Thinking of stopping your PPI? Good plan—if you do it the right way. Many people on long-term proton pump inhibitors (PPIs) get hit by rebound acid when they stop, which can feel worse than before. This guide gives clear, practical steps so you can cut back safely and feel better faster.
Ask yourself: why are you on a PPI? If it’s for an ulcer, H. pylori, Barrett’s esophagus, recent GI bleeding, or long-term NSAID protection, talk to your clinician first. If your PPI began for mild GERD or heartburn and you're symptom-free, tapering is reasonable. Also get tested for H. pylori if that wasn’t done—treating it can remove the need for ongoing acid suppression.
Have alarm symptoms? Weight loss, trouble swallowing, vomiting, black stools, or severe pain need immediate medical review. Don’t attempt to stop on your own in those cases.
There’s no single perfect schedule, but here are safe, real-world approaches you can try depending on how long you’ve used a PPI:
Short-term users (less than 8–12 weeks): Try stepping down to every-other-day for 1–2 weeks, then stop. Use antacid as needed.
Long-term users (months to years): Move slower. Example plan: week 1–2 reduce to half the dose daily; week 3–4 take half dose every other day; week 5 stop the PPI and use an H2 blocker or antacid as needed for rebound symptoms. If symptoms return strongly, pause the taper and give your body more time at the lower dose.
Alternate approach: keep full dose but stretch the time between doses (take in morning every 36–48 hours) for 2–4 weeks, then stop. Pick whichever feels easier to follow.
How to handle rebound acid: use a short course of an H2 blocker like famotidine (over-the-counter in many places) for a few weeks, and keep antacids handy for breakthrough episodes. Avoid relying on H2 blockers long-term without medical advice because tolerance can build.
Non-drug supports that actually help: eat the big meal earlier in the evening, lose excess weight if you carry it around the waist, avoid smoking and late-night alcohol, reduce caffeine and spicy meals if they bother you, and raise the head of the bed if you get nighttime reflux. Small changes reduce the need for acid meds.
Expect the worst symptoms 1–2 weeks after stopping; many people improve in 4–8 weeks. If symptoms persist beyond 8–12 weeks or get worse, see your provider—some people need to restart a low dose or investigate other causes.
Finally, keep your clinician in the loop. Tapering works best with a plan and follow-up. You’ll avoid the panic of sudden rebound and stand a good chance of stopping the PPI for good.
