Version July 2025
| Medication | Low dose | Standard dose | High dose* |
| Histamine 2 receptor antagonists¶ | |||
| CimetidineΔ | 200 mg twice daily◊ | 400 mg twice daily | Not recommended |
| Famotidine | 10 mg twice daily◊ | 20 mg twice daily◊ | 40 mg twice daily |
| Nizatidine | 75 mg twice daily§ | 150 mg twice daily | 300 mg twice daily |
| Proton pump inhibitors | |||
| Dexlansoprazole | Not available | 30 mg once daily | 60 mg once or twice daily |
| Esomeprazole | 20 mg once daily◊ | 40 mg once daily | 40 mg twice daily |
| Lansoprazole | 15 mg once daily◊ | 30 mg once daily | 30 mg twice daily |
| Omeprazole | Not recommended¥ | 20 mg once daily◊ | 40 mg once or twice daily |
| Pantoprazole | 20 mg once daily | 40 mg once daily | 40 mg twice daily |
| Rabeprazole | 10 mg once daily‡ | 20 mg once daily | 20 mg twice daily |
| Potassium-competitive acid blockers | |||
| Vonoprazan† | 10 mg once daily | 20 mg once daily | 20 mg twice daily |
Dosing in this table is for oral administration in adults with normal kidney and liver function. For additional information, including dose adjustments, refer to drug monographs.
Standard-dose PPI regimens are typically used when PPI therapy is initiated. Low-dose PPI regimens may be useful for tapering off PPI therapy. High-dose PPI regimens are commonly used in instances of inadequate treatment response to standard-dose PPI regimens, although they may not have regulatory approval. Doses for different PPIs within each category do not necessarily provide equivalent intragastric 24-hour acid suppression.
High-dose H2RA regimens are uncommonly used as they are unlikely to confer greater symptom control than standard-dose regimens.H2RA: histamine 2 receptor antagonist; PPI: proton pump inhibitor.
* Twice-daily doses of PPIs and vonoprazan are used clinically but may not have regulatory approval.
¶ H2RAs require dose adjustment for kidney impairment.
Δ Significant drug interactions can occur. When initiating or altering drug therapy, use of a drug interactions program is advised.
◊ Available without a prescription (over the counter) in the United States and elsewhere; consult local product availability.
§ Not available in the United States. Consult local product availability.
¥ In some countries outside the United States, omeprazole 10 mg once daily is approved for maintenance of symptom relief after initial standard-dose therapy.
‡ In some countries, dose strength is limited to certain dose forms (eg, sprinkle capsule), which may be costlier. Consult local product availability.
† Vonoprazan should not be used in persons who are pregnant or breastfeeding.