Right way of taking PPI

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Regular Member

Date Joined Jun 2012
Total Posts : 32
   Posted 7/15/2012 9:41 AM (GMT -6)   
I have been to 2-3 doctors for GERD who always have written more and more PPIs . I was always told , take it 1st thing in the morning before breakfast.
Today, I had a long talk with a GI doc. (it was a free camp from a company). His comments to make PPI effective were:
1) Take it on empty stomach (make sure you have not eaten or drank except water for 3 hrs before)
2) After taking it wait for 30 min.
3) After 30 min. eat your biggest meal of the day (whether its breakfast, lunch or dinner doesn't matter). Dinner should be the lightest meal though for GERD people.
4) Make sure this meal is atleast 500 Cal. with some protein items.
5) Do not start this meal with milk, tea, coffee, juice etc.
He said, PPI gets ignited by meals. If you take a milk,tea etc after 30 min. of PPI, it will be in-effective.
Usual things like eat dinner no later then 3-4 hrs before sleep, bed elevation, 15 min. walk after a meal , correct BMI/ obesity, active life (with no pulling, bending, pushing etc after meals) and discipline in what to eat were usual stuff.

Forum Moderator

Date Joined Apr 2007
Total Posts : 32602
   Posted 7/15/2012 11:07 AM (GMT -6)   
It is good to see you had the opportunity to consult with a GI physician who took the time to explain how to take your medications appropriately as well as the theory behind why you should take it as he stated.  My Dr. simply wrote the script and sent me on my way many years ago so most of what I have learned re taking the med correctly I have read in this very forum.
I think you are safe to take this Drs. advice.

Moderator: Anxiety, Osteoarthritis,
GERD/Heartburn and Heart/Cardiovascular Disease.

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Regular Member

Date Joined Apr 2012
Total Posts : 458
   Posted 7/15/2012 1:27 PM (GMT -6)   
Thanks for posting this. I have been researching this GERD stuff for so long, one of the most surprising things I saw was a doctor who wrote that the PPI is much less effective unless taken in the way you described. When my PCP gave me the PPI, she said "I don't care when you take it". The GI and ENT doctors I saw after her, did eventually mention the 30 minute before meal thing (which I was already doing, but it was good to know they told people about that).

There have been papers written where they tested the acid suppression based on when a meal was eaten after the PPI was taken, and if I remember right 30 minutes is safely within the maximum effectiveness zone.

Veteran Member

Date Joined Apr 2011
Total Posts : 1604
   Posted 7/15/2012 3:34 PM (GMT -6)   
Has to be what works for the individual though - mine does nothing for me unless I take it last thing at night, which is the only way it protects me from nighttime reflux and morning nausea. If I take it in the morning it doesn't cover me until the next morning and I wake up feeling very very ill.


Forum Moderator

Date Joined Mar 2012
Total Posts : 1110
   Posted 7/15/2012 4:04 PM (GMT -6)   
I take mine first thing in the morning and I wait an hour to eat. My dr wrote that specifically on the bottle
Diagnosed GERD, no other medical conditions (this one is enough)

New Member

Date Joined Jun 2012
Total Posts : 11
   Posted 7/15/2012 5:43 PM (GMT -6)   
What about the timing of the acid suppressors like Pepcid.  Does it make a difference then?

Regular Member

Date Joined Jun 2012
Total Posts : 32
   Posted 7/16/2012 4:09 PM (GMT -6)   
This is what I have read.
30 to 1 hr before eating, taste,smell,thought of food or time of regular eating sends signal from brain via vagus nerve to somach's proton pump to start secretion of acid. Amount of acid section is proportional to eaten food or requirement to disolve. While H2 blockers (zantac/pepcid) block one of the first stimuli for acid production, PPIs block the final step in the pathway of acid secretion in the stomach, resulting in greater suppression of acid.
Hence timing of H2 blockers (Pepcid) is also effective if its taken 30 to 60 min. before eating.
Empty stomach because if food is there, proton pumps are already active and secretion of acid has already started.
Eat a large meal after PPI/Pepcid so that more and more proton pumps can be impacted, I think.
There is a good visualization of gastric acid production on website:

New Member

Date Joined Jul 2012
Total Posts : 4
   Posted 7/16/2012 5:28 PM (GMT -6)   
I have a problem with taking my PPI 30min before eating... If I don't eat when I wake up I get really, really nauseous. cry

Post Edited (gabbi111969) : 7/16/2012 10:10:48 PM (GMT-6)

Regular Member

Date Joined Jun 2012
Total Posts : 32
   Posted 7/16/2012 8:17 PM (GMT -6)   
gabbi11169, you can take PPI 30min. to 1 hr before lunch . Try above steps. I hope it will help

New Member

Date Joined Jul 2012
Total Posts : 4
   Posted 7/16/2012 10:13 PM (GMT -6)   
Thanks guddan :-)

I will try that. It's hard for me to remember to take meds during the day tho. So much easier to remember when waking up and going to bed. tongue
43yr old with Osteoarthritis since teens, GERD, Just diagnosed with Barrett's Syndrome
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