Matching articles for "Protonix"

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.
Med Lett Drugs Ther. 2022 Apr 4;64(1647):49-56 | Show Full IntroductionHide Full Introduction

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
Med Lett Drugs Ther. 2022 Apr 4;64(1647):e56-7 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2018 Jan 15;60(1538):9-16 | Show Full IntroductionHide Full Introduction

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
Med Lett Drugs Ther. 2018 Jan 15;60(1538):e16-8 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2017 Aug 14;59(1527):131-3 | Show Full IntroductionHide Full Introduction

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.

  1. AZCERT. New drugs added to CredibleMeds drugs lists. November 2, 2016. Available at: www.crediblemeds.org. Accessed November 22, 2016.
  2. In brief: PPIs and hypomagnesemia. Med Lett Drugs Ther 2011; 53:25.
  3. EJ Hoorn et al. A case series of proton pump inhibitor-induced hypomagnesemia. Am J Kidney Dis 2010; 56:112.
  4. BA Hansen and Ø Bruserud. Hypomagnesemia as a potentially life-threatening adverse effect of omeprazole. Oxf Med Case Reports 2016; 2016:147.
  5. H Asajima et al. Lansoprazole precipitated QT prolongation and torsade de pointes associated with disopyramide. Eur J Clin Pharmacol 2012; 68:331.
  6. JN Bibawy et al. Pantoprazole (proton pump inhibitor) contributing to torsades de pointes storm. Circ Arrhythm Electrophysiol 2013; 6:e17.
  7. RL Woosley and KA Romero. QT drugs list. Available at: www.crediblemeds. org. Accessed November 22, 2016.


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Med Lett Drugs Ther. 2016 Dec 5;58(1509):153 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2015 Jun 22;57(1471):91 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2014 Oct 27;56(1454):103-8 | Show Full IntroductionHide Full Introduction

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

  1. Drugs for peptic ulcer disease and GERD. Treat Guidel Med Lett 2014; 12:25.


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Med Lett Drugs Ther. 2014 Jul 21;56(1447):64 | Show Full IntroductionHide Full Introduction

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.
Treat Guidel Med Lett. 2014 Apr;12(140):25-30 | Show Full IntroductionHide Full Introduction

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.
Treat Guidel Med Lett. 2011 Sep;9(109):55-60 | Show Full IntroductionHide Full Introduction

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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Med Lett Drugs Ther. 2010 Nov 29;52(1352):93 | Show Full IntroductionHide Full Introduction

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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Med Lett Drugs Ther. 2010 Mar 8;52(1333):17-9 | Show Full IntroductionHide Full Introduction

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).
Med Lett Drugs Ther. 2009 Mar 23;51(1308):21-2 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2009 Feb 23;51(1306):13-4 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2009 Jan 12;51(1303):2-3 | Show Full IntroductionHide Full Introduction

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.
Treat Guidel Med Lett. 2008 Aug;6(72):55-60 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2007 Feb 26;49(1255):17-8 | Show Full IntroductionHide Full Introduction

AmpliChip CYP450 Test

   
The Medical Letter on Drugs and Therapeutics • August 15, 2005;  (Issue 1215)
The FDA recently cleared the AmpliChip CYP450 Test (Roche), which analyzes blood-derived DNA to detect genetic variations in the activity of cytochrome P450 (CYP) enzymes CYP2D6 and CYP2C19 and determines the...
The FDA recently cleared the AmpliChip CYP450 Test (Roche), which analyzes blood-derived DNA to detect genetic variations in the activity of cytochrome P450 (CYP) enzymes CYP2D6 and CYP2C19 and determines the metabolizer status of the patient. The test is intended to help guide clinicians in prescribing individualized drug therapy. About 25% of all drugs, including many antidepressants and antipsychotics, are substrates of either CYP2D6 or CYP2C19. The test is being promoted initially to psychiatrists.
Med Lett Drugs Ther. 2005 Aug 15;47(1215):71-2 | Show Full IntroductionHide Full Introduction

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.
Treat Guidel Med Lett. 2004 Feb;2(18):7-12 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2003 Jun 8;45(1158):46-8 | Show Full IntroductionHide Full Introduction

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.
Med Lett Drugs Ther. 2001 Apr 30;43(1103):36-7 | Show Full IntroductionHide Full Introduction

Pantoprazole: A Clarification

   
The Medical Letter on Drugs and Therapeutics • August 7, 2000;  (Issue 1084)
The Medical Letter article on pantoprazole (July 24, 2000) stated that, according to Medical Letter consultants, pantoprazole tablets, like rabeprazole tablets (Aciphex), can be crushed and administered through...
The Medical Letter article on pantoprazole (July 24, 2000) stated that, according to Medical Letter consultants, pantoprazole tablets, like rabeprazole tablets (Aciphex), can be crushed and administered through a feeding tube. The article should have specified that this can only be done through a feeding tubes placed distal to the stomach because all proton pump inhibitors are inactivated by gastric acid. The labeling of pantoprazole and rabeprazole advises against crushing the tablets because oral administration is assumed and both drugs are formulated to prevent inactivation in the stomach.
Med Lett Drugs Ther. 2000 Aug 7;42(1084):72 | Show Full IntroductionHide Full Introduction

Pantroprazole (Protonix)

   
The Medical Letter on Drugs and Therapeutics • July 24, 2000;  (Issue 1083)
Pantoprazole, the fourth benzimidazole proton pump inhibitor to become available in the United States, has been marketed for short-term oral treatment of erosive gastroesophageal reflux disease...
Pantoprazole, the fourth benzimidazole proton pump inhibitor to become available in the United States, has been marketed for short-term oral treatment of erosive gastroesophageal reflux disease (GERD).
Med Lett Drugs Ther. 2000 Jul 24;42(1083):65-6 | Show Full IntroductionHide Full Introduction