Review of the best according to the editorial board. On the selection criteria. This material is subjective and does not constitute advertising and does not serve as a purchase guide. Before buying, you need to consult with a specialist.
Proton pump inhibitors (PPIs) are a group of drugs that decrease the synthesis of hydrochloric acid in the stomach. Doctors recommend these funds both for therapeutic and prophylactic purposes.
- When are proton pump inhibitors prescribed?
- Ranking of the best proton pump inhibitors
- Best OTC Proton Pump Inhibitors
- Best Prescription Proton Pump Inhibitors
- The best combination drugs
- Omez DSR _
When are proton pump inhibitors prescribed?
- The main indication for drugs from this group is diseases caused by high acidity of gastric juice: gastric ulcer or duodenal ulcer. As they wrote in old textbooks: 'no acid – no ulcer'. This position remains true even after the discovery of the true cause of peptic ulcer disease – a bacteria called Helicobacter Pilory (Helicobacter pylori).
- To kill this bacteria, proton pump inhibitors can be prescribed when the acidity of the gastric contents is normal. Helicobacter pylori has adapted well to existence in an acidic environment, and with an increase in pH above 4 it becomes more sensitive to antibiotics. Therefore, for its eradication, a complex of PPIs is prescribed, and 2 – 3 antibacterial agents.
- Another acid-dependent disease in which proton pump inhibitors are prescribed is complicated gastroesophageal reflux disease. It disrupts the normal operation of the lower esophageal sphincter – a circular muscle that blocks the flow of stomach contents into the esophagus. Acid constantly falling on unprotected mucous membranes causes inflammation, ulcers, disrupts the normal structure of cells, which over time can lead to malignant neoplasm. PPIs are recommended to protect the esophageal mucosa from acid action.
- Another situation when drugs from this group are recommended for people with normal stomach acidity is chronic pancreatitis with excretory pancreatic insufficiency. Simply put, when the iron, depleted by constant inflammation, produces insufficient enzymes for normal digestion. In such cases, enzyme preparations are usually prescribed. But for them to work, you need an alkaline environment. Alkali to neutralize the acidic food lump coming from the stomach is synthesized by the same pancreas, and if it is insufficient, the taken tablets with enzymes may also be ineffective. To prevent this from happening, proton pump inhibitors are prescribed, reducing the acidity in the stomach, and, therefore, in the food bolus leaving it.
- For preventive purposes, proton pump inhibitors are recommended for people who have to regularly take medications from the group of non-steroidal anti-inflammatory drugs: diclofenac, ibuprofen, paracetamol, aspirin, etc. These medications slow down the regeneration of the stomach lining and often cause 'silent', asymptomatic ulcers. To prevent this, an API is prescribed.
Ranking of the best proton pump inhibitors
|Nomination||a place||Name of product||price|
|Best OTC Proton Pump Inhibitors||1||Omez||73 rbl.|
|Best Prescription Proton Pump Inhibitors||1||Nexium||132 RUB|
|The best combination drugs||1||Pilobact||RUB 1,030|
|2||Omez DSR _||425 RUB|
Best OTC Proton Pump Inhibitors
Speaking of drugs dispensed from pharmacies without a doctor's prescription, it should be noted that drugs with the same active ingredient can be either prescription or not. For example, Omez, which we will talk about in this section of the ranking of the best proton pump inhibitors, is dispensed from pharmacies without a prescription. And its domestic analogue Gastrozol is prescription. An even stranger situation has developed with the drug Ultop, which contains a similar active ingredient: 10 mg capsules are dispensed without a prescription, and 20 and 40 mg are prescription. Therefore, no matter how we would like to use only active substances in the rating, allowing readers to choose from the proposed analogues, taking into account financial capabilities, in this section of the rating of the best proton pump inhibitors we are forced to use the trade names of the drugs.
OTC PPIs can be taken on their own for 2 weeks, but if they do not bring relief in the first 3 days, it is best to see your doctor right away.
Active ingredient: Omeprazole.
