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THE PHARMA REVIEW (MAY JUNE 2020)

A Balanced Prescription to Prevent Adverse Effects of Long term Use of PPIs

Dr. Neeraj1. V, Prof Dr. Harvinder Popli2 & Dr. Ginpreet Kaur3

Introduction: Proton pump inhibitors (PPIs) are used to treat acid-related gastric disorders including gastroesophageal reflux disease (GERD) and secondary prevention of aspirin/non-steroidal anti-inflammatory drugs (NSAID)-induced ulcers1. All currently used and approved PPIs are derivative of benzimidazole, with omeprazole, as the first clinically useful PPI2. Subsequently discovered PPIs include lansoprazole, pantoprazole, rabeprazole and the stereo isomeric compounds esomeprazole and dexlansoprazole3. Each of these PPIs has different substitutions on their pyridine and/or benzimidazole rings, but in general, they are remarkably similar in their pharmacological properties2. Its been more than 25 years when PPIs were clinically introduced; since then these drugs are considered to be quite valuable, safe, and effective agents for the management of a variety of acid-related disorders2. More recently, the novel imidazopyridine PPI, tenatoprazole were introduced in preliminary preclinical and clinical evaluation. Though these new PPIs are yet to be approved for clinical use, these new subset of PPI with a prolonged half-life (serum half-life of 7 hours) may ultimately offer advantages over its benzimidazole cousins3.

 

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