Matching articles for "Losec"
Drugs for GERD and Peptic Ulcer Disease
The Medical Letter on Drugs and Therapeutics • April 4, 2022; (Issue 1647)
Gastroesophageal reflux disease (GERD) is the most
common GI condition encountered in the outpatient
setting; it affects about 20% of people in the...
Gastroesophageal reflux disease (GERD) is the most
common GI condition encountered in the outpatient
setting; it affects about 20% of people in the US.
Comparison Table: H2-Receptor Antagonists and PPIs (online only)
The Medical Letter on Drugs and Therapeutics • April 4, 2022; (Issue 1647)
...
View the Comparison Table: H2-Receptor Antagonists and PPIs
Nonopioid Drugs for Pain
The Medical Letter on Drugs and Therapeutics • February 12, 2018; (Issue 1540)
Nonopioid drugs can be used in the treatment of many
nociceptive and neuropathic pain conditions. Use of
opioids for pain will be reviewed in a future...
Nonopioid drugs can be used in the treatment of many
nociceptive and neuropathic pain conditions. Use of
opioids for pain will be reviewed in a future issue.
Drugs for GERD and Peptic Ulcer Disease
The Medical Letter on Drugs and Therapeutics • January 15, 2018; (Issue 1538)
Gastroesophageal reflux disease (GERD) is the most
frequent GI condition encountered in the outpatient
setting; it affects about 20% of the US population.
Heartburn and regurgitation are the classic...
Gastroesophageal reflux disease (GERD) is the most
frequent GI condition encountered in the outpatient
setting; it affects about 20% of the US population.
Heartburn and regurgitation are the classic symptoms
of GERD.
Comparison Table: Drugs for GERD and Peptic Ulcer Disease (online only)
The Medical Letter on Drugs and Therapeutics • January 15, 2018; (Issue 1538)
...
View the Comparison Table: Drugs for GERD and Peptic Ulcer Disease
Tocilizumab (Actemra) for Giant Cell Arteritis
The Medical Letter on Drugs and Therapeutics • September 25, 2017; (Issue 1530)
The FDA has approved the interleukin-6 (IL-6) receptor
antagonist tocilizumab (Actemra – Genentech) for
subcutaneous (SC) treatment of giant cell arteritis
in adults. It is the first drug to be approved in...
The FDA has approved the interleukin-6 (IL-6) receptor
antagonist tocilizumab (Actemra – Genentech) for
subcutaneous (SC) treatment of giant cell arteritis
in adults. It is the first drug to be approved in the US
for this indication. Tocilizumab is also approved for
treatment of rheumatoid arthritis, polyarticular or
systemic juvenile idiopathic arthritis, and cytokine
release syndrome.
Safety of Long-Term PPI Use
The Medical Letter on Drugs and Therapeutics • August 14, 2017; (Issue 1527)
Proton pump inhibitors (PPIs), which are used for
treatment of gastroesophageal reflux disease (GERD)
and for prevention of upper gastrointestinal adverse
effects caused by NSAIDs and aspirin, are one...
Proton pump inhibitors (PPIs), which are used for
treatment of gastroesophageal reflux disease (GERD)
and for prevention of upper gastrointestinal adverse
effects caused by NSAIDs and aspirin, are one of
the most commonly prescribed classes of drugs in
the US. All PPIs are similarly effective and generally
well tolerated, but their long-term use has been
associated with a number of safety concerns.
Recommendations addressing these concerns have
recently been published.
Drug Interaction: Clopidogrel and PPIs
The Medical Letter on Drugs and Therapeutics • February 27, 2017; (Issue 1515)
The antiplatelet drug clopidogrel (Plavix, and others)
reduces major cardiovascular events, but can cause
bleeding. Proton pump inhibitors (PPIs) are often
used with clopidogrel to prevent...
