Bavbek, Sevim (55888132700)Sevim (55888132700)BavbekKepil Özdemir, Seçil (57563132400)Seçil (57563132400)Kepil ÖzdemirBonadonna, Patrizia (6603061858)Patrizia (6603061858)BonadonnaAtanaskovic-Markovic, Marina (6506020842)Marina (6506020842)Atanaskovic-MarkovicBarbaud, Annick (7102785517)Annick (7102785517)BarbaudBrockow, Knut (7003392139)Knut (7003392139)BrockowLaguna Martinez, Jose (58725872200)Jose (58725872200)Laguna MartinezNakonechna, Alla (55523500200)Alla (55523500200)NakonechnaPagani, Mauro (23101074200)Mauro (23101074200)PaganiArcolacı, Alessandra (57200242157)Alessandra (57200242157)ArcolacıLombardo, Carla (7005662010)Carla (7005662010)LombardoTorres, Maria J. (58280986000)Maria J. (58280986000)Torres2025-06-122025-06-122024https://doi.org/10.1111/all.15961https://www.scopus.com/inward/record.uri?eid=2-s2.0-85178047809&doi=10.1111%2fall.15961&partnerID=40&md5=d074bfa4d3ab4b22c1ddcbb67fa1fc05https://remedy.med.bg.ac.rs/handle/123456789/1287Proton pump inhibitors (PPIs) are invaluable therapeutic options in a variety of dyspeptic diseases. In addition to their well-known risk profile, PPI consumption is related to food and environmental allergies, dysbiosis, osteoporosis, as well as immediate and delayed hypersensitivity reactions (HSRs). The latter, although a rare event, around 1%–3%, due to the extraordinarily high rate of prescription and consumption of PPIs are related to a substantial risk. In this Position Paper, we provide clinicians with practical evidence-based recommendations for the diagnosis and management of HSRs to PPIs. Furthermore, the unmet needs proposed in the document aim to stimulate more in-depth investigations in the topic. © 2023 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.allergyanaphylaxisdrug hypersensitivityhypersensitivity reactionproton pump inhibitors