Proton pump inhibitors decrease secretion of gastric acid. They act by blocking the last enzyme in the system that actively transports acid from gastric parietal cells into the gastrointestinal lumen, hydrogen–potassium adenosine triphosphatase, also known as the proton pump. Omeprazole, the first drug in this class, was introduced in 1989. Since then, 4 other proton pump inhibitors have been introduced: lansoprazole (1995), rabeprazole (1999), pantoprazole (2000), and esomeprazole (2001). In 2003 omeprazole became available over-the-counter in the United States. The purpose of this review is to compare the benefits and harms of different PPIs.
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