

    Any information would be appretiated.


    James C

  • #2
    Hi James

    I take 45mg of Zoton (Lansoprazole). I take 30mg an hour before my breakfast at the same time every day (my watch alarm reminds me), and 15mg when I go to bed at night. The second dose was due to waking up in the night with hearburn, coughing etc despite having an inclined bed. I sometimes have a warm milk drink on turning in as well.

    I was told by a medical consultant to take the 30mg an hour before breakfast to give the ppi time to work and keep the levels in the body at a constant level.

    From talking to other people on ppi's there seems to be no definite dose to taking ppi's as people have a wide spectrum and intensity of symptoms, and no to people have the same body chemistry, lifestyle. It seems to be down to trial and error.

    It will be interesing to see what other people do.


    • #3
      Thanks for the reply. I was told (when I was on Prevacid) to take it with a meal since it works better when combined with a protein based meal. As for Nexium I wasn't told anything, they just moved me over to it due to insurance reasons. Currently I take them both with meals but I might start taking them shortly before. Sometimes if I forget to take my nighttime PPI during dinner I will take it before bed, but I noticed that my stomach will get upset if I do so at times; very weird.

      Also, FYI, I've read that milk can stimulate acid production don't know if that would be benefitial at night. Of course it will help you sleep

      James C


      • #4

        I was just going to log off (early evening here in the UK) when I got notification of your reply.

        I just checked the instructions for my Zoton ppi and it recommends taking it when you first wake up before breakfast. That seems to make sense as the drug would need to be absorbed before it could act on the acid producing cells. I agree though that at times the effectiveness can change, in my case if my anxiety levels are high.

        When I have occasionally forgotten to take the pill, I am soon reminded at just how effective ppi's can be when the acid kicks in big style

        Thanks for the tip on the milk I didn't realise that it could stimulate acid. I was working on the basis that as it's alkaline it would help neutralise any left over acid, and of course it does aid sleep

        It will be interesting to see what experiences other people have.


        • #5
          I'm off PPIs for good, thanks to my lap Nissen, but if I were still using them, I would check the manufacturer's disclosures re: when to take them, and I would check with my doctor and my pharmacist, if I had further questions. I think following what other folks do here is risky, however interesting all the various answers might be.


          • #6

            Hi James For maxium results, according to the manufacturers , nexium, prilosec, and prevacid are reccomended to be taken a half hour before meals. Aciphex is supposed to be taken after meals, and with protonix it doesn't matter.

            At first i took each of my nexium before meals but wasn't sleeping well at night , so i then began taking my second nexium right before bedtime which worked must better for me. Much of this PPI thing involves self experimentation and trial and error according to the individuals needs--

            Milk contains fat which slows gastric emptying, thus reducing LES pressure, a low fat milk is reccomended with GERD. Milk also contains sugar which can exacerbate GERD , in some , in that case, the person could try a lactose free product.


            • #7
              I take Protonix which for me works longer and better than Prevacid and Nexium. I find it works best over a 24 hr. period if I take it between 30 and 60 minutes before dinner.


              • #8
                [QUOTE=Tricia]Hi James For maxium results, according to the manufacturers , nexium, prilosec, and prevacid are reccomended to be taken a half hour before meals. Aciphex is supposed to be taken after meals, and with protonix it doesn't matter.

                regarding aciphex, that contradicts what my general physician, GI doctor, pharmacist, and the literature that came with the drug said; they all say to take aciphex (& protonix, & nexium, & prilosec, & prevacid) 30-60 minutes b4 a meal, NOT after a meal

                regardless of what i (or anyone) says up here though, see what your doctor says

                - jon -


                • #9
                  I normally take my ppi once in the morning before I eat and then right before bed. Well it helped me but I always woke up in the morning with a dry coated weird feeling in my mouth. Yesterday I decided to get max results I need to take it before dinner. I did just that. I woke up in the middle of the night coughing to death because phelm was draining.........Cant win either way can ya? Tonight I did the same......I havent put my bed up...I probably should, huh?


                  • #10

                    Hi Jon Where are you from, because i have literature on aciphex as well ,given to me with samples, and it states for top maxium effectiveness aciphex should be taken after meals . My pharmacology books say this particular PPI is most potent when taken after meals as well.

                    As well as virtually all websites [url][/url] as well as the aciphex site itself [url][/url]

                    however these drugs can be taken anytime -- this is when aciphex is most potent. The 2 websites only specify what time you should take it concerning ulcers. Concerning GERD they don't say a particular time.


                    • #11
                      basic pharmacology

                      Here's a site from the Academy of American Physicians explaining the basic pharmacology of PPIS . As for dosage and administration here's what it says


                      PPIs are inactivated by exposure to gastric juice and are delivered in delayed-release gelatin capsules containing enteric-coated granules (omeprazole and lansoprazole) or in delayed-release enteric-coated tablets (rabeprazole and pantoprazole).2,8-11 Omeprazole is supplied in doses of 10, 20, and 40 mg, and lansoprazole is supplied in doses of 15 and 30 mg. Both of these agents should be taken 30 minutes before meals, and their capsules should not be opened, chewed, or crushed, but should be swallowed whole.

                      Rabeprazole( Aciphex ) is supplied in one dose of 20 mg, and pantoprazole (Protonix) is supplied in one dose of 40 mg. Both agents must be swallowed whole without crushing, chewing, or splitting. Rabeprazole( aciphex) should be taken after meals, but pantoprazole may be taken without regard to meals. Antacids may be administered concomitantly with all PPIs. Lansoprazole, rabeprazole, and pantoprazole should be used with caution in patients with severe hepatic impairment.2,8-12


                      • #12
                        Thanks Tricia...Very interesting article. In fact, two years ago when I tried Aciphex for a few weeks, my instructions were to take it before breakfast. I have a friend that just recently started on Aciphex and was told the same thing.


                        • #13

                          You're lucky you don't need them anymore. It's funny but no doctor or pharmacy ever instructed me on when to take a particular PPI .

                          I did ask a GI once and he just said take them whenever you want. I wonder how much it really matters.


                          • #14

                            Tricia - are you sure that you're supposed to take the aciphex after meals??? I was told to take it 20 minutes before meals!!!! Could you double check -- I ran and got the box of medication, but there was no information on the packaging that says when to take the medication. The pharmacist's instructions were to take it before meals. Let me know.......b


                            • #15
                              The package insert says the aciphex can be taken without reguard to timing of meals. The down side is that it also says that a high fat meal may cause the delay of absorption of it for up to 4 hours or longer. To me I didnt take it that they were saying you should take after a meal just that you could. I didnt read anything on the insert that said it was best to take it at any certain time. You can find the package insert at the eisai inc web site.