Medicines Used in Peptic Ulcers

Lansoprazole (Lanzol, Lanzap)

It acts rapidly and for a longer time than omeprazole. It is given in doses of 30 mg per day for 4 to 12 weeks. Its dose should be decreased in liver disease.

Pentoprazole (Pantocid, Pantodac 40 mg tab, 40 mg inj.) It is similar to omeprazole in action but is available as injectable IV preparation to be used in bleeding peptic ulcers and acute stress ulcers.

Rabeprazole (Tazo, Veloz, 10 mg, 20 mg)

It is the quickest and longer acting drug. It also increases mucus formation in the stomach.

Esomeprazole (Nexpro, Esoz, 20 mg, 40 mg)

It has greater efficacy in GERD and equally effective as omeprazole.

Drugs Providing Protection to Mucosa

Sucralfate (Ulcekon, Ulcerfate, Mucogaurd)

This drug consists of aluminum and contains the salt of sucrose. It becomes a viscous paste in the acid of the stomach, which gets selectively adhered to the ulcer base and provides protection from acid and enzyme pepsin to the ulcer. It also has a protective effect on the cells through local release of prostaglandin. It is used in the treatment of kidney phosphate stones as it reduces blood phosphate levels.

Dosage: The healing dose is 1 g taken one hour before main meals and 1 g at bedtime. A suspension is recommended for the treatment of oral ulcers (aphthous stomatitis). A gel preparation (PEPSIGARD GEL) can be used on bedsores, diabetic foot ulcers and burns.

Adverse Effects: Constipation can occur in 2-3% of the patients. Other adverse effects are nausea, dyspepsia, dry mouth, headache, and itching.

Misoprostol (Cytolog, Misoprost Tab)

It has both, an inhibitory effect on the acid secretion in the stomach and a protective effect on the cells of the stomach. It Increases the protectIve mucus and strengthens the barrier with reduction of the back diffusion of acid. It accelerates ulcer healing. It has been mainly used for treatment of ulcers caused by aspirin and related drugs with low acid. It is given in a dose of 200ug 4 times a day.

Adverse Effects: It produces nausea, dyspepsia, diarrhoea, and abdominal pain. It stimulates the uterus and should be avoided" during pregnancy.

Carbenoxalone (Gastrilcer)

This is extracted from the roots of the plant liquorice. It increases mucus and promotes healing, but because of its serious adverse effect of retaining salt and water, leading to high blood pressure, and availability of safer alternatives, this drug has little or no place in the treatment of gastric ulcers. The claims that the deglycyrrhinized liquorice which does not produce such adverse effects and retains anti-ulcer activity, are far from being true.

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