NHS Dudley Health Economy Medicines Formulary
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1.3 Antisecretory drugs and mucosal protectants

General guidance

Confirmed or suspected ulcer disease

  • Nearly all duodenal ulcers and most gastric ulcers not associated with NSAIDs are caused by H pylori. The appropriate treatment is H pylori eradication not long term acid suppression.

Gastro-oesophageal reflux disease

  • There is a lack of comparative data to identify the best approach to the management of GORD – i.e. step-up or step-down.
  • However, it is widely agreed that patients should be maintained using the agent and dose which provides symptomatic relief at the lowest cost with the least influence on normal physiology.
  • A stepwise approach should therefore be adopted, with the recognition that the disease severity fluctuates over time.
  • Patients with severe oesophageal ulceration and/or confirmed Barretts oesophagus should receive long term treatment with a proton pump inhibitor at the dose recommended by the gastroenterologists.

Proton Pump Inhibitors (PPI) Adult Guidance (image)

Proton Pump Inhibitors (PPI) Adult Guidance (pdf)

Proton Pump Inhibitors (PPI) patient information leaflet


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