Year 2016 / Volume 108 / Number 3
Review
Practical considerations in the management of proton-pump inhibitors

145-153

DOI: 10.17235/reed.2015.3812/2015

Lara Aguilera Castro, Carlos Martín de Argila de Prados, Agustín Albillos Martínez,

Abstract
Proton-pump inhibitors (PPIs) are one of the most active ingredients prescribed in Spain. In recent decades there has been an overuse of these drugs in both outpatient clinics and hospitals that has lead to a significant increase in healthcare spending and to an increase in the risk of possible side effects. It is important for health professionals to know the accepted indications and the correct doses for the use of these drugs. On the market there are different types of PPI: omeprazole, pantoprazole, lansoprazole, rabeprazole and esomeprazole. Omeprazole is the oldest and most used PPI, being also the cheapest. Although there are no important differences between PPIs in curing diseases, esomeprazole, a new-generation PPI, has proved to be more effective in eradicating H. pylori and in healing severe esophagitis compared to other PPIs. In recent years the use of generic drugs has spread; these drugs have the same bioavailability than the original drugs. In the case of PPIs, the few comparative studies available in the literature between original and generic drugs have shown no significant differences in clinical efficacy.
Share Button
New comment
Comments
No comments for this article
References
1. Diaz-Rubio M. Historical perspective of gastric acid inhibition. Drugs 2005; 65 (Suppl 1): 1-6.
2. Banic M, Malfertheiner P, Babic Z, et al. Historical impact to drive research in peptic ulcer disease. Dig Dis 2011; 29: 444-53. DOI: 10.1159/000331512
3. Black JW, Duncan WA, Durant CJ,et al. Definition and antagonism of histamine H 2 -receptors. Nature 1972; 236: 385-90. DOI: 10.1038/236385a0
4. Martin de Argila de Prados C. Crónica de una revolución: Manejo de las enfermedades relacionadas con la secreción ácida del estómago. Línea de comunicación 2015, Madrid (en imprenta).
5. Vela MF. Medical treatments of GERD: the old and new. Gastroenterol Clin North Am 2014; 43: 121-33. DOI: 10.1016/j.gtc.2013.12.001
6. Sachs G. Pump blockers and ulcer disease. N Engl J Med 1984; 310: 785-6. DOI: 10.1056/NEJM198403223101211
7. Subgrupos ATC y Principios activos de mayor consumo en el Sistema Nacional de Salud en 2010. Información terapéutica del Sistema Nacional de Salud 2011; 35: 124-128.
8. García del Pozo J. Estudio de utilización de antiulcerosos en España (2000-2008). Información terapéutica de la Seguridad Social 2009; 33: 49-54.
9. Simo Miñana J. Utilización de medicamentos en España y en Europa. Aten Primaria 2012; 44: 335-47. DOI: 10.1016/j.aprim.2011.06.009
10. Sanchez-Cuen JA, Irineo-Cabrales AB, Bernal-Magana G, et al. Inadequate prescription of chronic consumption of proton pump inhibitors in a hospital in Mexico. Cross-sectional study. Rev Esp Enferm Dig 2013; 105: 131-6. DOI: 10.4321/S1130-01082013000300003
11. Ponce J, Esplugues JV. Rationalizing the use of PPIs: an unresolved matter. Rev Esp Enferm Dig 2013; 105: 121-4. DOI: 10.4321/S1130-01082013000300001
12. Ksiadzyna D, Szelag A, Paradowski L. Overuse of proton pump inhibitors. Pol Arch Med Wewn 2015 (en imprenta).