The antiplatelet drug clopidogrel (Plavix, and others)
reduces major cardiovascular events, but can cause
bleeding. Proton pump inhibitors (PPIs) are often
used with clopidogrel to prevent gastrointestinal
bleeding, however, some evidence suggests that PPIs
may interfere with the activation of clopidogrel and
diminish its antiplatelet effect. FDA-approved labeling
recommends avoiding concurrent use of the PPIs
omeprazole and esomeprazole with clopidogrel.
Which PPI?
The Medical Letter on Drugs and Therapeutics • June 22, 2015; (Issue 1471)
An article published in the New York Times on May 1,
2015 listed the 10 drugs on which Medicare Part D
spent the most in 2013. The most costly ($2.53
billion) was the proton pump inhibitor (PPI)...
An article published in the New York Times on May 1,
2015 listed the 10 drugs on which Medicare Part D
spent the most in 2013. The most costly ($2.53
billion) was the proton pump inhibitor (PPI) Nexium
(esomeprazole magnesium), which has recently become
available generically.
Antithrombotic Drugs
The Medical Letter on Drugs and Therapeutics • October 27, 2014; (Issue 1454)
Antiplatelet drugs are the drugs of choice for
prevention and treatment of arterial thrombosis.
Anticoagulants are the drugs of choice for prevention
and treatment of venous thromboembolism and...
Antiplatelet drugs are the drugs of choice for
prevention and treatment of arterial thrombosis.
Anticoagulants are the drugs of choice for prevention
and treatment of venous thromboembolism and for
prevention of cardioembolic events in patients with
atrial fibrillation.
Drugs for Inflammatory Bowel Disease
The Medical Letter on Drugs and Therapeutics • August 4, 2014; (Issue 1448)
Aminosalicylates are effective for induction and maintenance
of remission in mild to moderate ulcerative
colitis. They are not recommended for treatment of
Crohn's disease.
FORMULATIONS — Oral mesalamine...
Aminosalicylates are effective for induction and maintenance
of remission in mild to moderate ulcerative
colitis. They are not recommended for treatment of
Crohn's disease.
FORMULATIONS — Oral mesalamine is rapidly absorbed in the small intestine and most of the drug does not reach the colon. Pentasa releases mesalamine gradually throughout the gastrointestinal tract. Delzicol, Asacol HD, Lialda, and Apriso delay the release of the drug until it reaches the distal ileum and colon. Sulfasalazine (Azulfidine, and generics), balsalazide (Colazal, and others), and olsalazine (Dipentum) are prodrugs; mesalamine is azo-bonded to a second moiety and released in the colon following bacterial cleavage of the bond. Mesalamine is also available as an enema (Rowasa, and generics) and as a rectal suppository (Canasa).
FORMULATIONS — Oral mesalamine is rapidly absorbed in the small intestine and most of the drug does not reach the colon. Pentasa releases mesalamine gradually throughout the gastrointestinal tract. Delzicol, Asacol HD, Lialda, and Apriso delay the release of the drug until it reaches the distal ileum and colon. Sulfasalazine (Azulfidine, and generics), balsalazide (Colazal, and others), and olsalazine (Dipentum) are prodrugs; mesalamine is azo-bonded to a second moiety and released in the colon following bacterial cleavage of the bond. Mesalamine is also available as an enema (Rowasa, and generics) and as a rectal suppository (Canasa).
In Brief: Esomeprazole Strontium
The Medical Letter on Drugs and Therapeutics • July 21, 2014; (Issue 1447)
The FDA has approved the proton pump inhibitor (PPI) esomeprazole strontium for use in adults for the same indications as esomeprazole magnesium (Nexium): treatment of gastroesophageal reflux disease (GERD),...
The FDA has approved the proton pump inhibitor (PPI) esomeprazole strontium for use in adults for the same indications as esomeprazole magnesium (Nexium): treatment of gastroesophageal reflux disease (GERD), prevention of NSAID-induced gastric ulcers, eradication of Helicobacter pylori, and treatment of pathological hypersecretory conditions. It was first marketed in December 2013 as a branded drug (Esomeprazole Strontium) and a month later as a generic drug.
