Proton-pump inhibitors (PPIs) represent a new and mighty weapon against stomach and duodenal ulcers, gastroesophageal reflux disease (heartburn), and other conditions, where it is an excess of stomach acid, which is the main culprit of illness. For the time being, there are five representatives of the PPI class of medications, approved and available on the U.S. market:
- lansoprazole (brand name Prevacid)
- omeprazole (brand name Prilosec, Zegerid)
- pantoprazole (brand name Protonix)
- esomeprazole (brand name Nexium)
- rabeprazole (brand name Aciphex)
Besides, proton pump inhibitors can be found in some combination drugs, such as Prevpac and NapraPAC. Prevpac is the combination of lansoprazole and two antibiotics, amoxicillin and claritromycin; such combination works best in the treatment of gastrointestinal ulcers, caused by H. pilory bacteria. NapraPAC contains lansoprazole and naproxen, which is nonsteroidal anti-inflammatory drug. NapraPAC is usually prescribed for treating osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis.
Being the representative of one and the same class of medications, all the above mentioned drugs are very similar in the mode of action, effectiveness and safety profiles. That is why choosing a particular medication depends on the doctor’s preference or patient’s medical insurance. However, some differences still exist – and some of them may be of key importance when choosing proton pump inhibitor in every particular case.
The common features of all PPIs, as well as the distinguishing features of particular medications, are summarized in the following table, which is compiled exclusively for Pillwatch.com readers.
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Year of approval
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2001
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2000
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1999
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1995
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1989
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Manufacturer
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Astrazeneca
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Wyeth pharms
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Eisai
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Takeda Pharms
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Astrazeneca
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Mode of action
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provide a long-lasting reduction of gastric acid production by “shutting down” acid-producing “proton pumps”, which are situated in the mucous lining of the stomach |
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Recommended daily dose
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20-40 mg
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40 mg
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20 mg
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15-30 mg
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20-40 mg
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Side Effects
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Headache, diarrhea, abdominal pain
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Headache (6%),
Diarrhea (4%), flatulence (2%), abdominal pain (1), hyperglycemia (1%), eructation (1%) |
Pain (3%), pharyngitis (3%), flatulence (3%), infection (2 %), constipation (2 %) |
Diarrhea (3.8%), abdominal pain (2.1%), nausea (1.3%), constipation (1.0%) |
Headache (6.9%), abdominal pain (5.2%), nausea (4%), diarrhea (3.7%), vomiting (3.2%), flatulence (2.7%) |
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Clinically proved efficacy in relieving heartburn |
After treatment 70.5 – 74.2% of patients experienced no heartburn for 7 consecutive days according to 4 clinical studies |
Reduced number of heartburn episodes up to 5.1 (daytime) and 3.9 (nighttime) at month 1, and 2.9 (daytime) and 2.5 (nighttime) at month 12 |
69-92 % of patients without relapse of heartburn at week 52 according to 2 clinical studies |
84% of days without heartburn at week 8 |
NA
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Average cost per pill
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5.3 $ (brand)
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4.46 $ (brand)
3.63 $ (generic)
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5.3 $ (brand)
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5.3 $ (brand)
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0.64 $ (OTC)
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Known benefits
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Rapid onset of action; works longer than other PPIs |
Lowest cost among brand PPIs
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Rapid onset of action
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No headache
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No prescription
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