Combination Therapy

Two agents of different therapeutic classes should not be used routinely. Only modest improvements have been shown when a prokinetic agent is combined with a standard dose of an H2RA. Therefore, patients not responding to standard H2RA doses should be switched to a PPI instead of adding a prokinetic agent. Monotherapy with a PPI is not only more effective, but it also improves compliance with once-daily dosing and is ultimately more cost effective.

The addition of an H2RA at bedtime to PPI therapy has been suggested to decrease nocturnal acid breakthrough. While there may be an immediate effect to control symptoms and keep the pH greater than 4, tachyphylaxis may develop within 1 week. If H2RAs are used at night, it maybe preferable to only use them as needed to provide

a "drug holiday" that may lessen the occurrence of tachyphylaxis. Immediate-release omeprazole-sodium bicarbonate has been shown to decrease nocturnal acid exposure compared with pantoprazole administered daily with the evening meal and lansoprazole administered at bedtime. Although more studies are needed, immediate-release omeprazole may offer an effective option for controlling nocturnal acid exposure and symptoms.

Dealing With Asthma Naturally

Dealing With Asthma Naturally

Do You Suffer From ASTHMA Chronic asthma is a paralyzing, suffocating and socially isolating condition that can cause anxiety that can trigger even more attacks. Before you know it you are caught in a vicious cycle Put an end to the dependence on inhalers, buying expensive prescription drugs and avoidance of allergenic situations and animals. Get control of your life again and Deal With Asthma Naturally

Get My Free Ebook

Post a comment