Strontium is incorporated into bone. It is not recommended for use in children or during pregnancy because of the absence of safety data in those populations. Use of esomeprazole strontium is not recommended for patients with severe renal impairment.
Esomeprazole strontium is the seventh PPI to become available as a single agent in the US. No new clinical trials were required for its approval, which was based on earlier clinical trials with esomeprazole magnesium. All of the PPIs appear to be equally effective.1
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Strontium is incorporated into bone. It is not recommended for use in children or during pregnancy because of the absence of safety data in those populations. Use of esomeprazole strontium is not recommended for patients with severe renal impairment.
Esomeprazole strontium is the seventh PPI to become available as a single agent in the US. No new clinical trials were required for its approval, which was based on earlier clinical trials with esomeprazole magnesium. All of the PPIs appear to be equally effective.1
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In Brief: Clopidogrel and Omeprazole
The Medical Letter on Drugs and Therapeutics • November 29, 2010; (Issue 1352)
Use of a proton pump inhibitor (PPI) to protect against gastrointestinal (GI) bleeding in patients taking the antiplatelet agent clopidogrel (Plavix) may interfere with the activation of clopidogrel and...
Use of a proton pump inhibitor (PPI) to protect against gastrointestinal (GI) bleeding in patients taking the antiplatelet agent clopidogrel (Plavix) may interfere with the activation of clopidogrel and diminish its antiplatelet effect, increasing the risk of cardiovascular events.1 A randomized, placebo-controlled trial (COGENT) has found that use of the PPI omeprazole in patients taking clopidogrel in addition to aspirin decreased the incidence of GI bleeding without increasing the risk of a cardiovascular event, but the number of cardiovascular events was small and the formulation of omeprazole was atypical.2 The FDA in the same issue of the same journal cautioned against concluding from the results of COGENT that concurrent use of clopidogrel and omeprazole is safe.3
To some extent, all PPIs reduce the enzymatic activity of CYP2C19, which is thought to be mainly responsible for the bioactivation of clopidogrel. Omeprazole is a strong inhibitor of CYP2C19; pantoprazole (Protonix, and others) appears to have less effect on CYP2C19 and not to attenuate the antiplatelet effect of clopidogrel.4-6 Medical Letter consultants believe that patients at risk for upper GI bleeding who take clopidogrel should also take a PPI, but not omeprazole. Until more data become available on other PPIs, pantoprazole would be a reasonable choice.
1. PPI interactions with clopidogrel revisited. Med Lett Drugs Ther 2009; 51:13.
2. DL Bhatt et al. Clopidogrel with or without omeprazole in coronary artery disease. N Engl J Med 2010; 363:1909.
3. MR Southworth and R Temple. Interaction of clopidogrel and omeprazole. N Engl J Med 2010; 363:1977.
4. DJ Angiolillo et al. Differential effects of omeprazole and pantoprazole on the pharmacodynamics and pharmacokinetics of clopidogrel in healthy subjects: randomized, placebo-controlled, crossover comparison studies. Clin Pharmacol Ther 2010; Sept 15 epub.
5. T Cuisset et al. Comparison of omeprazole and pantoprazole influence on a high 150-mg clopidogrel maintenance dose: the PACA (Proton Pump Inhibitors And Clopidogrel Association) prospective randomized study. J Am Coll Cardiol 2009; 54:1149.
6. H Neubaurer et al. Pantoprazole does not influence the antiplatelet effect of clopidogrel – a whole blood aggregometry study after coronary stenting. J Cardiovasc Pharmacol 2010; 56:91.
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To some extent, all PPIs reduce the enzymatic activity of CYP2C19, which is thought to be mainly responsible for the bioactivation of clopidogrel. Omeprazole is a strong inhibitor of CYP2C19; pantoprazole (Protonix, and others) appears to have less effect on CYP2C19 and not to attenuate the antiplatelet effect of clopidogrel.4-6 Medical Letter consultants believe that patients at risk for upper GI bleeding who take clopidogrel should also take a PPI, but not omeprazole. Until more data become available on other PPIs, pantoprazole would be a reasonable choice.
