Administration of proton pump inhibitors in patients requiring enteral nutrition.

further complicated by the fact that unless the PPI molecule is protected, it is subject to degradation in the presence of stomach acid.3 The PPIs (except for Zegerid) are therefore encapsulated or enterically coated to prevent premature activation of the drug in the presence of gastric acid.2,3 Opening the capsule and administering the contents have the potential to leave the granules vulnerable to degradation, premature activation, and decreased efficacy. Information about administering PPIs via enteral feeding tubes is limited. This article discusses the available literature and provides practitioners with suitable methods of administering PPIs via nasogastric, gastrostomy, and jejunostomy tubes. A search of PubMed utilizing the terms omeprazole, lansoprazole, esomeprazole, pantoprazole, rabeprazole, enteral, nasogastric, gastrostomy, and jejunal was conducted. All retrievable in vitro and in vivo studies describing an extemporaneous formulation administered via an enteral tube were included for review.