The US consumer advocacy organisation, Public Citizen, has called on the FDA to mention in a black-box warning that withdrawal from proton pump inhibitors (PPIs) can lead to severe rebound acid secretion, a complication that can force users to become dependent on them.

Public Citizen says that PPIs are frequently prescribed outside their approved uses, and up to two-thirds of all patients taking them are believed not to have a verified indication for the medication. The group adds that in many cases, “for those with presumed reflux disease on PPIs, other less acid-suppressive therapies are effective in treating symptoms, while in other cases, the medical problem does not even involve acid reflux.”