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PPI step-down — GPhC CRA MCQ

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EasyGastro-intestinal TherapeuticsPPI step-downGPhC CRA

A 52-year-old man has taken omeprazole 20mg daily for uncomplicated dyspepsia for eight months. His symptoms are controlled and he asks whether he should remain on it indefinitely. What is the most appropriate action?

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Correct answer: C — Discuss step-down or review with the prescriber if clinically suitable

Long-term PPI use should be reviewed to confirm ongoing indication and lowest effective dose. Step-down, intermittent use or stopping may be suitable for uncomplicated controlled symptoms. Some rebound symptoms can occur and should be discussed. NSAIDs and aspirin may worsen gastrointestinal symptoms and bleeding risk.

Reference: NICE CKS; BNF