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Proton pump inhibitors in the treatment of dyspepsia

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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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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