1. PPI interactions with clopidogrel revisited. Med Lett Drugs Ther 2009; 51:13.
2. DL Bhatt et al. Clopidogrel with or without omeprazole in coronary artery disease. N Engl J Med 2010; 363:1909.
3. MR Southworth and R Temple. Interaction of clopidogrel and omeprazole. N Engl J Med 2010; 363:1977.
4. DJ Angiolillo et al. Differential effects of omeprazole and pantoprazole on the pharmacodynamics and pharmacokinetics of clopidogrel in healthy subjects: randomized, placebo-controlled, crossover comparison studies. Clin Pharmacol Ther 2010; Sept 15 epub.
5. T Cuisset et al. Comparison of omeprazole and pantoprazole influence on a high 150-mg clopidogrel maintenance dose: the PACA (Proton Pump Inhibitors And Clopidogrel Association) prospective randomized study. J Am Coll Cardiol 2009; 54:1149.
6. H Neubaurer et al. Pantoprazole does not influence the antiplatelet effect of clopidogrel – a whole blood aggregometry study after coronary stenting. J Cardiovasc Pharmacol 2010; 56:91.
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Naproxen/Esomeprazole (Vimovo)
The Medical Letter on Drugs and Therapeutics • September 20, 2010; (Issue 1347)
The FDA has approved the marketing of Vimovo
(AstraZeneca), a fixed-dose combination of the nonsteroidal
anti-inflammatory drug (NSAID) naproxen
and the proton pump inhibitor (PPI) esomeprazole,...
The FDA has approved the marketing of Vimovo
(AstraZeneca), a fixed-dose combination of the nonsteroidal
anti-inflammatory drug (NSAID) naproxen
and the proton pump inhibitor (PPI) esomeprazole, for
symptomatic relief of osteoarthritis, rheumatoid arthritis
and ankylosing spondylitis and to decrease the risk
of developing gastric ulcers in patients at risk for
NSAID-associated ulcers.
Primary Prevention of Ulcers in Patients Taking Aspirin or NSAIDs
The Medical Letter on Drugs and Therapeutics • March 8, 2010; (Issue 1333)
Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) are common causes of peptic ulcer disease. Patients infected with Helicobacter pylori who take aspirin or another NSAID have an especially high...
Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) are common causes of peptic ulcer disease. Patients infected with Helicobacter pylori who take aspirin or another NSAID have an especially high risk. Drugs that have been tried for prevention of ulcers in patients taking NSAIDs including H2-receptor antagonists, proton pump inhibitors (PPIs), aluminum- or magnesium-containing antacids, the prostaglandin misoprostol (Cytotec, and others), and antibiotics to eradicate H. pylori.
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Generic Drugs Revisited
The Medical Letter on Drugs and Therapeutics • October 19, 2009; (Issue 1323)
The equivalence of generic drugs to their brand-name precursors continues to be controversial. The last Medical Letter review of this subject (2002) concluded that well-documented therapeutic inequivalence...
The equivalence of generic drugs to their brand-name precursors continues to be controversial. The last Medical Letter review of this subject (2002) concluded that well-documented therapeutic inequivalence between brand-name and FDA-approved generic drugs had not been reported. Is that still true? New data have become available for some drugs.
Encapsulated Mesalamine Granules (Apriso) for Ulcerative Colitis
The Medical Letter on Drugs and Therapeutics • May 18, 2009; (Issue 1312)
Apriso (Salix) is a new formulation of mesalamine (5-aminosalicylic acid; 5-ASA) approved by the FDA for maintenance of remission in mild to moderate ulcerative colitis (UC). Mesalamine is a locally acting...
Apriso (Salix) is a new formulation of mesalamine (5-aminosalicylic acid; 5-ASA) approved by the FDA for maintenance of remission in mild to moderate ulcerative colitis (UC). Mesalamine is a locally acting antiinflammatory agent that is widely used both to maintain and induce remission in inflammatory bowel disease. Various mesalamine formulations have been developed to target drug delivery to areas of the small intestine and colon. Most of these agents require frequent dosing and have a high pill burden. The newest products - Lialda, introduced in 2007,1 and now Apriso - can be dosed once daily.
