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ATC Group: A02B DRUGS FOR PEPTIC ULCER AND GASTRO-OESOPHAGEAL REFLUX DISEASE (GORD)

Anatomical Therapeutic Chemical Classification System

Hierarchical Position

Level
Code
Title
1
A
Alimentary tract and metabolism
2
A02
Drugs for acid related disorders
3
A02B
DRUGS FOR PEPTIC ULCER AND GASTRO-OESOPHAGEAL REFLUX DISEASE (GORD)

Contents

Code
Title
A02BA
H2-receptor antagonists
A02BB
Prostaglandins
A02BC
Proton pump inhibitors
A02BD
Combinations for eradication of Helicobacter pylori
A02BX
Other drugs for peptic ulcer and gastro-oesophageal reflux disease (GORD)

Active Ingredients

Chemical substance
Description
Alginic acid

Alginic acid is a polysaccharide distributed widely in the cell walls of brown algae which is hydrophilic and forms a viscous gum when hydrated. Its salts with metals such as sodium and calcium are known as alginates. It is a significant component of the biofilms produced by the bacterium Pseudomonas aeruginosa, a major pathogen found in the lungs of some people who have cystic fibrosis. The biofilm and P. aeruginosa have a high resistance to antibiotics and are susceptible to inhibition by macrophages. Its colour ranges from white to yellowish-brown. It is sold in filamentous, granular or powdered forms.

Tripotassium dicitrato bismuthate

Under the effect of gastric acid, a precipitate is formed from tripotassium dicitrato bismuthate, which adheres primarily to the ulcerated area and inhibits the activity of pepsin. Tripotassium dicitrato bismuthate contributes to the healing of a high percentage of gastric and duodenal ulcers.

Bismuth subnitrate
Carbenoxolone

Carbenoxolone is a glycyrrhetinic acid derivative with a steroid-like structure, similar to substances found in the flavor-ful root of the licorice plant. It influences endogenous glucocorticoids by potently inhibiting 11β-hydroxysteroid dehydrogenase. Electrolyte imbalance is a serious side effect of carbenoxolone when used systemically. Carbenoxolone is best known in cellular physiology as a modestly potent, reasonably effective, water-soluble blocker of gap junctions. It exerts anti-inflammatory activity. Carbenoxolone has used orally in the clinical treatment of peptic ulcers, now it is used topically for the treatment of lip sores and mouth ulcers.

Cimetidine

Cimetidine is a histamine H2-receptor antagonist which rapidly inhibits both basal and stimulated gastric secretion of acid and reduces pepsin output. It is a reversible, competitive antagonist, and is used as an anti-ulcer drug.

Dexlansoprazole

Dexlansoprazole belongs to a class of antisecretory compounds, the substituted benzimidazoles, that suppress gastric acid secretion by specific inhibition of the (H+, K+)-ATPase at the secretory surface of the gastric parietal cell.

Esomeprazole

Esomeprazole is the S-isomer of omeprazole and reduces gastric acid secretion through a specific targeted mechanism of action. Esomeprazole is a weak base and is concentrated and converted to the active form in the highly acidic environment of the secretory canaliculi of the parietal cell, where it inhibits the enzyme H+ K+ -ATPase – the acid pump and inhibits both basal and stimulated acid secretion.

Famotidine

Famotidine is a potent competitive H2-receptor antagonist. Famotidine has a rapid onset of action and, at the recommended doses, has a long duration of action and is highly effective at relatively low blood concentrations.

Lansoprazole

Lansoprazole is a gastric proton pump inhibitor. It inhibits the final stage of gastric acid formation by inhibiting the activity of H+/K+ ATPase of the parietal cells in the stomach. The inhibition is dose-dependent and reversible, and the effect applies to both basal and stimulated secretion of gastric acid.

Misoprostol

Misoprostol is an analogue of naturally occurring prostaglandin E1 which promotes peptic ulcer healing and symptomatic relief. Misoprostol protects the gastroduodenal mucosa by inhibiting basal, stimulated and nocturnal acid secretion and by reducing the volume of gastric secretions, the proteolytic activity of the gastric fluid, and increasing bicarbonate and mucus secretion.

Nizatidine

Nizatidine is a potent, selective, competitive and fully reversible histamine H2-receptor antagonist. Nizatidine significantly decreased basal and stimulated gastric acid and pepsin concentration, in addition to the volume of gastric secretion.

Omeprazole

Omeprazole, a racemic mixture of two enantiomers reduces gastric acid secretion through a highly targeted mechanism of action. It is a specific inhibitor of the acid pump in the parietal cell. It is rapidly acting and provides control through reversible inhibition of gastric acid secretion with once daily dosing.