13. Martin-Echevarria E, Pereira Julia A, Torralba M, et al. Evaluacion del uso de los inhibidores de la bomba de protones en un servicio de medicina interna. Rev Esp Enferm Dig 2008; 100: 76-81. DOI: 10.4321/S1130-01082008000200003
14. De Burgos Lunar C, Novo del Castillo S, Llorente Diaz E, et al. Estudio de prescripcion-indicacion de inhibidores de la bomba de protones. Rev Clin Esp 2006; 206: 266-70. DOI: 10.1157/13088585
15. Zink DA, Pohlman M, Barnes M,et al. Long-term use of acid suppression started inappropriately during hospitalization. Aliment Pharmacol Ther 2005; 21: 1203-9. DOI: 10.1111/j.1365-2036.2005.02454.x
16. Eid SM, Boueiz A, Paranji S, et al. Patterns and predictors of proton pump inhibitor overuse among academic and non-academic hospitalists. Intern Med 2010; 49: 2561-8. DOI: 10.2169/internalmedicine.49.4064
17. Garcia Rodriguez LA, Ruigomez A, Panes J. Use of acid-suppressing drugs and the risk of bacterial gastroenteritis. Clin Gastroenterol Hepatol 2007; 5: 1418–23. DOI: 10.1016/j.cgh.2007.09.010
18. Bavishi C, Dupont HL. Systematic review: the use of proton pump inhibitors and increased susceptibility to enteric infection. Aliment Pharmacol Ther 2011; 34:1269–1281. DOI: 10.1111/j.1365-2036.2011.04874.x
19. Janarthanan S, Ditah I, Adler DG, et al. Clostridium difficile-associated diarrhoea and proton pump inhibitor therapy: a metaanalysis. Am J Gastroenterol 2012; 107: 1001-10. DOI: 10.1038/ajg.2012.179
20. Leonard J , Marshall JK , Moayyedi P . Systematic review of the risk of enteric infection in patients taking acid suppression. Am J Gastroenterol 2007; 102: 2047–56. DOI: 10.1111/j.1572-0241.2007.01275.x
21. Laheij RJ, Sturkenboom MC, Hassing RJ, et al. Risk of community-acquired pneumonia and use of gastric acidsuppressive drugs. JAMA 2004; 292: 1955–60. DOI: 10.1001/jama.292.16.1955
22. Gulmez SE, Holm A, Frederiksen H, et al. Use of proton pump inhibitors and the risk of community-acquired pneumonia: a population-based case-control study. Arch Intern Med 2007; 167: 950–5. DOI: 10.1001/archinte.167.9.950
23. Eom CS, Jeon CY, Lim JW, et al. Use of acid-suppressive drugs and risk of pneumonia: a systematic review and metaanalysis. CMAJ 2011; 183: 310-19. DOI: 10.1503/cmaj.092129
24. Dublin S, Walker RL, Jackson ML, et al. Use of proton pump inhibitors and H2 blockers and risk of pneumonia in older adults: a population-based casecontrol study. Pharmacoepidemiol Drug Saf 2010; 19: 792–802. DOI: 10.1002/pds.1978
25. Filion KB, Chateau D, Targownik LE, et al. Proton pump inhibitors and the risk of hospitalisation for community-acquired pneumonia: replicated cohort studies with metaanalysis. Gut 2014; 63: 552-8. DOI: 10.1136/gutjnl-2013-304738
26. Wang YP, Liu CJ, Chen TJ, et al. Proton pump inhibitor use significantly increases the risk of cryptogenic liver abscess: a population-based study. Aliment Pharmacol Ther 2015; 41: 1175-81. DOI: 10.1111/apt.13203
27. Khalili H, Huang ES, Jacobson BC, et al. Use of proton pump inhibitors and risk of hip fracture in relation to dietary and lifestyle factors: a prospective cohort study. BMJ 2012; 344: e372. DOI: 10.1136/bmj.e372
28. Targownik LE, Lix LM, Leung S, et al. Proton-pump inhibitor use is not associated with osteoporosis or accelerated bone mineral density loss. Gastroenterology 2010; 138: 896-904. DOI: 10.1053/j.gastro.2009.11.014
