The 8 best proton pump inhibitors

*Review of the best according to the editorial board. About the selection criteria. This material is subjective, not intended as an advertisement, and does not serve as a guide to purchase. Consultation with a specialist is required before purchase.

Proton pump inhibitors (PPIs) are a group of drugs that reduce the synthesis of hydrochloric acid in the stomach. These remedies are recommended by doctors both for therapeutic and preventive purposes.

When proton pump inhibitors are prescribed

1. The main indication for drugs from this group are diseases caused by increased acidity of gastric juice: peptic ulcer or duodenal ulcer. As they used to say in the old textbooks: “no acid – no ulcer”. This situation remains true even after the discovery of the true cause of peptic ulcer disease – a bacterium called He
2. Cobacter Pilory (Helicobacter).
3. To kill this bacteria, proton pump inhibitors can also be prescribed for normal gastric acidity. Helicobacter has adapted well to exist in an acidic environment, and when the pH increases above 4, it becomes more sensitive to antibiotics. Therefore, for its eradication, a complex of PPIs and 2 to 3 antibacterial agents are prescribed.
4. Another acid-dependent condition in which proton pump inhibitors are prescribed is complicated gastroesophageal reflux disease. It disrupts the normal function of the lower esophageal sphincter, the circular muscle that blocks stomach contents from entering the esophagus. Constant acid on unprotected mucosa causes inflammation, ulcers, and disrupts normal cell structure, which can eventually lead to malignancy. To protect esophageal mucosa from the action of acid and recommend PPIs.
5. Another situation where drugs from this group are recommended for people with normal stomach acidity – chronic pancreatitis with excretory pancreatic insufficiency. Simply put, when the gland, depleted by constant inflammation, does not produce enough enzymes for normal digestion. In such cases, enzyme medications are usually prescribed. But for them to work, they need an alkaline environment. Alkaline to neutralize the acidic food lump coming from the stomach is synthesized by the same pancreas, and if it is insufficient, the enzyme pills taken 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.
6. Proton pump inhibitors are recommended as a preventive measure for people who have to take non-steroidal anti-inflammatory drugs such as diclofenac, ibuprofen, paracetamol, aspirin, etc. regularly.p. These drugs slow down the regeneration of the gastric mucosa and often cause “silent”, asymptomatic ulcers. PPIs are prescribed to prevent this from happening.

Rating of the best proton pump inhibitors

Top over-the-counter proton pump inhibitors

Speaking of over-the-counter remedies from pharmacies, it should be noted that drugs with the same active ingredient may or may not be prescription. For example, Omez, which we will talk about in this section of the rating of the best proton pump inhibitors, is dispensed from pharmacies without a prescription. And its domestic counterpart Gastrozol is a prescription. The situation is even stranger with the drug Ultop, which contains a similar active ingredient: 10 mg capsules are dispensed without a prescription, while 20 and 40 mg capsules are prescription. Therefore, as much as we would like to use only the active substances in the rating, allowing readers to choose from the proposed analogues taking into account their financial capabilities, in this section of the rating of the best proton pump inhibitors, we are forced to use the trade names of drugs.

Over-the-counter PPIs can be taken on their own for 2 weeks, but if they do not bring relief in the first 3 days, it is better to see a doctor right away.

Omez

Rating: 4.9

Active ingredient: Omeprazole.

A time-tested drug that combines proven efficacy with an affordable price. Available in 10, 20 and 40 mg capsules. The capsules are taken once a day for half an hour before a meal, with water. If necessary, the capsule can be opened and the contents mixed with water or food.

The dosage must be chosen individually, most often therapeutic effect occurs when taking 20 mg, but often 10 mg is also sufficient (or, conversely, a higher dose is required).

The most frequent side effects include headache, insomnia, dizziness, diarrhea or constipation, nausea, bloating, and abdominal pain.

The remedy is contraindicated for use in children under 18 years of age (omeprazole is approved in pediatrics from 2 years, but there are separate forms for patients of this age), with individual intolerance.

Can be used during pregnancy.

Possible over-the-counter analogues: Ultop.

Advantages of

• economy,
• Can be taken by pregnant women.

Disadvantages

• Does not combine with some antiviral and antifungal drugs (see instructions for more details)

Controlock

Rating: 4.7

Active substance: pantoprazole.

The combination of German quality and relatively affordable price. Available in 20 and 40 mg tablets; only the minimum dosage is available without a prescription.

Take 20 mg once a day before meals with plenty of fluid (some patients may require a higher dose).

Effective from the first days of use, but the maximum effect is achieved only after a week of regular use (if during the first days it reduces gastric secretion by 26%, after a week – up to 50%), therefore it is possible to judge about the disappearance of symptoms not earlier than after 5 – 7 days of use. Acidity is restored in 3 to 4 days after the end of application.

Unlike other proton pump inhibitors from this section of the rating of the best remedies, 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.

Combined with almost any medication (the exception is azatanovir, which is contraindicated in the therapy with Controlloch).

Not recommended for children under 18 years of age, pregnant or lactating women because of insufficient safety information for these groups.

Possible over-the-counter analogues: Panum, Paltaz.

Advantages

• relatively affordable price,
• Combines with most medications.

Disadvantages

• 14 pills in a pack, which is inconvenient for continuous use.

Pariet

Rating: 4.5

Active substance: rabeprazole

Formally the license for the production of this drug belongs to the Russian branch of Johnson & Johnson, but the substance (active ingredient) is produced in Switzerland, and the tablets themselves in Japan. So the quality of this proton pump inhibitor is beyond doubt, but the price is also quite high.

Available in dosages of 10 and 20 mg, without a prescription is the first.

Take 1 tablet per day, without crushing or chewing the tablet. Time of day and food intake do not affect the effectiveness of the drug.

