PPI introduction

ICD Deactivation

Dr Laura Dewhirst, Dr Sophie Jones, Dr Alice Martin, Dr Jon Tomas

Scope of the Guideline

This guidance has been produced to support patients requiring specialist palliative care input for symptom control management who may need to be considered for administration of subcutaneous (SC) proton pump inhibitors (PPI) when an alternative route is not suitable/desirable.


This guidance has been developed to establish a degree of consensus, alongside published case reports, around the use of SC PPI in clinical practice in patients with a palliative diagnosis. Currently there is low quality evidence available.

Disclaimer (SPAGG - Rewrite)

This Guide is intended for use by healthcare professionals and the expectation is that they will use clinical judgement, medical, and nursing knowledge in applying the general principles and recommendations contained within. They are not meant to replace the many available texts on the subject of palliative care.

Some of the management strategies describe the use of drugs outside their licensed indications. They are, however, established and accepted good practice. Please refer to the current BNF for further guidance.

While WMPCPS takes every care to compile accurate information , we cannot guarantee its correctness and completeness and it is subject to change. We do not accept responsibility for any loss, damage or expense resulting from the use of this information.