Matching articles for "esomeprazole"
Vonoprazan (Voquezna) for Erosive Esophagitis
The Medical Letter on Drugs and Therapeutics • December 25, 2023; (Issue 1692)
The FDA has approved vonoprazan (Voquezna –
Phathom), a potassium-competitive acid blocker, for
healing and maintenance of healing of all grades of
erosive esophagitis and relief of associated heartburn in...
The FDA has approved vonoprazan (Voquezna –
Phathom), a potassium-competitive acid blocker, for
healing and maintenance of healing of all grades of
erosive esophagitis and relief of associated heartburn in adults. Vonoprazan is also available copackaged
with amoxicillin (Voquezna Dual Pak) and with
amoxicillin and clarithromycin (Voquezna Triple Pak)
for treatment of Helicobacter pylori infection in adults.
Addendum: Dexlansoprazole for GERD
The Medical Letter on Drugs and Therapeutics • May 16, 2022; (Issue 1650)
A reader commented that our recent article on
Drugs for GERD and Peptic Ulcer Disease did not
include enough information on dexlansoprazole
(Dexilant, and generics), a proton pump inhibitor
(PPI) claimed to...
A reader commented that our recent article on
Drugs for GERD and Peptic Ulcer Disease did not
include enough information on dexlansoprazole
(Dexilant, and generics), a proton pump inhibitor
(PPI) claimed to provide "all-day and all-night relief
from heartburn". Dexlansoprazole recently became
available generically, but it is much more expensive
than other generic PPIs.
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.
Comparison Table: Some Nonopioid Analgesics for Pain (online only)
The Medical Letter on Drugs and Therapeutics • February 12, 2018; (Issue 1540)
...
View the Comparison Table: Some Nonopioid Analgesics for Pain
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
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.
Drugs for Helicobacter pylori Infection
The Medical Letter on Drugs and Therapeutics • July 17, 2017; (Issue 1525)
About 50% of the world’s population is infected with
Helicobacter pylori. These gastric bacteria can cause
chronic inflammation and have been associated with
development of gastritis, peptic ulcer disease,...
About 50% of the world’s population is infected with
Helicobacter pylori. These gastric bacteria can cause
chronic inflammation and have been associated with
development of gastritis, peptic ulcer disease, gastric
adenocarcinoma, and gastric mucosa-associated
lymphoid tissue (MALT) lymphoma. Eradication of H.
pylori can promote gastric healing, prevent recurrence
of duodenal and gastric ulcers, and reduce the
incidence of gastric cancer. Guidelines for treatment
of H. pylori infection were updated recently.
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.
In Brief: PPIs and Torsades de Pointes
The Medical Letter on Drugs and Therapeutics • December 5, 2016; (Issue 1509)
Therapeutics (AZCERT) has recently added the proton pump inhibitors (PPIs) omeprazole (Prilosec, and others), esomeprazole (Nexium, and others), lansoprazole (Prevacid, and others), and pantoprazole (Protonix,...
Therapeutics (AZCERT) has recently added the proton pump inhibitors (PPIs) omeprazole (Prilosec, and others), esomeprazole (Nexium, and others), lansoprazole (Prevacid, and others), and pantoprazole (Protonix, and generics) to its lists of Drugs with Conditional Risk of Torsades de Pointes (TdP) and Drugs to Avoid in Patients with Congenital Long QT Syndrome.1
PPIs do not directly cause prolongation of the QT interval, but they can cause hypomagnesemia, which is often accompanied by hypocalcemia and hypokalemia and can result in cardiac repolarization disturbances such as QT interval prolongation.2 Reports have described cases of QT interval prolongation and TdP associated with severe PPI-induced hypomagnesemia.3,4 TdP has also been reported in patients taking a PPI concomitantly with drugs that directly prolong the QT interval.5,6 The newer PPIs dexlansoprazole (Dexilant) and rabeprazole (Aciphex, and generics) have not been linked to QT interval prolongation or TdP to date, but they have been associated with hypomagnesemia.
Serum magnesium levels should be monitored periodically in patients taking a PPI for an extended period of time (>2 weeks). If possible, extended PPI therapy should be avoided in patients who require treatment with drugs that carry a known risk of TdP7 and in those with long QT syndrome. If extended PPI therapy must be used with a drug that prolongs the QT interval, close monitoring of magnesium levels and the QT interval is recommended.
