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?

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Last updated: April 2, 2025 • View editorial policy

From the FDA Drug Label

As with levodopa, treatment with carbidopa and levodopa orally disintegrating tablets may increase the possibility of upper gastrointestinal hemorrhage in patients with a history of peptic ulcer The carbidopa-levodopa medication may cause an ulcer, as it may increase the possibility of upper gastrointestinal hemorrhage in patients with a history of peptic ulcer 1.

From the Research

Several medications in this list can potentially cause ulcers, including carbidopa-levodopa, escitalopram, and Xtandi (enzalutamide), while pantoprazole is used to treat and prevent ulcers. The medications that may contribute to ulcer formation are:

  • carbidopa-levodopa, which can irritate the stomach lining
  • escitalopram, which may increase bleeding risk
  • Xtandi (enzalutamide), which lists mouth ulceration as a potential side effect On the other hand, the following medications are not typically associated with ulcer formation:
  • Bystolic (nebivolol)
  • Trazodone
  • Amantadine
  • Fenofibrate
  • Topical ketoconazole cream (which is applied to the skin) It's essential to note that the combination of multiple medications can sometimes increase ulcer risk, especially in patients with other risk factors like advanced age, history of ulcers, or concurrent use of NSAIDs 2. Pantoprazole, a proton pump inhibitor, has been shown to be effective in reducing the risk of gastric and duodenal ulcers, especially when used in patients who require continued NSAID therapy 3, 4. If you're experiencing ulcers while taking these medications, it's crucial to consult your healthcare provider, as they may need to adjust your regimen or add protective medications.

References

Research

Prophylaxis and treatment of non-steroidal anti-inflammatory drug-induced upper gastrointestinal side-effects.

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 2001

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