29. Lam JR, Schneider JL, Zhao W, et al. Gastric acid-inhibiting medications and vitamin B12 deficiency. JAMA 2013; 310: 2435-42. DOI: 10.1001/jama.2013.280490
30. Jung SB, Nagaraja V, Kapur A, et al. Association between vitamin B12 deficiency and long-term use of acid-lowering agents: a systematic review and meta-analysis. Intern Med J 2015; 45: 409-16. DOI: 10.1111/imj.12697
31. Danziger J, William JH, Scott DJ, et al. Proton-pump inhibitor use is associated with low serum magnesium concentrations. Kidney Int 2013; 83: 692–699. DOI: 10.1038/ki.2012.452
32. Sumukadas D, McMurdo MET, Habicht D. Proton pump inhibitors are associated with lower magnesium levels in older people with chronic kidney disease. J Am Geriatr Soc 2012; 60: 392-3. DOI: 10.1111/j.1532-5415.2011.03808.x
33. FDA Drug Safety Communication. Low Magnesium Levels Can Be Associated with Long Term Use of Proton Pump Inhibitor Drugs (PPIs). Washington, DC: US. Food and Drug Administration, 2011.
34. Attwood SE, Ell C, Galmiche JP, et al. Long-term safety of proton pump inhibitor therapy assessed under controlled, randomised clinical trial conditions: data from the SOPRAN and LOTUS studies. Aliment Pharmacol Ther 2015; 41: 1162-74. DOI: 10.1111/apt.13194
35. Esplugues JV. A pharmacological approach to gastric acid inhibition. Drugs 2005; 65 (Suppl 1): 7-12. DOI: 10.2165/00003495-200565001-00003
36. Gomollon F, Calvet X. Optimising acid inhibition treatment. Drugs 2005; 65 (Suppl 1): 25-33. DOI: 10.2165/00003495-200565001-00004
37. Sjostrom JE, Larsson H. Factors affecting growth and antibiotic susceptibility of Helicobacter pylori: effect of pH and urea on the survival of a wild-type strain and a urease-deficient mutant. J Med Microbiol 1996; 44: 425-33. DOI: 10.1099/00222615-44-6-425
38. Robinson M, Horn J. Clinical pharmacology of proton pump inhibitors: what the practising physician needs to know. Drugs 2003; 63: 2739-54. DOI: 10.2165/00003495-200363240-00004
39. Martin de Argila C. Safety of potent gastric acid inhibition. Drugs 2005; 65 (Suppl 1): 97-104. DOI: 10.2165/00003495-200565001-00013
40. Kuo CH, Lu CY, Shih HY, et al. CYP2C19 polymorphism influences Helicobacter pylori eradication. World J Gastroenterol 2014; 20: 16029-36.
41. Inaba T, Mizuno M, Kawai K, et al. Randomized open trial for comparison of proton pump inhibitors in triple therapy for Helicobacter pylori infection in relation to CYP2C19 genotype. J Gastroenterol Hepatol 2002; 17: 748-53. DOI: 10.1046/j.1440-1746.2002.02790.x
42. Ishizaki T, Horai Y. Review article: cytochrome P450 and the metabolism of proton pump inhibitors--emphasis on rabeprazole. Aliment Pharmacol Ther 1999; 13 (Suppl 3): 27-36. DOI: 10.1046/j.1365-2036.1999.00022.x
43. Furuta T, Sugimoto M, Shirai N, et al. CYP2C19 pharmacogenomics associated with therapy of Helicobacter pylori infection and gastro-esophageal reflux diseases with a proton pump inhibitor. Pharmacogenomics 2007; 8: 1199-210. DOI: 10.2217/14622416.8.9.1199
44. Orlando RC. Why is the high grade inhibition of gastric acid secretion afforded by proton pump inhibitors often required for healing of reflux esophagitis? An epithelial perspective. Am J Gastroenterol 1996; 91: 1692-6.
