For Patients Taking PPIs
It is recommended that antibiotics, PPIs, or bismuth preparations not be taken within 2 weeks prior to administering BreathTek UBT.
- If patients currently taking PPIs test positive for H. pylori infection, it is considered positive and eradication therapy can be started immediately; if the test is negative, it may be a false negative and results should be confirmed with a second breath test administered 2 weeks after discontinuing PPIs
- Histamine 2-receptor antagonists (H2RAs) may be substituted for PPIs. These medications include Zantac® (ranitidine), Tagamet® (cimetidine), Pepcid® (famotidine), and Axid® (nizatidine). The effect of H2RAs may reduce urease activity on urea breath tests. H2RAs may be discontinued for 24-48 hours before the BreathTek UBT1
Test for H. pylori infection before starting PPI therapy.
Approximately 60% of adult patients are already taking a PPI when they initially present with GI symptoms.2
- Commonly used PPIs include Nexium® (esomeprazole magnesium), Prevacid® (lansoprazole), Prilosec® (omeprazole), Zegerid® (omeprazole/sodium bicarbonate), AcipHex® (rabeprazole sodium), Dexilant® (dexlansoprazole), and Protonix® (pantoprazole sodium)
- Many patients resist discontinuing PPIs before testing because of concerns about symptom aggravation2
PPIs are commonly indicated for short-term therapy.
- Patients typically stay on prescription PPI therapy for an average of 180 days3
- Guidelines recommend a test-and-treat strategy for cases of uninvestigated dyspepsia1
Manufacturer-Recommended Duration of PPI Therapy
|Nexium®4 (esomeprazole magnesium)||Prevacid®5,6* (lansoprazole)|
|10 days to 8 weeksd,e||10 days to 12 weeksa,d,e|
|Up to 6 monthsg,h||Up to 12 monthsh,i|
|Prilosec®7,8† (omeprazole)||Zegerid®9,10‡ (omeprazole/sodium bicarbonate)|
|10 days to 8 weeksa,b,d,e||2 weeks to 8 weeksa,b,c,e,f|
|More than 5 yearsh,j||Up to 12 monthsh|
|Aciphex®11(rabeprazole sodium)||Dexilant®12 (dexlanso-prazole)|
|7 days to 16 weeksa,d,e||Up to 8 weeksc|
|Up to 12 monthsj||Up to 6 monthsh|
a -Duodenal ulcers
b -Gastric ulcers
c -Erosive esophagitis
d -Eradication of H. pylori infection to reduce the risk of duodenal ulcer recurrence
e -Gastroesophageal reflux disease (GERD)
f -Risk of upper gastrointestinal bleeding in critically ill
g -Risk reduction of NSAID-associated gastric ulcers
h -Healing of erosive esophagitis
i -Maintenance of healed duodenal ulcers
j -Pathological hypersecretory conditions
Long-term PPI use may mask H. pylori infection and cause many side effects.13-16
Abbreviations: NSAID, nonsteroidal anti-inflammatory drug; PPI, proton pump inhibitor.