Medications for Peptic Ulcer Disease
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The information provided here is meant to give you a general idea of what to expect from each of the medications listed below. Only the most general side effects are included, so ask your healthcare provider if you need to take any special precautions. Use each of these medications as recommended by your healthcare provider, or according to the instructions provided. If you have further questions about usage or side effects, contact your healthcare provider.
If you are diagnosed with a peptic ulcer caused by H. pylori, your healthcare provider will use a combination of medications. You’ll probably be given one or two types of antibiotics, as well as medicines that help control your stomach acid production (such as H-2 blockers or proton pump inhibitors). You might be advised to use antacids to help soothe uncomfortable symptoms.
Prescription Medications
- Tetracycline
- Metronidazole (Flagyl)
- Amoxicillin
- Clarithromycin
- Levaquin
- Cimetidine (Tagamet)
- Ranitidine (Zantac)
- Famotidine (Pepcid)
- Nizatidine (Axid)
- Omeprazole (Prilosec)
- Lansoprazole (Prevacid)
- Pantoprazole (Protonix)
- Rabeprazole (Aciphex)
- Esomeprazole (Nexium)
Sodium Sucralfate (Carafate)
Misoprostol (Cytotec)
Prescription Medications
Antibiotics
Common names include:
- Tetracycline
- Metronidazole (Flagyl)
- Amoxicillin
- Clarithromycin (Biaxin)
- Esomeprazole (Nexium)
- Levaquin
Antibiotics can clear up the bacteria H. pylori . You should always take all of the prescription, even if you begin to feel better before your medicine is finished.
Tetracycline:
- Always take with a full glass of water.
- Don’t take tetracycline within two hours of drinking a milk product or using an antacid.
- Be sure your healthcare provider knows if there’s any chance you may be pregnant, since tetracycline can permanently stain the baby’s developing teeth.
- Tetracycline may make you very sensitive to sunlight, so protect your skin appropriately.
Metronidazole:
- Take with food to avoid stomach upset.
- Don’t drink alcohol while you’re using this medication.
- Your urine may appear darker and you may notice a metallic taste in your mouth while you’re taking metronidazole.
- Some people feel dizzy or lightheaded when they first start taking metronidazole. You should avoid driving, operating dangerous machinery, and participating in hazardous activities until you know how this drug will affect you.
Amoxicillin:
- You can take this medicine on either a full or empty stomach.
- If you are taking birth control pills, use an an additional or backup form of contraception, such as a condom.
- Contact your healthcare provider if you develop diarrhea while taking this medication.
Clarithromycin:
- Do not take clarithromycin while you are using astemizole, cisapride, pimozide, or terfenadine. Combinations of clarithromycin and these drugs can cause heart problems. Have your doctor and pharmacist check to make sure you’re not taking any other drugs that could interact with clarithromycin.
Any type of antibiotic can cause an allergic reaction. Discontinue the drug and contact your healthcare provider immediately if you notice:
- A new skin rash
- Hives or welts on your skin
- Puffiness of the face or around your eyes
- Difficulty breathing
H-2 Blockers
Common names include:
- Cimetidine (Tagamet)
- Ranitidine (Zantac)
- Famotidine (Pepcid)
- Nizatidine (Axid)
H-2 blockers help decrease acid production in the stomach. They may be given to help with heartburn , indigestion, ulcers, or other forms of excess acidity in the stomach. Some of these drugs have potential drug interactions with other medications so consult your doctor and pharmacist.
Possible side effects include:
- Dizziness
- Confusion (cimetidine, especially in the elderly)
- Headache
- Diarrhea
Proton Pump Inhibitors
Common names include:
- Omeprazole (Prilosec)
- Lansoprazole (Prevacid)
- Pantoprazole (Protonix)
- Rabeprazole (Aciphex)
- Esomeprazole (Nexium)
Proton pump inhibitors decrease acid production in the stomach. They may be given to help with heartburn, indigestion, and difficulty swallowing.
Possible side effects include:
Sodium Sucralfate
Sucralfate coats your stomach and the ulcer, helping to protect it from further damage by stomach acid. This can help speed healing. It’s also useful to protect people taking NSAIDs against the development of peptic ulcers.
Do not take sucralfate within 30 minutes before or after taking antacids.
Misoprostol
Misoprostol protects the stomach lining and decreases acid production, helping peptic ulcers heal more quickly. It’s also useful to protect people taking NSAIDs against the development of peptic ulcers.
Do not take misoprostol if you are pregnant. It can cause miscarriage .
Some people develop nausea, stomach cramps, and diarrhea while using this medicine. These side effects usually go away within a few days. However, if they don’t go away or if they seem severe, contact your healthcare provider.
Over-the-Counter Medications
Antacids
Common brand names include:
- Gaviscon
- Di-Gel
- Mylanta
- Maalox Advanced Regular Strength
- Tums
Antacids work to neutralize acidity in the stomach. They’re given to improve symptoms of heartburn and indigestion.
Possible side effects include:
- Diarrhea
- Constipation
Special Considerations
Whenever you are taking a prescription medication, take the following precautions:
- Take them as directed—not more, not less, not at a different time.
- Do not stop taking them without consulting your doctor.
- Don’t share them with anyone else.
- Know what effects and side effects to expect, and report them to your doctor.
- If you are taking more than one drug, even if it is over-the-counter, be sure to check with a doctor or pharmacist about drug interactions.
- Plan ahead for refills so you don’t run out.
References:
American College of Gastroenterology website. Available at: http://www.acg.gi.org/ . Accessed March 3, 2006.
Cecil RL, Goldman L, Bennett JC. Cecil Textbook of Medicine . 21st ed. Philadelphia, PA: WB Saunders Company; 2000.
Meurer LN, Bower DJ. Management of helicobacter pylori infection. Am Fam Physician [online]. Apr 2002;65(7). Available at: http://www.aafp.org/afp/20020401/1327.html.
National Digestive Diseases Information Clearinghouse website. Available at:. http://digestive.niddk.nih.gov/ . Accessed March 3, 2006.
3/1/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Maalox Total Relief and Maalox liquid products: medication use errors. US Food and Drug Administration website. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm200672.htm. Published February 17, 2010. Accessed March 2, 2010.
5/28/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: FDA: possible fracture risk with high-dose, long-term use of proton pump inhibitors. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm213377.htm. Published May 25, 2010. Accessed May 28, 2010.
Last reviewed September 2009 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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