What medications cure peptic ulcers?
Antibiotics. Several combinations of antibiotics kill H. pylori. Most of the medications are equally effective. However, for the treatment to work, it's essential that you follow your doctor's instructions precisely. Antibiotics most commonly prescribed for treatment of H. pylori include amoxicillin (Amoxil, Wymox), clarithromycin (Biaxin), metronidazole (Flagyl) or tetracycline (Achromycin V). Some pharmaceutical companies package a combination of two antibiotics together, with an acid
suppressor or cytoprotective agent specifically for treatment of H. pylori infection. These combination treatments are sold under the names Prevpac and Helidac. You'll need to take antibiotics for only 1 to 2 weeks, depending on their type and number. Other medications prescribed in conjunction with antibiotics generally are taken for a longer period.
Acid blockers. Acid blockers — also called histamine (H-2) blockers — reduce the amount of hydrochloric acid released into your digestive tract, which relieves ulcer pain and encourages healing. Acid blockers work by keeping histamine from reaching histamine receptors. Histamine is a substance normally present in your body. When it reacts with histamine receptors, the receptors signal acid-secreting cells in your stomach to release hydrochloric acid. Available by prescription or over-the-counter (OTC), acid blockers include the medications ranitidine (Zantac), famotidine (Pepcid), nizatidine (Axid) and cimetidine (Tagamet). For treatment of ulcers, prescription-strength acid blockers are more effective. H2 blockers include cimetidine (Tagamet), ranitidine (Zantac), famotidine (Pepcid), and nizatidine (Axid). They prevent production of acid by blocking histamine, a chemical that promotes acid production. Nonprescription strengths are available, but for most people the stronger prescription version are needed. H2 blockers work very well at reducing acid and pain. (Reducing acid helps the ulcers heal.) They may take a few days to start having an effect. Treatment with H2 blockers usually takes 6-8 weeks.
Antacids. Antacids relieve symptoms of ulcers by neutralizing stomach acid. Their effectiveness varies with the amount of antacid taken and the amount of acid a person produces. Almost all antacids can be purchased without a doctor's prescription and are available in tablet or liquid form. Generally, antacids are not effective in healing ulcers. Sodium bicarbonate and calcium carbonate, the strongest antacids, may be taken occasionally for short-term relief. Aluminum hydroxide is a relatively safe, commonly used antacid. However, aluminum may bind with phosphate in the digestive tract, reducing phosphate levels in the blood and causing weakness and a loss of appetite. Magnesium hydroxide is a more effective antacid than aluminum hydroxide. Many antacids contain both magnesium hydroxide and aluminum hydroxide.
Proton pump inhibitors. A more effective way to reduce stomach acid is to shut down the "pumps" within acid-secreting cells. Proton pump inhibitors reduce acid by blocking the action of these tiny pumps. They include the prescription medications omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex) and esomeprazole (Nexium). Another drug, pantoprozole (Protonix), can be taken orally or administered intravenously in the hospital. Proton pump inhibitors also appear to inhibit H. pylori. However, the drugs cost almost twice as much as acid blockers. Uncommon side effects include stomach pain, diarrhea and headache. Proton pump inhibitors are the most potent of the drugs that reduce acid production. Proton pump inhibitors promote healing of ulcers in a greater percentage of people in a shorter period of time than do H2 blockers. They are also very useful in treating conditions that cause excessive stomach acid secretion, such as Zollinger-Ellison syndrome.
Cytoprotective agents. These medications help protect the tissues that line your stomach and small intestine. They include the prescription medications sucralfate (Carafate) and misoprostol (Cytotec). The drugs cause some side effects. Sucralfate may cause constipation. Misoprostol may cause diarrhea and uterine bleeding. Misoprostol shouldn't be taken by pregnant women because it can cause miscarriage. Another nonprescription cytoprotective agent is bismuth subsalicylate (Pepto-Bismol). In addition to protecting the lining of your stomach and intestines, bismuth preparations appear to inhibit H. pylori activity. Protective agents do not affect the amount of acid in the stomach; instead, they protect the mucous lining of the stomach from acid. One type is very thick and sticks to the ulcer, forming a physical barrier between the ulcer and the acid. An example is sucralfate (Carafate). The other type increases the amount of mucus, which forms a physical barrier, and bicarbonate, which helps neutralize the acid. An example is misoprostol (Cytotec); this agent is used only for treatment of ulcers caused by medication.