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PPIs do not directly cause prolongation of the QT interval, but they can cause hypomagnesemia, which is often accompanied by hypocalcemia and hypokalemia and can result in cardiac repolarization disturbances such as QT interval prolongation.2 Reports have described cases of QT interval prolongation and TdP associated with severe PPI-induced hypomagnesemia.3,4 TdP has also been reported in patients taking a PPI concomitantly with drugs that directly prolong the QT interval.5,6 The newer PPIs dexlansoprazole (Dexilant) and rabeprazole (Aciphex, and generics) have not been linked to QT interval prolongation or TdP to date, but they have been associated with hypomagnesemia.
Serum magnesium levels should be monitored periodically in patients taking a PPI for an extended period of time (>2 weeks). If possible, extended PPI therapy should be avoided in patients who require treatment with drugs that carry a known risk of TdP7 and in those with long QT syndrome. If extended PPI therapy must be used with a drug that prolongs the QT interval, close monitoring of magnesium levels and the QT interval is recommended.
- AZCERT. New drugs added to CredibleMeds drugs lists. November 2, 2016. Available at: www.crediblemeds.org. Accessed November 22, 2016.
- In brief: PPIs and hypomagnesemia. Med Lett Drugs Ther 2011; 53:25.
- EJ Hoorn et al. A case series of proton pump inhibitor-induced hypomagnesemia. Am J Kidney Dis 2010; 56:112.
- BA Hansen and Ø Bruserud. Hypomagnesemia as a potentially life-threatening adverse effect of omeprazole. Oxf Med Case Reports 2016; 2016:147.
- H Asajima et al. Lansoprazole precipitated QT prolongation and torsade de pointes associated with disopyramide. Eur J Clin Pharmacol 2012; 68:331.
- JN Bibawy et al. Pantoprazole (proton pump inhibitor) contributing to torsades de pointes storm. Circ Arrhythm Electrophysiol 2013; 6:e17.
- RL Woosley and KA Romero. QT drugs list. Available at: www.crediblemeds. org. Accessed November 22, 2016.
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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 Peptic Ulcer Disease and GERD
The Medical Letter on Drugs and Therapeutics • April 1, 2014; (Issue 140)
H2-RECEPTOR ANTAGONISTS (H2RAs) —
Currently available H2RAs are listed in Table 1.
These drugs inhibit the action of histamine at the H2-receptor of the gastric parietal cell, decreasing basal
acid...
H2-RECEPTOR ANTAGONISTS (H2RAs) —
Currently available H2RAs are listed in Table 1.
These drugs inhibit the action of histamine at the H2-receptor of the gastric parietal cell, decreasing basal
acid secretion and, to a lesser degree, food-stimulated
acid secretion. All H2RAs are about equally effective
for treatment of PUD and GERD. H2RAs are faster
acting than PPIs in relieving symptoms of dyspepsia or
GERD, but they are not as effective as PPIs in relieving
symptoms or in healing erosive esophagitis. Repeated
administration of H2RAs leads to pharmacologic tolerance
and has been associated with the development
of new dyspeptic symptoms. Rebound acid hypersecretion
can occur after stopping H2RAs.
Drugs for Pain
The Medical Letter on Drugs and Therapeutics • April 1, 2013; (Issue 128)
Pain can be acute or chronic. The two major types of
chronic pain are nociceptive pain and neuropathic
pain. Nociceptive pain can be treated with nonopioid
analgesics or opioids. Neuropathic pain is less...
Pain can be acute or chronic. The two major types of
chronic pain are nociceptive pain and neuropathic
pain. Nociceptive pain can be treated with nonopioid
analgesics or opioids. Neuropathic pain is less responsive
to opioids and is often treated with adjuvant drugs
such as antidepressants and antiepileptics. Combining
different types of analgesics may provide an additive
analgesic effect without increasing adverse effects.
A Fixed-Dose Combination of Ibuprofen and Famotidine (Duexis)
The Medical Letter on Drugs and Therapeutics • October 31, 2011; (Issue 1376)
The FDA has approved Duexis (Horizon), a fixed-dose
combination of the nonsteroidal anti-inflammatory drug
(NSAID) ibuprofen and the H2-receptor antagonist
(H2RA) famotidine, for symptomatic relief of...
The FDA has approved Duexis (Horizon), a fixed-dose
combination of the nonsteroidal anti-inflammatory drug
(NSAID) ibuprofen and the H2-receptor antagonist
(H2RA) famotidine, for symptomatic relief of osteoarthritis
and rheumatoid arthritis and to decrease the risk of
developing gastric and duodenal ulcers in patients at
risk for NSAID-associated ulcers. Vimovo, a combination
of the NSAID naproxen and the proton pump
inhibitor (PPI) esomeprazole, is also approved by the
FDA for prevention of NSAID-associated gastric ulcers.
