Proton pump inhibitors dosage

Standard proton pump inhibitor dosages reduce the risk of NSAID-related gastric and duodenal ulcers and are at least... 

If no history of GI symptoms is present daily 1.5 mg/kg/BW of CyC + 5FU and weekly 0.2 mg/kg/BW of MTX, or the maximum dosages tolerated, are given. When GI symptoms appear, they are treated and subsequently each IV session is preceded by giving a proton pump inhibitor and/or anti-emetics and/or spasmolytics. 

El-Sherif et al. [79] developed and validated a reversed-phase HPLC method for the quantitative determination of omeprazole and two other proton pump inhibitors in the presence of their acid-induced degradation products. The drugs were monitored at 280 nm using Nova-Pak Ci8 column and mobile phase consisting of 0.05 M potassium dihydrogen phosphate-methanol-acetonitrile (5 3 2). Linearity range for omeprazole was 2-36 fig/ml. The recovery of omeprazole was 100.50 0.8%, and the minimum detection was 0.54 /zg/ml. The method was applied to the determination of pure, laboratory prepared mixtures, and pharmaceutical dosage forms. The results were compared with the official USP method for omeprazole. 

AstraZeneca (formerly Astra) has launched the proton-pump inhibitor esomeprazole (19) (as Nexium) as a treatment for peptic ulcer, gastroesophageal reflux disease, duodenal ulcer, and esophagitis. Esomeprazole is the (S)-enantiomer of omeprazole and was developed as a result of its improved pharmokinetic profile and better potency after oral dosing than (f )-form of omeprazole or the racemate. The dosage is higher than would be expected for a simple chiral switch. The stereogenic center is at sulfur. Detailed accounts of the development of the process have been published.189190... 

Standard dosages of a proton pump inhibitor and a non-selective NSAID appear to be as effective as a selective cyclooxygenase-2 (COX-2) inhibitor in reducing the risk of NSAID-induced ulcers and upper Cl complications. 

In some cases, medications that cost more may be more cost effective. This is particularly true with pancreatic enzymes and the microencapsulated enteric-coated dosage forms. These latter products may cost more per unit, but they offer greater patient acceptance and compliance when compared to uncoated tablets. In addition, when cost is based on the total number of tablets or capsules per day, rather than the cost of a single tablet or capsule, the high-potency preparations are usually similar in price to the uncoated products. The addition of an H2-receptor antagonist or proton pump inhibitor may actually be cost effective for patients who are not adequately controlled on maximal enzyme therapy. 

To prevent degradation of proton-pump inhibitors by acid in the gastric lumen, oral dosage forms are supplied in different formulations (1) enteric-coated drugs contained inside gelatin capsules (omeprazole, esomeprazole, and... 

The antihistamines and other agents presented in this chapter represent the extremes of many spectrums. Traditional antihistamines, like promethazine, have been marketed for more than 50 years proton pump inhibitors have had new dosage forms approved as... 

An active substance, although initially released from its dosage form (and dissolved), may become unavailable for absorption due to reactimis with other medicines or food components [4]. An example is the formation of insoluble complexes of tetracycline with calcium or aluminium ions from antacids or milk products. Interaction (chelation or binding) with iron ions leads to a reduced absorption for a variety of active substances such as doxycycline, penicillamine, methyldopa and ciprofloxacin. The absorption of active substances showing pH-dependent dissolution behaviour may be influenced by medicines that influence the gastric pH, such as H2-antagonists, proton pump inhibitors and antacids. Antimycotic active substances such as ketoconazole or itraconazole dissolve better in acidic fluids. Therefore their bioavailability may be increased by the concomitant use of an acidic drink like cola, whereas the concomitant use of antacids or proton pump inhibitors is likely to reduce the bioavailability. Concomitant use of milk may increase the dissolution of acidic active substances, whereas fats from food may increase the bioavailability of lipophilic active substances like albendazole and griseofulvin. 

Table 1. Pharmacokinetic properties of proton pump inhibitors at standard dosages...

---