* Review of the best according to the editors of ecdfburma.org. About the selection criteria. This material is subjective, is not an advertisement and does not serve as a guide to the purchase. Before buying, you need to consult with a specialist.
Proton Pump Inhibitors (PPIs) are a group of drugs that reduce the synthesis of hydrochloric acid in the stomach. Doctors recommend these funds for both therapeutic and prophylactic purposes.
When proton pump inhibitors are prescribed
- The main indication for drugs from this group is diseases caused by increased acidity of the gastric juice: peptic ulcer of the stomach or duodenum. As they wrote in old textbooks: "no acid - no ulcers." This situation remains true even after the discovery of the true cause of peptic ulcer disease - a bacteria called Helicobacter Pilory (Helicobacter pylori).
- To destroy this bacterium, proton pump inhibitors can also be prescribed with normal acidity of the gastric contents. Helicobacter is well adapted to exist 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 and 2 to 3 antibacterial agents are prescribed.
- Another acid-dependent disease in which proton pump inhibitors are prescribed is complicated gastroesophageal reflux disease. With it, the normal operation of the lower esophageal sphincter, the circular muscle that blocks the flow of stomach contents into the esophagus, is disrupted. Constantly falling on unprotected mucous acid causes inflammation, ulcers, disrupts the normal structure of cells, which over time can lead to malignant neoplasms. To protect the mucous membrane of the esophagus from acid and recommend PPI.
- Another situation where drugs from this group are recommended for people with normal acidity of the stomach are chronic pancreatitis with excretory pancreatic insufficiency. Simply put, when exhausted by constant inflammation of iron, it does not produce enough enzymes for normal digestion. In such cases, enzyme preparations are usually prescribed. But for them to work, an alkaline environment is needed. Alkali to neutralize the acidic food lump coming from the stomach, synthesizes the same pancreas, and with its insufficiency, 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 lump coming out of it.
- For prophylactic purposes, proton pump inhibitors are recommended for people who are forced to regularly take drugs from the group of non-steroidal anti-inflammatory drugs: diclofenac, ibuprofen, paracetamol, aspirin, etc. These drugs slow down the regeneration of the gastric mucosa and often cause "mute", asymptomatic ulcers. To prevent this, an IPP is prescribed.
Rating of the best proton pump inhibitors
|Nomination||a place||Name of product||price|
|Top OTC Proton Pump Inhibitors||1||Omez||73 ₽|
|3||Soars||1 698 ₽|
|Best Prescription Proton Pump Inhibitors||1||Nexium||132 ₽|
|The best combination drugs||1||Pilobact||1 030 ₽|
|2||Omez DSR||425 ₽|
Top OTC Proton Pump Inhibitors
Speaking about drugs dispensed from pharmacies without a doctor’s prescription, it should be noted that drugs with the same active substance can be both prescription and not. For example, Omez, which we will discuss in this section of the ranking of the best proton pump inhibitors, is dispensed from pharmacies without a prescription. And its domestic counterpart Gastrozole is a prescription. An even stranger situation is with the Ultop drug, which contains a similar active substance: 10 mg capsules are dispensed without a prescription, and 20 and 40 mg are prescribed. 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 possibilities, in this section of the rating of the best proton pump inhibitors we are forced to use the trade names of the drugs.
Over-the-counter PPIs can be taken on their own for 2 weeks, but if in the first 3 days they do not bring relief, it is best to consult a doctor right away.
Active ingredient: Omeprazole.
A time-tested tool 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, washed down with water. If necessary, the capsule can be opened and 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 necessary).
Of the side effects, the most common are headache, insomnia, dizziness, diarrhea or constipation, nausea, bloating, and abdominal pain.
The drug is contraindicated for use by children under 18 years of age (omeprazole is allowed in pediatrics from 2 years old, but for patients of this age there are separate forms), with individual intolerance.
It can be used during pregnancy.
Possible over-the-counter analogues: Ultop.
- can be taken by pregnant women.
- not compatible with certain antiviral and antifungal drugs (for more details, see the instructions)
Active ingredient: pantoprazole.
A combination of German quality and relatively affordable price. Available in tablets of 20 and 40 mg, over-the-counter is dispensed only in the minimum dosage.
Take 20 mg once daily before meals with a sufficient amount of liquid (some patients may require a higher dose).
Effective from the first days of administration, 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 after a week - up to 50%), therefore, you can judge the disappearance of symptoms no earlier than after 5-7 days reception. Acidity is restored 3 to 4 days after the end of use.
Unlike other proton pump inhibitors from this section of the ranking of the best drugs, Controlok can be taken without consulting a doctor for up to 4 weeks.
The most common side effects are digestive disorders (nausea, bloating, pain, constipation or diarrhea); headache, dizziness.
It is combined with almost any medication (with the exception of azatanovir, which is contraindicated in taking Controlok).
Not recommended for children under 18 years of age, pregnant and lactating due to lack of safety information for these groups of people.
Possible over-the-counter analogues: Panum, Paltaz.
- relatively affordable price,
- combined with most drugs.
- 14 tablets per pack, which is inconvenient for continuous use.