Drugs for Peptic Ulcer Disease and GERD
The Medical Letter on Drugs and Therapeutics • September 1, 2011; (Issue 109)
Peptic ulcer disease (PUD) is usually caused by nonsteroidal
anti-inflammatory drugs (NSAIDs) or by
infection with Helicobacter pylori. Gastroesophageal
reflux disease (GERD) can be caused by...
Peptic ulcer disease (PUD) is usually caused by nonsteroidal
anti-inflammatory drugs (NSAIDs) or by
infection with Helicobacter pylori. Gastroesophageal
reflux disease (GERD) can be caused by transient
lower esophageal sphincter relaxation, reduced lower
esophageal sphincter tone, hiatal hernia, delayed gastric
emptying or hormonal changes due to pregnancy.
Acid suppressive therapy is the cornerstone of management
for both PUD and GERD.
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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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).
Drugs for Insomnia
The Medical Letter on Drugs and Therapeutics • March 1, 2009; (Issue 79)
The majority of patients with insomnia do not have a predisposing psychiatric disease. Rather, untreated insomnia may be a risk factor for development of psychiatric problems such as depression or...
The majority of patients with insomnia do not have a predisposing psychiatric disease. Rather, untreated insomnia may be a risk factor for development of psychiatric problems such as depression or anxiety.
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.
Treatment of Peptic Ulcers and GERD
The Medical Letter on Drugs and Therapeutics • August 1, 2008; (Issue 72)
Peptic ulcers caused by treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) are mainly gastric ulcers. Most duodenal and other gastric ulcers are caused by the gram-negative bacillus Helicobacter...
Peptic ulcers caused by treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) are mainly gastric ulcers. Most duodenal and other gastric ulcers are caused by the gram-negative bacillus Helicobacter pylori. Gastroesophageal reflux disease (GERD) is caused by gastric acid reflux into the esophagus. Drugs that suppress gastric acid production are the primary treatment for GERD and peptic ulcers.
Proton Pump Inhibitors for GERD in Children
The Medical Letter on Drugs and Therapeutics • February 26, 2007; (Issue 1255)
A recent advertisement for the proton pump inhibitor (PPI) lansoprazole (Prevacid - TAP) suggests that children who cough at night, complain of abdominal pain, refuse to eat, or have a bad taste in their mouths...
A recent advertisement for the proton pump inhibitor (PPI) lansoprazole (Prevacid - TAP) suggests that children who cough at night, complain of abdominal pain, refuse to eat, or have a bad taste in their mouths may all have gastroesophageal reflux disease (GERD). A Bunny's Tummy Trouble, a children's book about GERD published by TAP, is now available as a patient handout in pediatricians' waiting rooms. The use of acid-suppressive drugs in infants and children has increased markedly in recent years and many of these drugs are now available in child-friendly formulations. A table in the article lists some of the drugs used to treat GERD in children.
Drugs for Peptic Ulcers
The Medical Letter on Drugs and Therapeutics • February 1, 2004; (Issue 18)
Most peptic ulcers not caused by nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with infection of the gastric mucosa by the gram-negative bacilli Helicobacter pylori. The majority of NSAID-related...
Most peptic ulcers not caused by nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with infection of the gastric mucosa by the gram-negative bacilli Helicobacter pylori. The majority of NSAID-related ulcers are gastric. H. pylori infection causes both duodenal and gastric ulcers. Eradication of H. pylori promotes healing and markedly decreases recurrence of both duodenal and gastric ulcers (A Shiotamni and DY Graham, Med Clin North Am 2002; 86:1447; FKL Chan and WK Leung, Lancet 2002; 360:933). The first step in the management of peptic ulcers is the diagnosis and treatment of H. pylori.
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
Esomeprazole (Nexium)
The Medical Letter on Drugs and Therapeutics • April 30, 2001; (Issue 1103)
Esomeprazole magnesium (Nexium - AstraZeneca), the S-isomer of omeprazole (Prilosec), is the fifth benzimidazole proton pump inhibitor to become available in the United States. Omeprazole, which was the first,...
Esomeprazole magnesium (Nexium - AstraZeneca), the S-isomer of omeprazole (Prilosec), is the fifth benzimidazole proton pump inhibitor to become available in the United States. Omeprazole, which was the first, is going off patent this year.