Pantoprazole

Pantoprazole is a substituted benzimidazole which inhibits the secretion of hydrochloric acid in the stomach by specific blockade of the proton pumps of the parietal cells.

Pirenzepine
Rabeprazole

Rabeprazole belongs to the class of anti-secretory compounds, the substituted benzimidazoles, that do not exhibit anticholinergic or H2 histamine antagonist properties, but suppress gastric acid secretion by the specific inhibition of the H+/K+ -ATPase enzyme (the acid or proton pump).

Ranitidine

Ranitidine is a specific rapidly acting histamine H2-antagonist. It inhibits basal and stimulated secretion of gastric acid, reducing both the volume and the acid and pepsin content of the secretion. Ranitidine has a relatively long duration of action and so a single 150 mg dose effectively suppresses gastric acid secretion for twelve hours.

Roxatidine

Roxatidine is a competitive histamine H2 receptor antagonist. Roxatidine is a potent and selective inhibitor of basal and stimulated gastric acid secretion through competitive blockade of H2-receptors. Total pepsin secretion is reduced in a dose-dependent manner. There is an independent mucosal protection action. Roxatidine is indicated for the treatment of peptic ulcer, gastro-oesophageal reflux disease, gastritis, upper gastrointestinal haemorrhage and Zollinger-Ellison syndrome also it can be used as a premedication before anaesthesia. Roxatidine possessed a robust estrogenic activity.

Sucralfate

Sucralfate forms an ulcer adherent complex with the proteinaceous exudate of the ulcer site. This property enables sucralfate to form a protective barrier over the ulcer lesion giving sustained protection against the penetration and action of gastric acid, pepsin and bile.

Troxipide

Tripoxide is a gastric cytoprotective agent used for the treatment of gastritis and gastric uclers. Troxipide has a mode of action different from that for other anti-gastric agents: it does not inhibit acid secretion and does not have acid neutralizing activity. It exerts its activity by increasing mucus production, cytoprotective prostaglandin secretion, regeneration of collagen fibers, reducing inflammatory mediator induced neutrophil migration and reactive oxygen species generation in gastric mucosa, enhancing gastric mucosal metabolism and microcirculation.

Vonoprazan

Vonoprazan is a potassium competitive acid blocker (PCAB). It inhibits H+, K+-ATPase in a reversible and potassium-competitive manner. Vonoprazan is a strong base with a high affinity for the acid pump of gastric cells inhibiting gastric acid production.

Monographs

Monograph
Type
Country
ACIPHEX Delayed-release tablet
MPI, US: SPL/PLR
US
ACIPHEX SPRINKLE Delayed-release capsule
MPI, US: SPL/PLR
US
CYTOTEC Tablet
MPI, EU: SmPC
UK
DEXILANT Delayed-release capsules
MPI, US: SPL/PLR
US
LANSOPRAZOLE Gastro-resistant capsules
MPI, EU: SmPC
UK
NEXIUM Gastro-resistant granules
MPI, EU: SmPC
UK
NEXIUM Gastro-resistant tablets
MPI, EU: SmPC
UK
NEXIUM Powder for solution for injection / infusion
MPI, EU: SmPC
UK
OMEPRAZOLE Gastro-resistant capsules
MPI, EU: SmPC
UK
OMEPRAZOLE Powder for solution for infusion
MPI, EU: SmPC
UK
PANTOLOC CONTROL Gastro-resistant tablet
MPI, EU: SmPC
PANTOPRAZOLE 20mg Gastro-resistant tablets
MPI, EU: SmPC
UK
PANTOPRAZOLE 40mg Gastro-resistant tablets
MPI, EU: SmPC
UK
PANTOPRAZOLE Powder for solution for injection
MPI, EU: SmPC
UK
PEDIPPI Powder for oral suspension
MPI, EU: SmPC
IE
PEPCID AC Film-coated tablet
MPI, EU: SmPC
IE
PEPCID Film-coated tablet
MPI, US: SPL/PLR
US
PEPCID Oral suspension
MPI, US: SPL/PLR
US
PREVACID Delayed-release capsule / Delayed-release tablet
MPI, US: SPL/PLR
US
PRILOSEC Granule for delayed-release oral suspension
MPI, US: SPL/PLR
US
RABEPRAZOLE ACCORD Gastro-resistant tablet
MPI, EU: SmPC
UK
Tagamet 200mg Tablets
MPI, EU: SmPC
UK
ZANTAC Injection (Aqueous solution)
MPI, EU: SmPC
UK
ZANTAC Tablets
MPI, EU: SmPC
UK
ZOTON FASTAB Oro-dispersible tablet
MPI, EU: SmPC
UK