The drugs segment is an established market offering antacids, PPIs, H2RAs
These favorable safety profiles along with profound pharmacodynamic effects on gastric acid secretion and a convenient 12-hourly dosing schedule has made Famotidine exceedingly popular among H2RAs
26) However, H2RAs
can lead to tachyphylaxis--an acute decrease in response to a drug--within 2 to 6 weeks, thus limiting their long-term efficacy.
Overall, a new diagnosis of B12 deficiency was more common amongst patients with a 2 year supply or greater of PPIs and H2RAs
, compared with non-users.
cost was based on ranitidine 150 mg twice daily (at $12 per month) for 9.
The literature review identified seven randomised, controlled trials (RCT) comparing H2RA
and PPI in the prevention of UGI bleeding associated with SRMD (10-16) and three individual meta-analyses (17-19).
include cimetidine, ranitidine, famotidine, and nizatidine.
The average monthly dose and H2RA
costs decreased significantly for the long-term care and ambulatory patient populations for the first six months following the DUR letter intervention.
Patients whose disease has required PPIs for control often will have symptomatic relapses and failure of healing of oesophagitis on standard dose, or even higher dose H2RA
and/or prokinetic therapy.
If lifestyle changes don't work, you may try medications: Antacids (Turns, Rolaids), or a non-prescription histamine-2 receptor antagonist (H2RA
) like Tagamet may help; for stronger symptoms, try prescription-strength H2RAs
, or acid suppressants such as proton pump inhibitors (PPIs), which include Prilosec, Nexium, and Prevacid, or drugs that strengthen the lower esophageal sphincter.
Whenever possible, implement step-down therapy to the lowest effective dose or prescribe an H2RA
rather than a PPI.