Comparative Pharmacology
Head-to-head clinical analysis: DEXILANT versus NEXIUM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DEXILANT versus NEXIUM.
DEXILANT vs NEXIUM
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Dexlansoprazole is a proton pump inhibitor (PPI) that suppresses gastric acid secretion by specific inhibition of the H+/K+ ATPase enzyme system at the secretory surface of gastric parietal cells.
Esomeprazole is a proton pump inhibitor that suppresses gastric acid secretion by specific inhibition of the H+/K+ ATPase enzyme (proton pump) at the secretory surface of gastric parietal cells. It is the S-isomer of omeprazole and is a weak base that accumulates in the acidic environment of the parietal cell canaliculi, where it is converted to the active sulfenamide form that binds covalently to the proton pump, irreversibly inhibiting acid secretion.
30 mg orally once daily for up to 8 weeks; for healing esophagitis, 60 mg orally once daily for up to 8 weeks; maintenance 30 mg orally once daily.
20-40 mg orally once daily; IV: 20 mg once daily.
None Documented
None Documented
Terminal elimination half-life is 1–2 hours in healthy subjects, but due to prolonged gastric acid suppression via irreversible binding to proton pumps, duration of action exceeds 24 hours. Half-life is not directly correlated with pharmacodynamic effect.
Approximately 1–1.5 hours in extensive CYP2C19 metabolizers; in poor metabolizers, half-life can be prolonged to 2–3 hours. Clinically, the plasma half-life does not directly correlate with the duration of acid suppression due to prolonged binding to the proton pump.
Renal (approximately 50% as inactive metabolites) and fecal (approximately 50% as inactive metabolites).
Primarily hepatic metabolism via CYP2C19 and CYP3A4; approximately 80% of metabolites excreted in urine, and the remainder in feces via biliary elimination. Less than 1% of unchanged drug is excreted in urine.
Category C
Category C
Proton Pump Inhibitor
Proton Pump Inhibitor