Dexlansoprazole (Kapidex) for GERD and Erosive Esophagitis
The Medical Letter on Drugs and Therapeutics • March 23, 2009; (Issue 1308)
The FDA has approved the proton-pump inhibitor (PPI) dexlansoprazole (Kapidex - Takeda), a delayed release formulation of the R-enantiomer of lansoprazole (Prevacid - Takeda), for treating and maintaining...
The FDA has approved the proton-pump inhibitor (PPI) dexlansoprazole (Kapidex - Takeda), a delayed release formulation of the R-enantiomer of lansoprazole (Prevacid - Takeda), for treating and maintaining healing of erosive esophagitis and for treatment of heartburn associated with non-erosive gastroesophageal reflux disease (GERD).
PPI Interactions with Clopidogrel Revisted
The Medical Letter on Drugs and Therapeutics • February 23, 2009; (Issue 1306)
Current guidelines recommend use of a proton pump inhibitor (PPI) to decrease the risk of gastrointestinal bleeding in patients taking clopidogrel (Plavix) with aspirin. A recent issue of The Medical Letter...
Current guidelines recommend use of a proton pump inhibitor (PPI) to decrease the risk of gastrointestinal bleeding in patients taking clopidogrel (Plavix) with aspirin. A recent issue of The Medical Letter considered whether omeprazole (Prilosec, and others) or other PPIs could interfere with the antiplatelet effect of clopidogrel. The conclusion was that patients taking both drugs should probably continue to do so until more data became available. Several new publications require reconsideration of that recommendation.
PPI Interactions with Clopidogrel
The Medical Letter on Drugs and Therapeutics • January 12, 2009; (Issue 1303)
Clopidogrel (Plavix), which prevents arterial thrombosis by inhibiting platelet activation, is commonly prescribed (usually with aspirin) for months after acute coronary syndromes and stent implantation. It may...
Clopidogrel (Plavix), which prevents arterial thrombosis by inhibiting platelet activation, is commonly prescribed (usually with aspirin) for months after acute coronary syndromes and stent implantation. It may also, however, increase the risk of bleeding. Therefore, a proton pump inhibitor (PPI) such as omeprazole (Prilosec, and others) is often given concurrently to decrease the risk of gastrointestinal (GI) bleeding. Some reports have suggested that omeprazole may interfere with the antiplatelet effect of clopidogrel.
Ramelteon (Rozerem) for Insomnia
The Medical Letter on Drugs and Therapeutics • November 7, 2005; (Issue 1221)
Ramelteon (Rozerem - Takeda), a melatonin receptor agonist, has been approved by the FDA for treatment of insomnia characterized by difficulty falling asleep. Unlike all other prescription hypnotics, which are...
Ramelteon (Rozerem - Takeda), a melatonin receptor agonist, has been approved by the FDA for treatment of insomnia characterized by difficulty falling asleep. Unlike all other prescription hypnotics, which are classified as schedule IV drugs, ramelteon is not a controlled substance.
Atypical Antipsychotics in the Elderly
The Medical Letter on Drugs and Therapeutics • August 1, 2005; (Issue 1214)
The FDA has reported that 5106 elderly patients with dementia treated with atypical (second generation) antipsychotics in 17 randomized controlled trials had a higher mortality rate (4.5% vs. 2.6%) than those...
The FDA has reported that 5106 elderly patients with dementia treated with atypical (second generation) antipsychotics in 17 randomized controlled trials had a higher mortality rate (4.5% vs. 2.6%) than those receiving placebo. Most of the deaths were due to cardiovascular and infectious causes (such as pneumonia). The drugs used in the trials were aripiprazole (Abilify), olanzapine (Zyprexa), quetiapine (Seroquel), and risperidone (Risperdal). As the increase in mortality was considered a class effect, the FDA advisory also included ziprasidone (Geodon), clozapine (Clozaril) and the olanzapine/fluoxetine combination (Symbyax). The manufacturers of all of these drugs will be required to add a "black box" warning to their labeling.
