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The initial treatment of choice for non-eradication of duodenal ulcers is Pantoprazole at a daily dose of 40 mg.
A network meta-analysis revealed that Pantoprazole (40 mg once a day for 4 weeks) is the best choice for non-eradication of duodenal ulcers. Additionally, Cimetidine (400 mg two times a day), Omeprazole (20 mg once a day), Lansoprazole (15 mg once a day), Ilaprazole (5 mg once a day), and Rabeprazole (10 mg once a day) are considered viable options for treatment. If these medications are not accessible, Famotidine (40 mg two times a day) is suggested as an alternative.
The objective of the study was to assess the effectiveness and safety of H2 receptor antagonists and proton pump inhibitors (PPIs) in the initial non-eradication management of duodenal ulcers. The researchers conducted a search of medical literature for randomized clinical trials that assessed the safety and effectiveness of these drugs, either in comparison with each other or with a placebo. Except for Ranitidine (300 mg four times a day) and Vonoprazan (20 mg once a day), which showed declined safety compared to the placebo, the remaining interventions demonstrated superior safety and effectiveness when compared to the placebo.
Cimetidine (400 mg four times a day) and Pantoprazole (40 mg once a day) were found to be the most effective options. For Cimetidine (except at a dosage of 400 mg once a day), Famotidine, Rabeprazole, Ilaprazole, Lansoprazole (except at a dosage of 7.5 mg once a day), and Omeprazole (except at dosages of 10 mg once a day or 30 mg once a day), there were no discernable differences in efficacy among different doses of these drugs.
Pantoprazole at a dosage of 40 mg once daily is the preferred choice to improve duodenal ulcers. As first-line options, Cimetidine (400 mg twice daily), Omeprazole (20 mg once daily), Lansoprazole (15 mg once daily), Ilaprazole (5 mg once daily), and Rabeprazole (10 mg once daily) can also be considered. Famotidine at a dosage of 40 mg twice daily is recommended if these medications are not available.
Experimental and Therapeutic Medicine
Efficacy and safety of proton pump inhibitors and H2 receptor antagonists in the initial non-eradication treatment of duodenal ulcer: A network meta-analysis
Xiangbo Meng et al.
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