A time-tested product that combines proven effectiveness and affordable price. Available in capsules of 10, 20 and 40 mg. Capsules are taken 1 time per day half an hour before meals with water. If necessary, the capsule can be opened and the contents mixed with water or food.
The dosage is selected individually, most often the therapeutic effect appears when taking 20 mg, but 10 mg is often enough (or, conversely, a higher dose is needed).
The most common side effects are headache, insomnia, dizziness, diarrhea or constipation, nausea, bloating, and abdominal pain.
The drug is contraindicated for use in children under 18 years of age (omeprazole is allowed in pediatrics from 2 years of age, but for patients of this age there are separate forms), with individual intolerance.
Can be used during pregnancy.
Possible over-the-counter counterparts: Ultop.
- can be taken by pregnant women.
- does not combine with some antiviral and antifungal drugs (for more details, see the instructions)
Active ingredient: pantoprazole.
A combination of German quality and relatively affordable prices. It is available in tablets of 20 and 40 mg, without a prescription it is dispensed only in the minimum dosage.
Take 20 mg once daily before meals with plenty of fluids (some patients may need a higher dose).
Effective from the first days of admission, but the maximum effect is achieved only after a week of regular use (if in the first days it reduces gastric secretion by 26%, then in a week – up to 50%), therefore, the disappearance of symptoms can be judged not earlier than after 5-7 days reception. The acidity is restored in 3 – 4 days after the end of the application.
Unlike other proton pump inhibitors from this section of the ranking of the best remedies, Controloc can be taken without consulting a doctor for up to 4 weeks.
The most common side effects are indigestion (nausea, bloating, pain, constipation or diarrhea); headache, dizziness.
It is combined with almost any medicinal product (with the exception of azatanovir, in which therapy it is contraindicated to take Controlok).
Not recommended for children under 18 years old, pregnant and lactating due to lack of information on safety in these groups of people.
Possible OTC counterparts: Panum, Paltaz.
- relatively affordable price,
- combines with most drugs.
- 14 tablets per pack, which is inconvenient for constant intake.
Active substance: rabeprazole
Formally, the license for the production of this drug belongs to the Russian branch of Johnson and Johnson, but the substance (active ingredient) is produced in Switzerland, and the tablets themselves are in Japan. So the quality of this proton pump inhibitor is beyond question, but the price is quite high.
Available in dosages of 10 and 20 mg, the first is dispensed without a prescription.
Take 1 tablet a day without crushing or chewing the tablet. Neither time of day nor food intake affects the effectiveness of the drug.
The effect begins to appear within an hour after ingestion, and within a day, gastric secretion decreases by 69%.
It is combined with most medicines, but it is not recommended to take it simultaneously with azatonavir.
Contraindicated in case of individual intolerance, pregnancy, lactation and children under 18 years of age due to the lack of safety studies in these groups.
Possible OTC counterparts: Bereta, Norflux, Ulcernil, Rabelok.
- efficiency does not depend on food intake,
- combines with most drugs.
- high price.
Best Prescription Proton Pump Inhibitors
In this section, we have compiled drugs that should only be sold with a doctor's prescription.
Active ingredient: esomeprazole.
It is available in the form of tablets for oral administration of 20 and 40 mg, as well as in the form of a powder for the preparation of suspensions at a dosage of 10 mg.
This is one of the few original modern medicines with an affordable price (except for the form of production in powder, which has no analogues on the Russian market)
When taken for the first time, the action begins within an hour, the effect 'reaches its maximum' by the 5th day of use, reducing the concentration of hydrochloric acid in gastric juice by 90%.
The usual method of application is once a day, but if the medicine is prescribed in combination with antibiotics to destroy Helicobacterium – 2 times a day along with antibiotics.
Esomeprazole powder can be used to treat children, but indications are limited to GERD and reflux esophagitis.
Side effects – headache, dyspepsia.
Contraindicated in case of individual intolerance, children under one year old, pregnant lactating women due to lack of safety data.
Possible analogues: Esomeprazole, Emanera, Pemozar, Rediomez
Active ingredient: lansoprazole.
Available in capsules of 15 and 30 mg.