In Brief: Zegerid - Immediate-Release Omeprazole
The Medical Letter on Drugs and Therapeutics • April 11, 2005; (Issue 1206)
The FDA has approved marketing of Zegerid powder for oral suspension (Santarus), an immediate-release formulation of the proton-pump inhibitor (PPI) omeprazole (Prilosec, and others). All other oral PPIs are...
The FDA has approved marketing of Zegerid powder for oral suspension (Santarus), an immediate-release formulation of the proton-pump inhibitor (PPI) omeprazole (Prilosec, and others). All other oral PPIs are delayed-release, enteric-coated formulations designed to prevent degradation of the drug by gastric acid. Each 20- or 40-mg packet of Zegerid contains 1680 mg of sodium bicarbonate, which protects the drug from gastric acid degradation. A dose of Zegerid contains 460 mg of sodium, which may be excessive for some patients. Zegerid is the first oral PPI to be approved by the FDA for reduction of risk of upper GI bleeding in critically ill patients. The drug may be useful for patients who are unable to swallow and have nasogastric (NG) tubes in place. Zegerid costs $70.00 for 14 days' treatment, compared to less than $10 for 14 tablets of Prilosec OTC.
Minimal Surgery for Treatment of GERD
The Medical Letter on Drugs and Therapeutics • September 1, 2003; (Issue 1164)
Laparoscopic surgery has become increasingly popular for the treatment of gastroesophageal reflux disease (GERD). The usual surgical procedure, a Nissen fundoplication, prevents reflux into the esophagus. The...
Laparoscopic surgery has become increasingly popular for the treatment of gastroesophageal reflux disease (GERD). The usual surgical procedure, a Nissen fundoplication, prevents reflux into the esophagus. The review compares medical treatment with a proton pump inhibitor vs. surgical therapy as well as open vs. the new laparoscopic technique. Morbidity and mortality with the procedures are discussed.
Prilosec, Nexium and Stereoisomers
The Medical Letter on Drugs and Therapeutics • June 23, 2003; (Issue 1159)
Recently pharmaceutical manufacturers have marketed a stereoisomer of a successful drug nearing patent expiration as a new drug. Examples, such as esomeprazole (Nexium) , levalbuterol (Xopenex), escitalopram...
Recently pharmaceutical manufacturers have marketed a stereoisomer of a successful drug nearing patent expiration as a new drug. Examples, such as esomeprazole (Nexium) , levalbuterol (Xopenex), escitalopram (Lexapro) and dexmethylphenidate
Drug Interactions
The Medical Letter on Drugs and Therapeutics • June 8, 2003; (Issue 1158)
Changes caused by one drug in the absorption, distribution, metabolism or excretion of another may lead to a pharmacokinetic adverse drug interaction (DN Juurlink et al, JAMA 2003; 289:1652). Additive drug...
Changes caused by one drug in the absorption, distribution, metabolism or excretion of another may lead to a pharmacokinetic adverse drug interaction (DN Juurlink et al, JAMA 2003; 289:1652). Additive drug interactions, such as vasodilation caused by both sildenafil (Viagra) and nitrates, can also have adverse effects.
Omeprazole
The Medical Letter on Drugs and Therapeutics • March 9, 1990; (Issue 813)
Omeprazole (Losec - Merck), a new drug that suppresses gastric acid secretion, has been approved by the US Food and Drug Administration for short-term (four to eight weeks) treatment of severe or refractory...
Omeprazole (Losec - Merck), a new drug that suppresses gastric acid secretion, has been approved by the US Food and Drug Administration for short-term (four to eight weeks) treatment of severe or refractory gastroesophageal reflux and for long-term treatment of pathological hypersecretory conditions such as Zollinger-Ellison syndrome, multiple endocrine adenomas, and systemic mastocytosis. Although widely used abroad for treatment of peptic ulcers, it has not been approved for that indication in the USA.