Active substance: rabeprazole
Formally, the license for the production of this medicine belongs to the Russian branch of Johnson and Johnson, but the substance (active substance) is produced in Switzerland, and the tablets themselves are in Japan. So the quality of this proton pump inhibitor is not in doubt, but the price is quite high.
Available in dosages of 10 and 20 mg, the first is dispensed without a prescription.
Take 1 tablet daily without crushing or chewing the tablet. Neither time of day, nor food intake affect the effectiveness of the drug.
The effect begins to appear within an hour after administration, and within a day, gastric secretion decreases by 69%.
It is combined with most drugs, but simultaneous administration with azatonavir is not recommended.
It is contraindicated in case of individual intolerance, pregnancy, lactation and for children under 18 years of age due to the lack of safety studies in these groups.
Possible over-the-counter analogues: Beret, Norflux, Ultsernil, Rabelok.
- effectiveness is independent of food intake
- combined with most drugs.
- high price.
Best Prescription Proton Pump Inhibitors
In this section, we have collected drugs that should only be sold by 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 in a dosage of 10 mg.
This is one of the few original modern medicines with an affordable price (except for the powder form, which has no analogues on the Russian market)
At the first dose, the action begins within an hour, the effect "reaches its maximum" by the 5th day of use, reducing the concentration of hydrochloric acid in the gastric juice by 90%.
The usual method of use is 1 time per day, but if the medicine was prescribed in combination with antibiotics to kill Helicobacter, 2 times a day along with antibiotics.
Esomeprazole powder can be used to treat children, but the indications are limited to GERD and reflux esophagitis.
Side effects - headache, dyspepsia.
Contraindicated in case of individual intolerance, to children up to a year, pregnant women nursing 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 a maximum, a decrease in the synthesis of hydrochloric acid to 97% is achieved. Function recovery occurs 3 to 4 days after discontinuation of use. Eating slows down absorption but does not affect effectiveness.
Consume 1 time per day, preferably in the morning. If the medicine is prescribed to destroy Helicobacter pylori, it should be taken 2 times a day. If antacids are prescribed in parallel, it is better to take them separately with Lantsidom, since they prevent the complete absorption of the drug.
Possible adverse events are typical for the entire group of proton pump inhibitors - abdominal discomfort, stool, 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 analogues: Lanzabel, Lanzaptol, Epicurus.
- affordable price;
- prohibited during pregnancy.
The active substance 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 expired and generics appeared, the original manufacturer remains a monopolist, and the price of the medicine 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. In ordinary, at first glance, capsules, several types of granules are packed, which dissolve in the intestine depending on the pH of the medium. That is, after administration, not all active substance is released at once. and different granules dissolve at different times as the food lump moves. Due to this, the effect occurs more smoothly and lasts longer. If necessary, the capsule can be opened and diluted in a small amount of water or food that does not require chewing.
Possible side effects are flatulence, dyspepsia.
It is contraindicated in case of individual intolerance, to patients taking HIV protease inhibitors, children under 18 years old, 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 which pills to take, they began to produce drugs that combine these groups of drugs in one remedy. Another possible combination is proton pump inhibitors and agents. normalizing the motility of the gastrointestinal tract. They are prescribed for the treatment of reflux esophagitis.
Strictly speaking. this is not one drug, but a set of tablets and capsules containing the proton pump inhibitor omeprazole, the antibiotic clarithromycin, and the drug with the antibacterial and antiprotozoal effect of tinidazole. All this is packed in strips with the inscription "morning" or "evening". The contents of the corresponding strip should be taken during or immediately after a meal, as is clear from the description, in the morning and evening. It is impossible to divide, chew or in any other way grind tablets or capsules.
- intolerance to components
- alcoholism (can not be combined with ethyl alcohol),
- liver or kidney failure,
- impaired bone marrow hematopoiesis,
- children, pregnant, lactating.
The course of treatment is from 7 to 14 days, the doctor gives specific recommendations. The package of the drug is designed for 7 days, so you may need two.
- full range of drugs to eliminate Helicobacter pylori.
- many contraindications and side effects.
- high price.
A combination of 20 mg of omeprazole and 30 mg of domperidone, a regulator of gastrointestinal motility. It minimizes the possible reflux of bile, restoring the normal peristalsis of the esophagus and stomach, and reduces the acidity of the gastric juice. thereby reducing damage to the esophagus and promoting its healing. In addition, the tool can be used to reduce nausea and vomiting caused by exacerbation of gastritis, gastric ulcer.
Take 1 time per day half an hour before meals.
- the simultaneous use of certain antiviral, antifungal and antibacterial agents (for more information, refer readers to the instructions, since the list is not limited to 1 to 2 items);
- gastrointestinal bleeding, perforation, intestinal obstruction;
- liver failure of moderate and severe degree,
- pregnant and lactating,
- children under 18 years old.
- normalizes the motility of the esophagus, stomach, intestines,
- wide range of contraindications
- adverse events are possible.
Attention! This rating is subjective, is not an advertisement and does not serve as a guide to the purchase. Before buying, you need to consult with a specialist.