proton pump inhibitors in the treatment of dyspepsia

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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:

Last reviewed 07/2021

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