Published on 30 September 2022
Anti-ulcer drugs are used to treat digestive tract conditions that arise from the acidity in the stomach and reflux of the acid into the lower foodpipe. They are often used without a prescription. It is therefore necessary to be aware of a couple of recent recommendations regarding the anti-ulcer drugs ranitidine and proton pump inhibitors.
Ranitidine is a widely used anti-ulcer drugs. It has been withdrawn from the market in the United States. It has also been removed from the list of Essential Drugs in India, though it is still available in India.
The withdrawal of ranitidine comes following the detection of an impurity called N-Nitrosodimethylamine (NDMA) in ranitidine formulations. The levels of NDMA in ranitidine increase if the formulation is kept for a long time or stored at temperatures higher than room temperature. NDMA can increase the risk for cancers if taken in high quantities over long periods, and therefore as a precaution, ranitidine is currently not recommended.
Ranitidine is usually taken for short duration, and it is unlikely that most users of ranitidine would develop cancers due to the impurity in the formulations. Those taking ranitidine may be shifted to other medications to control their gastric acidity.
Proton Pump Inhibitors
Proton pump inhibitors include the drugs esomeprazole, omeprazole, pantoprazole, lansoprazole, rabeprazole, ilaprazole, and dexlansoprazole. These drugs are used to treat conditions such as stomach ulcers and acid reflux for specified durations, which is usually up to 8 weeks. Some patients require long-term continuous treatment with these drugs.
Recent recommendations advise that if a person does not require these drugs, the dose should be reduced and subsequently they should be discontinued. This will not only reduce the cost of treatment, it could also prevent side effects that may be associated with the long-term use of the medications. Other treatments can be tried out for short-term relief of symptoms that could arise following the discontinuation of the drugs.
Helgadottir H, Bjornsson ES. Problems Associated with Deprescribing of Proton Pump Inhibitors. Int J Mol Sci. 2019 Nov 2;20(21):5469. doi: 10.3390/ijms20215469. Available under Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/)
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