Medical management

Drugs used in the medical management of peptic ulcer disease fall into three classes:

• inhibition of acid secretion - proton pump inhibitors such as omeprazole
• neutralization of acid - H2 antagonists, e.g. ranitidine 150 mg bd or 300 mg nocte for 4-8 weeks. Ranitidine is preferred because it has fewer side effects and drug interactions than cimetidine
• increased mucosal resistance:
• sucralfate - there is some concern about long-term use because of the drug's aluminium content. It may also reduce phenytoin absorption.
• misoprostol

NICE have produced guidelines as to the management of dyspepsia in primary care (see linked items).