The effect begins to appear within an hour of taking it, and in one day the gastric secretion is reduced by 69%.

Combined with most medications, but not recommended concomitantly with azatonavir.

Contraindicated in cases of individual intolerance, pregnancy, lactation and children under 18 years of age due to lack of safety studies in these groups.

Possible over-the-counter analogues: Beret, Norflux, Ulcernil, Rabelock.

Advantages

• Effectiveness does not depend on food intake,
• Combines with most medications.

Disadvantages

• high price.

The best prescription proton pump inhibitors

In this section, we have gathered drugs that should be sold only with a doctor’s prescription.

Nexium

Rating: 4.8

Active substance: esomeprazole.

Available as oral tablets at 20 and 40 mg and as powder for suspension at 10 mg.

It is one of few original modern drugs with affordable price (except for powdered formulation, which has no analogues on the Russian market)

The effect begins within an hour during the first use, the effect “reaches its maximum” by the 5th day of use, decreasing the concentration of hydrochloric acid in gastric juice by 90%.

The usual route of administration – once a day, but if the drug 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 indications are limited to GERD and reflux esophagitis.

Side effects – headache, dyspepsia.

Contraindicated for individual intolerance, children under one year of age, pregnant and lactating due to lack of safety data.

Possible analogues: Esomeprazole, Emanera, Pemozar, Rediomez

Lancid

Rating: 4.6

Active substance: lansoprazole.

Available in 15 and 30 mg capsules.

The effect increases during the first 4 days of intake, at its maximum it reaches the decrease of hydrochloric acid synthesis up to 97%. Recovery of function occurs 3 to 4 days after stopping use. Food intake slows absorption but does not affect efficacy.

Take once a day, preferably in the morning. If the drug is prescribed to kill Helicobacter, it must be taken 2 times a day. If antacids are prescribed at the same time, it is better to take them separately with Lancid, since they prevent complete absorption of the drug.

Possible adverse events are typical for the whole group of proton pump inhibitors – abdominal discomfort, stool disorders, bloating, headache.

Contraindicated for individual intolerance, in the 1st trimester of pregnancy (but there are no safety studies in other periods), during lactation.

Possible analogues: Lanzabel, Lanzaptol, Epicurus.

Advantages

• affordable price;

Disadvantages

• Prohibited in pregnancy.

Dexylant

Rating: 4.4

The active ingredient is dexlansoprazole.

On the one hand, this product is based on a relatively new active substance with high biological activity. On the other hand – until the patent expires and generics appear, the original manufacturer remains a monopolist, and the price of the drug is quite high.

Available in capsules of 30 and 60 mg.

The peculiarity of this drug is not only in the active ingredient, but also in the form of release. The capsules, common at first glance, contain several types of pellets that dissolve in the intestine depending on the pH of the medium. That is, after taking it, not all of the active substance is released at once. and different pellets dissolve at different times as the food lump progresses. Due to this, the effect comes more smoothly and lasts longer. If necessary, the capsule may be opened and the contents diluted in a small amount of water or food that does not require chewing.

Possible side effects – flatulence, dyspepsia.

Contraindicated in individual intolerance, patients taking HIV protease inhibitors, children under 18, pregnant and lactating.

Advantages

• original drug,
• Modified release, prolonging the effect.

Disadvantages

• high price.

The best combination preparations

As mentioned above, it is not uncommon for proton pump inhibitors to be prescribed in combination with antibiotics to destroy Helicobacter, eliminating the cause of ulcers or gastritis. To save the patient from having to remember when and what pills to take, they began to produce drugs that combine these groups of drugs in one product. Another possible combination is proton pump inhibitors and remedies. normalizing the motility of the gastrointestinal tract. They are prescribed for the treatment of reflux esophagitis.

Pilobact

Rating: 4.3

Strictly speaking. is not a single drug, but a set of tablets and capsules containing the proton pump inhibitor omeprazole, the antibiotic clarithromycin and the agent with antibacterial and antiprotozoal effect tinidazole. All of these are packaged in a strip labeled “morning” or “evening”. Take the contents of the respective strip during or immediately after a meal, as is clear from the description – in the morning and in the evening. Splitting, chewing, or otherwise crushing tablets or capsules is not allowed.

It is contraindicated in:

1. Components intolerance,
2. Alcoholism (cannot be combined with ethyl alcohol),
3. liver or kidney insufficiency,
4. Impaired medullary hematopoiesis,
5. Children, pregnant, lactating.

The course of treatment – from 7 to 14 days, the specific recommendations are given by the attending physician. Drug packaging is designed for 7 days, so you may need two.

Advantages

• A full range of drugs for the elimination of Helicobacter.

Disadvantages

• Many contraindications and side effects.
• high price.

Omez DCP

Rating: 4.2

Combination of 20 mg omeprazole and 30 mg domperidone, a regulator of gastrointestinal motility. Minimizes possible bile flow, restoring normal peristalsis of the esophagus and stomach, reducing the acidity of gastric juice. Thus reducing damage to the esophagus and promoting healing. In addition, the remedy can be used to reduce nausea and vomiting caused by an exacerbation of gastritis, peptic ulcer.

Take once a day, half an hour before meals.

Contraindicated when:

1. simultaneous use of some antiviral, antifungal and antibacterial agents (for more information, we refer readers to the instructions, as the list is not limited to 1 – 2 names);
2. Gastrointestinal bleeding, perforation, intestinal obstruction;
3. Moderate to severe liver function impairment,
4. Pregnant and lactating women,
5. In children under 18 years of age.

Advantages

• Normalizes motility of the esophagus, stomach, intestines,

Disadvantages

• wide range of contraindications,
• possible undesirable effects.