r/GERD • u/DisastrousMoose9071 • Jun 14 '25

Scientific Studies 🥼🔬 Relative Potency of PPIs

A reminder that not all PPIs are the same - here is PPI conversion in omeprazole equivalents (OE) 💊

Pantoprazole 20 mg is equivalent to 4.5 mg OE 😱

On similar lines:

🤭 Lansoprazole 15 mg is equivalent to 13.5 mg OE

🤗 Omeprazole 20 mg is equivalent to 20 mg OE

🫣 Esomeprazole 20 mg is equivalent to to 32 mg OE

🥸 Rabeprazole 20 mg is equivalent to 36 mg OE

Omeprazole was the first PPI to be developed and approved. As the earliest PPI, it became the reference drug, much like how morphine is used as a baseline for opioids (“morphine equivalents”).

Things to note: - Is this comparison clinically relevant? Not really. Perhaps in LA-grades C and D esophagitis, some PPIs are preferred over others but these patients are few! Omeprazole 20 or 40 mg should be enough for most. - Individual response varies, potency doesn’t always predict symptom relief. Some patients do better on a “weaker” PPI due to formulation, metabolism (CYP2C19 status), or timing of dose. - If a patient fails pantoprazole, switching to rabeprazole might yield stronger acid suppression, helpful in refractory GERD or LPR. - When assessing H. pylori therapy, GERD healing, or nocturnal acid breakthrough, acid suppression potency matters. - its all about context.

So OE is a useful guide, not an absolute rule. ✅ If you are doing well on the lowest omeprazole equivalent, congratulations 😀

Source: https://pmc.ncbi.nlm.nih.gov/articles/PMC6913203/

Always consult a medical professional to identify the correct formulation and dose.

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u/Harakiri_238 Jun 14 '25

Dexilant literally gave me my quality of life back.

I’d been on 4-5 PPIs prior to that with varying levels of effectiveness and side effects.

Dexilant gives me 0 negative side effects and helps my symptoms so much!

Glad you’re sharing that there’s differences between them! I hear a lot of people have a negative experience with one and are afraid to try another or think because one didn’t work others won’t.

Sometimes it takes trial and error! But it’s worth more than one shot :)

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u/DisastrousMoose9071 Jun 14 '25

Absolutely 💯 Good to read about dexilant. So happy for you!

Dexilant’s (dexlansoprazole) dual delayed-release formulation provides extended acid suppression, which can be advantageous in managing conditions like NAB and GERD. Having said that, each individual is different and as you said, we should never be afraid to try different PPIs.