What PPI dose is used for different GERD grades?

Grade A-B: standard dose PPI (omeprazole 20 mg or equivalent); Grade C-D or Barrett’s oesophagus: double dose (40 mg omeprazole BD); erosive disease: 8 weeks initially; maintenance at lowest effective dose; step-down after healing.

What H. pylori eradication regimen is first-line?

Standard triple therapy (clarithromycin resistance <15%): PPI + amoxicillin + clarithromycin × 14 days; concomitant/quadruple therapy (bismuth or non-bismuth) preferred where clarithromycin resistance is high; confirm eradication 4 weeks post-treatment.

How does CYP2C19 genotype affect omeprazole efficacy?

CYP2C19 rapid/ultrarapid metabolizers have lower omeprazole exposure; double dose or switch to rabeprazole/pantoprazole (less CYP2C19 dependent) for better acid suppression; poor metabolizers have 5-10x higher omeprazole AUC.

What are the evidence-based indications for stress ulcer prophylaxis?

ICU SUP: mechanical ventilation >48h OR coagulopathy (INR>1.5/platelets<50K) are strongest indications per PEPTIC and RE-EVALUATEPEPTIC trials; routine prophylaxis in non-ICU patients is not recommended; risk of VAP and C. difficile.

What are risks of long-term PPI use?

Long-term PPI (>1 year): hypomagnesemia (screen if symptomatic), Clostridium difficile risk (1.5-2x), hip fracture risk (modest), renal impairment (observational data), SIBO; use minimum effective dose and reassess indication annually.

Proton Pump Inhibitor Dosing and GERD Severity Assessment

Calculates PPI dosing for GERD grades A-D (Los Angeles classification), H. pylori triple/quadruple therapy regimens, stress ulcer prophylaxis in ICU, and CYP2C19 pharmacogenomics impact on omeprazole/lansoprazole efficacy.

Use the full interactive calculator below, or

Related Calculators

PK Parameter Calculator

Medical Calculators

Renal Drug Dosing

Medical Calculators

Vancomycin Dosing

Medical Calculators

Proton Pump Inhibitor Dosing and GERD Severity Assessment

Related Calculators

Frequently Asked Questions

What PPI dose is used for different GERD grades?

What H. pylori eradication regimen is first-line?

How does CYP2C19 genotype affect omeprazole efficacy?

What are the evidence-based indications for stress ulcer prophylaxis?

What are risks of long-term PPI use?