45. Calvet X, Gomollon F. What is potent acid inhibition, and how can it be achieved? Drugs 2005; 65 (Suppl 1): 13-23. DOI: 10.2165/00003495-200565001-00004
46. Hatlebakk JG. Review article: gastric acidity--comparison of esomeprazole with other proton pump inhibitors. Aliment Pharmacol Ther 2003; 17 (Suppl 1): 10-5. DOI: 10.1046/j.1365-2036.17.s1.3.x
47. Verdu EF, Armstrong D, Idstrom JP, et al. Intragastric pH during treatment with omeprazole: role of Helicobacter pylori and H. pylori-associated gastritis. Scand J Gastroenterol 1996; 31: 1151-6.
48. Labenz J, Tillenburg B, Peitz U, et al. Efficacy of omeprazole one year after cure of Helicobacter pylori infection in duodenal ulcer patients. Am J Gastroenterol 1997; 92: 576-81.
49. Holtmann G, Bytzer P, Metz M, et al. A randomized, double-blind, comparative study of standard-dose rabeprazole and high-dose omeprazole in gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2002; 16: 479-85. DOI: 10.1046/j.1365-2036.2002.01207.x
50. Miner P, Jr, Katz PO, Chen Y, et al. Gastric acid control with esomeprazole, lansoprazole, omeprazole, pantoprazole, and rabeprazole: a five-way crossover study. Am J Gastroenterol 2003; 98: 2616-20. DOI: 10.1111/j.1572-0241.2003.08783.x
51. Labenz J, Petersen KU, Rösch W, et al. A summary of Food and Drug Administration-reported adverse events and drug interactions occurring during therapy with omeprazole, lansoprazole and pantoprazole. Aliment Pharmacol Ther 2003; 17: 1015-9. DOI: 10.1046/j.1365-2036.2003.01550.x
52. Gisbert JP, Martin de Argila de Prados C. Tratamiento de las enfermedades gastroenterológicas. Asociación Española de Gastroenterología, Ponce García J, editores. Úlcera péptica e infección por Helicobacter pylori. Barcelona: Elsevier; 2011. p. 109-21.
53. Arroyo Villarino MT, Lanas Arbeloa A. Tratamiento de las enfermedades gastroenterológicas. Asociación Española de Gastroenterología, Ponce García J, editores. Gastroenteropatía por AINE. Barcelona: Elsevier; 2011. p. 123-31.
54. Mo C, Sun G, Lu ML, et al. Proton pump inhibitors in prevention of low-dose aspirin-associated upper gastrointestinal injuries. World J Gastroenterol 2015; 21: 5382-92. DOI: 10.3748/wjg.v21.i17.5382
55. Sung JJ, Barkun A, Kuipers EJ, et al. Intravenous esomeprazole for prevention of recurrent peptic ulcer bleeding: a randomized trial. Ann Intern Med 2009; 150: 455-64. DOI: 10.7326/0003-4819-150-7-200904070-00105
56. Sachar H, Vaidya K, Laine L. Intermittent vs continuous proton pump inhibitor therapy for high-risk bleeding ulcers: a systematic review and meta-analysis. JAMA Intern Med 2014; 174: 1755-62. DOI: 10.1001/jamainternmed.2014.4056
57. Hsu YC, Lin HJ. Intermittent bolus or continuous infusion of proton pump inhibitors for ulcer bleeding? JAMA Intern Med 2015; 175: 461.
58. Yen HH, Yang CW, Su WW, et al. Oral versus intravenous proton pump inhibitors in preventing re-bleeding for patients with peptic ulcer bleeding after successful endoscopic therapy. BMC Gastroenterol 2012; 12: 66. DOI: 10.1186/1471-230X-12-66
59. Dean BB, Gano AD, Knight K, et al. Effectiveness of proton pump inhibitors in nonerosive reflux disease. Clin Gastroenterol Hepatol 2004; 2: 656-64. DOI: 10.1016/S1542-3565(04)00288-5
