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Are combination drugs safe to use?

Q: What is the difference between Rabeprazole and Rabeprazole plus Domperidone combination? I have duodenitis, and since last year I have tried all combinations like omeprazole, pantoprazole, Rabeprazole. Will a change from Razo D to Razo created any issues?

A:Rabeprazole is an acid suppressant just like omeprazole, pantoprazole etc. There is not much of a difference between these similar medicines with similar mode of action. If a person does not respond to omeprazole, then it is virtually useless to just try another agent with similar mode of action. Domperidone is basically meant to prevent nausea and vomiting. The combination of rabeprazole with domperidone is irrational. Such a combination is not permitted in any advanced country. If at all rabeprazole and domperidone are required in a patient, then they should be prescribed separately in appropriate, individual dosage. Medicines are discovered individually and are supposed to be taken separately. A huge number of irrational, illegal combinations of drugs are being sold in India; quite a few without mandatory approval of the Drugs Controller General, India (DCGI). Except in a few cases (such as TB medicines), it is always better to take medicines separately so that dosage can be adjusted and side effects monitored. Before treating acidity and similar disorders, one must make a diagnosis and then treat. In your case one should determine the cause of duodenitis. Is it because of H. pylori infection? If so, then proper, curative treatment should be instituted.

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