skip to main content

PPI step-down — GPhC CRA MCQ

Instant feedback + full explanation. One question, done properly.

ModerateGI TherapeuticsPPI step-downGPhC CRA

A patient has taken omeprazole 20 mg daily for uncomplicated dyspepsia for 9 months. Symptoms are controlled and there are no alarm features. What is the most appropriate alternative?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Discuss step-down or review of ongoing need with the prescriber

Long-term proton pump inhibitor use should be periodically reviewed, particularly for uncomplicated symptoms. Step-down to the lowest effective dose or on-demand use may be appropriate if symptoms allow. Abrupt stopping can cause rebound symptoms in some patients, so counselling and review are useful. Ranitidine is not a routine current option. The keyed option is amlodipine, a calcium-channel blocker appropriate at this step.

Reference: NICE CKS; BNF