60. Leite LP, Johnston BT, Just RJ, et al. Persistent acid secretion during omeprazole therapy: a study of gastric acid profiles in patients demonstrating failure of omeprazole therapy. Am J Gastroenterol 1996; 91: 1527-31.
61. Badillo R, Francis D. Diagnosis and treatment of gastroesophageal reflux disease. World J Gastrointest Pharmacol Ther 2014; 5: 105-12. DOI: 10.4292/wjgpt.v5.i3.105
62. Subramanian CR, Triadafilopoulos G. Refractory gastroesophageal reflux disease. Gastroenterol Rep (Oxf) 2015; 3: 41-53. DOI: 10.1093/gastro/gou061
63. Gisbert JP, Calvet X, Ferrandiz J, et al. Guia de practica clinica sobre el manejo del paciente con dispepsia. Actualizacion 2012. Gastroenterol Hepatol 2012; 35:725 e1-38. DOI: 10.1016/j.gastrohep.2012.05.002
64. Soo S, Moayyedi P, Deeks J, et al. Pharmacological interventions for non-ulcer dyspepsia. The Cochrane database of systematic reviews 2000; CD001960.
65. Talley NJ, Lauritsen K. The potential role of acid suppression in functional dyspepsia: the BOND, OPERA, PILOT, and ENCORE studies. Gut 2002; 50 (Suppl 4): 36-41. DOI: 10.1136/gut.50.suppl_4.iv36
66. Mascort JJ, Marzo M, Alonso-Coello P, et al. Guia de practica clinica sobre el manejo del paciente con dispepsia. Gastroenterol Hepatol 2003; 26: 571-613. DOI: 10.1016/S0210-5705(03)70414-2
67. Dellon ES. Diagnosis and management of eosinophilic esophagitis. Clin Gastroenterol Hepatol 2012; 10: 1066-78. DOI: 10.1016/j.cgh.2012.06.003
68. Molina-Infante J, Katzka DA, Dellon ES. Proton pump inhibitor-responsive esophageal eosinophilia: a historical perspective on a novel and evolving entity. Rev Esp Enferm Dig 2015; 107: 29-36.
69. Lindkvist B. Diagnosis and treatment of pancreatic exocrine insufficiency. World J Gastroenterol 2013; 19: 7258-66. DOI: 10.3748/wjg.v19.i42.7258
70. Boparai V, Rajagopalan J, Triadafilopoulos G. Guide to the use of proton pump inhibitors in adult patients. Drugs 2008; 68: 925-47. DOI: 10.2165/00003495-200868070-00004
71. Kirchheiner J, Glatt S, Fuhr U, et al. Relative potency of proton-pump inhibitors-comparison of effects on intragastric pH. Eur J Clin Pharmacol 2009; 65: 19-31. DOI: 10.1007/s00228-008-0576-5
72. McKeage K, Blick SK, Croxtall JD, et al. Esomeprazole: a review of its use in the management of gastric acid-related diseases in adults. Drugs 2008; 68: 1571-607. DOI: 10.2165/00003495-200868110-00009
73. Baldwin CM, Keam SJ. Rabeprazole: a review of its use in the management of gastric acid-related diseases in adults. Drugs 2009; 69: 1373-401. DOI: 10.2165/00003495-200969100-00007
74. McNicholl AG, Linares PM, Nyssen OP, et al. Meta-analysis: esomeprazole or rabeprazole vs. first-generation pump inhibitors in the treatment of Helicobacter pylori infection. Aliment Pharmacol Ther 2012; 36: 414-25. DOI: 10.1111/j.1365-2036.2012.05211.x
75. Eggleston A, Katelaris PH, Nandurkar S, et al. Clinical trial: the treatment of gastro-oesophageal reflux disease in primary care--prospective randomized comparison of rabeprazole 20 mg with esomeprazole 20 and 40 mg. Aliment Pharmacol Ther 2009; 29: 967-78. DOI: 10.1111/j.1365-2036.2009.03948.x
76. Zheng RN. Comparative study of omeprazole, lansoprazole, pantoprazole and esomeprazole for symptom relief in patients with reflux esophagitis. World J Gastroenterol 2009; 15: 990-5. DOI: 10.3748/wjg.15.990
