Curbside Consultation in GERD: 49 Clinical Questions

Philip O. Katz, MD

Question 16: A Pharmaceutical Rep Tells Me That Ppis Often Fail Because Patients Do Not Take Them As Directed. Is It True That Some Ppis Need To Be Given Before Meals, But Others Do Not? (continued)

All available proton pump inhibitors (PPIs) are indicated for once-daily dosing, usually in the morning. Although food has different effects on the bioavailability of each molecule and meal timing may not affect bioavailability of rabeprazole or pantoprazole, it is my practice to recommend that all PPIs be given prior to meals for optimal efficacy. This is based on the concepts outlined in Question 15 and results of an intragastric pH study performed in our laboratory in which significantly superior daytime pH control (time intragastric pH >4) was seen when the PPI was taken before…