Can amantadine (HCL) 100 mg, Bystolic (nebivolol) 5 mg, carbidopa-levodopa 25 mg-100 mg, escitalopram 10 mg, fenofibrate 145 mg, ketoconazole 2% topical cream, pantoprazole 40 mg, trazodone 50 mg, or Xtandi (enzalutamide) 40 mg cause peptic ulcer disease?

From the FDA Drug Label

As with levodopa, treatment with carbidopa and levodopa tablets may increase the possibility of upper gastrointestinal hemorrhage in patients with a history of peptic ulcer

• Carbidopa-levodopa may increase the possibility of upper gastrointestinal hemorrhage in patients with a history of peptic ulcer, which can be associated with ulcer formation 1.
• No other medications listed have direct information in the provided drug label regarding the causation of ulcers.
• Pantoprazole, a proton pump inhibitor, is often used to reduce the risk of ulcers, but its presence in the medication list does not directly answer the question of whether any of these medications can cause ulcers.

From the Research

Several medications in the list can potentially cause ulcers, but the most significant risk factors are associated with carbidopa-levodopa, escitalopram, and trazodone, while pantoprazole is used to treat and prevent ulcers. Nonsteroidal anti-inflammatory drugs (NSAIDs) are common ulcer causes but aren't in this list. However, carbidopa-levodopa can cause gastrointestinal irritation, especially at higher doses like the 8 pills daily in this regimen 2. Escitalopram (an SSID) may slightly increase ulcer risk, as selective serotonin reuptake inhibitors have been associated with an increased risk of bleeding, including gastrointestinal bleeding 2. Trazodone can cause gastrointestinal side effects including nausea and stomach pain. Enzalutamide (Xtandi) may cause abdominal pain but isn't strongly associated with ulcers. Fenofibrate can cause digestive issues but rarely ulcers. Amantadine, Bystolic (nebivolol), and topical ketoconazole are unlikely to cause ulcers.

• Key points to consider:
  • The use of proton pump inhibitors, such as pantoprazole, is effective in healing gastric and duodenal ulcers and reducing the risk of ulcer complications 3, 4.
  • The risk of ulcer development is increased with the use of certain medications, such as NSAIDs, and in patients with a prior history of ulcer disease or concomitant corticosteroid use 5.
  • If experiencing symptoms like stomach pain, black stools, or vomiting blood, it's essential to contact a healthcare provider immediately as these could indicate an ulcer requiring medical attention.
• Medications and their potential to cause ulcers:
  • Carbidopa-levodopa: can cause gastrointestinal irritation, especially at higher doses
  • Escitalopram: may slightly increase ulcer risk
  • Trazodone: can cause gastrointestinal side effects including nausea and stomach pain
  • Enzalutamide (Xtandi): may cause abdominal pain but isn't strongly associated with ulcers
  • Fenofibrate: can cause digestive issues but rarely ulcers
  • Amantadine, Bystolic (nebivolol), and topical ketoconazole: unlikely to cause ulcers
  • Pantoprazole: used to treat and prevent ulcers.