900
P A R T 1 1
Drugs acting on the gastrointestinal system
TABLE 57.1
DRUGS IN FOCUS Drugs used to treat gastro-oesophageal reflux disease and ulcer disease (continued)
Drug name
Dosage/route
Usual indications
Histamine-2 antagonists (continued)
nizatidine (Nizac, Tazac)
150–300 mg PO at bedtime or 150 mg PO
b.d., 75 mg PO 30 min before food to prevent
heartburn; reduce dose in renal-impaired or
geriatric people
Treatment of duodenal ulcer, benign
gastric ulcer, pathological hypersecretory
syndrome, GORD; relief of symptoms of
heartburn, acid indigestion, sour stomach
in adults
Special considerations:
Not
recommended for use in children
ranitidine (Zantac)
150 mg daily to b.d. PO for heartburn; reduce
dose in renal-impaired or geriatric people
Treatment of duodenal ulcer, benign
gastric ulcer, pathological hypersecretory
syndrome, GORD; relief of symptoms of
heartburn, acid indigestion, sour stomach
in adults
Special considerations:
Not
recommended for use in children
Antacids
aluminium hydroxide
(AlternaGEL)
600–1200 mg q.i.d
Symptomatic relief of gastrointestinal
(GI) hyperacidity; treatment of
hyperphosphatemia; prevention of
formation of phosphate urinary stones
calcium salts (Tums)
0.5–2 g PO as needed as an antacid
Symptomatic relief of GI hyperacidity,
treatment of calcium deficiency,
prevention of hypocalcaemia
magnesium salts (Kruse’s
Fluid Magnesia)
280–1500 mg PO q.i.d., dose based on salt
used
Paediatric: half of the adult dose
Symptomatic relief of GI hyperacidity;
prophylaxis of stress ulcers; relief of
constipation
sodium bicarbonate
(generic)
Adult: 300–2000 mg PO daily to q.i.d.
Symptomatic relief of GI hyperacidity,
minimisation of uric acid crystalluria,
adjunctive treatment in severe diarrhoea
Proton pump inhibitors
esomeprazole (Nexium)
Acute: 20–40 mg/day PO for 4–8 weeks;
20–40 mg/day PO for maintenance
Treatment of GORD, severe erosive
oesophagitis, duodenal ulcers and
pathological hypersecretory conditions
lansoprazole (Zopral,
Zoton)
15–30 mg/day PO based on condition and
response; 30 mg IV over 30 minutes for up
to 7 days
Pediatric: 1–11 years (≤30 kg): 15 mg/kg per
day PO
1–11 years (>30 kg): 30 mg/kg per day PO
12–17 years: 15–30 mg/day PO
Treatment of gastric ulcer, GORD,
pathological hypersecretory syndromes;
maintenance therapy for healing duodenal
ulcers and oesophagitis; in combination
therapy for the eradication of Helicobacter
pylori infection; approved for use in
children for treatment of GORD, peptic
ulcer and Zollinger–Ellison syndrome
omeprazole (Losec)
20–40 mg/day PO for 4–8 weeks based on
condition and response
Treatment of gastric ulcers, GORD,
pathological hypersecretory syndromes;
maintenance therapy for healing
duodenal ulcers and oesophagitis; in
combination therapy for the eradication
of H. pylori infection; available over the
counter (OTC) for relief of heartburn
symptoms
pantoprazole (Gastenz,
Ozpan)
40 mg PO daily to b.d. or 40 mg/day IV for
7–14 days
Treatment of GORD in adults; healing
of erosive oesophagitis, treatment of
hypersecretory syndromes
rabeprazole (Pariet,
Prabez)
20–60 mg/day PO based on condition and
response
Treatment and maintenance of GORD;
treatment of duodenal ulcers,
pathological hypersecretory conditions;
used as combination therapy for the
eradication of H. pylori infection