The effect increases during the first 4 days of administration, at the maximum, a decrease in the synthesis of hydrochloric acid is achieved up to 97%. The restoration of functions occurs in 3 – 4 days after the termination of use. Food intake slows down absorption but does not affect effectiveness.
Consume once a day, preferably in the morning. If the medicine is prescribed for the destruction of Helicobacter, you need to take it 2 times a day. If antacids are prescribed in parallel, it is better to take them separately with Lancid, since they interfere with the complete absorption of the drug.
Possible adverse events are typical for the entire group of proton pump inhibitors – abdominal discomfort, stool disturbances, bloating, headache.
Contraindicated in case of individual intolerance, in the 1st trimester of pregnancy (but there are no safety studies in other periods), during lactation.
Possible analogs: Lanzabel, Lanzaptol, Epikur.
- affordable price;
- prohibited during pregnancy.
The active ingredient is dexlansoprazole.
On the one hand, this agent is based on a relatively new active substance with high biological activity. On the other hand, until the patent expires and generics appear, the original manufacturer remains a monopolist, and the price of the drug is quite high.
Available in capsules of 30 and 60 mg.
The peculiarity of this drug is not only in the active substance, but also in the form of release. At first glance, ordinary capsules are packed with several types of granules that dissolve in the intestine, depending on the pH of the medium. That is, after administration, not all of the active substance is released at once. and different granules dissolve at different times as the food bolus progresses. Due to this, the effect comes on more smoothly and lasts longer. If necessary, the capsule can be opened and the contents diluted in a little water or food that does not require chewing.
Possible side effects – flatulence, dyspepsia.
Contraindicated in case of individual intolerance, patients taking HIV protease inhibitors, children under 18 years of age, pregnant and lactating.
- original drug,
- modified release, prolonging effect.
- high price.
The best combination drugs
As already mentioned, proton pump inhibitors are often prescribed in combination with antibiotics to destroy Helicobacter pylori, eliminating the cause of ulcers or gastritis. To save the patient from the need to remember when and what pills to take, they began to produce drugs that combine these groups of drugs in one tool. Another possible combination is proton pump inhibitors and agents. normalizing the motility of the gastrointestinal tract. They are prescribed to treat reflux esophagitis.
Strictly speaking. it is not a single drug, but a set of tablets and capsules containing the proton pump inhibitor omeprazole, the antibiotic clarithromycin and the antibacterial and antiprotozoal agent tinidazole. All this is packed in strips with the words 'morning' or 'evening'. You need to take the contents of the corresponding strip during or immediately after eating, as is clear from the description – in the morning and in the evening. Do not divide, chew, or otherwise crush tablets or capsules.
- intolerance to the components,
- alcoholism (cannot be combined with ethyl alcohol),
- liver or kidney failure
- impaired bone marrow hematopoiesis,
- children, pregnant women, lactating.
The course of treatment is from 7 to 14 days, specific recommendations are given by the attending physician. The package of the drug is designed for 7 days, so you may need two.
- a full range of drugs to eliminate Helicobacter pylori.
- many contraindications and side effects.
- high price.
Omez DSR _
A combination of 20 mg of omeprazole and 30 mg of domperidone, a gastrointestinal motility regulator. It minimizes the possible reflux of bile, restoring normal peristalsis of the esophagus and stomach, and reduces the acidity of gastric juice. thus reducing damage to the esophagus and promoting healing. In addition, the agent can be used to relieve nausea and vomiting caused by an exacerbation of gastritis, gastric ulcer.
Take 1 time per day half an hour before meals.
- the simultaneous use of some antiviral, antifungal and antibacterial agents (for more information, we refer readers to the instructions, since the list is not limited to 1 – 2 items);
- gastrointestinal bleeding, perforation, intestinal obstruction;
- moderate and severe liver failure,
- pregnant and lactating
- children under 18 years old.
- normalizes the motility of the esophagus, stomach, intestines,
- a wide range of contraindications,
- undesirable effects are possible.
Attention! This rating is subjective and does not constitute an advertisement and does not serve as a purchase guide. Before buying, you need to consult with a specialist.