77. Takeuchi T, Oota K, Harada S, et al. Characteristics of Refractory Gastroesophageal Reflux Disease (GERD) Symptoms -Is Switching Proton Pump Inhibitors Based on the Patient's CYP2C19 Genotype an Effective Management Strategy? Intern Med 2015; 54: 97-105.
78. Edwards SJ, Lind T, Lundell L, Das R. Systematic review: standard- and double-dose proton pump inhibitors for the healing of severe erosive oesophagitis -- a mixed treatment comparison of randomized controlled trials. Aliment Pharmacol Ther 2009; 30: 547-56. DOI: 10.1111/j.1365-2036.2009.04077.x
79. Vakil N, Fennerty MB. Direct comparative trials of the efficacy of proton pump inhibitors in the management of gastro-oesophageal reflux disease and peptic ulcer disease. Aliment Pharmacol Ther 2003; 18: 559-68. DOI: 10.1046/j.1365-2036.2003.01756.x
80. Klok RM, Postma MJ, van Hout BA, et al. Meta-analysis: comparing the efficacy of proton pump inhibitors in short-term use. Aliment Pharmacol Ther 2003; 17: 1237-45. DOI: 10.1046/j.1365-2036.2003.01562.x
81. Díez MV, Errecalde MF. Aclaraciones al concepto de genérico. Información terapéutica del Sistema Nacional de Salud 1998; 22: 68-72.
82. Niv Y. Comparison of proton pump inhibitor-based triple therapy with losec and the generic drug, Omepradex, for efficacy of Helicobacter pylori eradication. Dig Dis Sci 2005; 50: 623-5. DOI: 10.1007/s10620-005-2546-4
83. Hatlebakk JG, Katz PO, Kuo B, et al. Nocturnal gastric acidity and acid breakthrough on different regimens of omeprazole 40 mg daily. Aliment Pharmacol Ther 1998; 12: 1235-40. DOI: 10.1046/j.1365-2036.1998.00426.x
84. Gisbert JP, Calvet X, Bermejo F, et al. III Conferencia Española de Consenso sobre la infección por Helicobacter pylori. Gastroenterol Hepatol 2013; 36: 340-74. DOI: 10.1016/j.gastrohep.2013.01.011
85. Villoria A, Garcia P, Calvet X, et al. Meta-analysis: high-dose proton pump inhibitors vs. standard dose in triple therapy for Helicobacter pylori eradication. Aliment Pharmacol Ther 2008; 28: 868-77.
86. Vallve M, Vergara M, Gisbert JP, et al. Single vs. double dose of a proton pump inhibitor in triple therapy for Helicobacter pylori eradication: a meta-analysis. Aliment Pharmacol Ther 2002; 16: 1149-56. DOI: 10.1046/j.1365-2036.2002.01270.x
87. Lanas A. Inhibidores de la bomba de protones y clopidogrel en el paciente cardiovascular: ¿riesgo cardiovascular versus riesgo gastrointestinal? Gastroenterol Hepatol 2010; 33: 1-5.
88. Huang B, Huang Y, Li Y, et al. Adverse cardiovascular effects of concomitant use of proton pump inhibitors and clopidogrel in patients with coronary artery disease: a systematic review and meta-analysis. Arch Med Res 2012; 43: 212-24. DOI: 10.1016/j.arcmed.2012.04.004
Citation tools
Aguilera Castro L, Martín de Argila de Prados C, Albillos Martínez A. Practical considerations in the management of proton-pump inhibitors. 3812/2015


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 9394 visits.
This article has been downloaded 1810 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 16/04/2015

Accepted: 12/06/2015

Online First: 15/12/2015

Published: 26/02/2016

Article revision time: 55 days

Article Online First time: 243 days

Article editing time: 316 days


Share
This article has been rated by 9 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology