Comparative Pharmacology
Head-to-head clinical analysis: LANSOPRAZOLE versus NEXIUM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LANSOPRAZOLE versus NEXIUM.
LANSOPRAZOLE vs NEXIUM
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Proton pump inhibitor that inhibits gastric acid secretion by binding to the H+/K+ ATPase enzyme (proton pump) in gastric parietal cells, preventing the final step of acid production.
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.
15-30 mg orally once daily; 30 mg IV over 30 minutes once daily (when oral not possible).
20-40 mg orally once daily; IV: 20 mg once daily.
None Documented
None Documented
Clinical Note
moderateDexlansoprazole + Clodronic acid
"The therapeutic efficacy of Clodronic acid can be decreased when used in combination with Dexlansoprazole."
Clinical Note
moderateLansoprazole + Clodronic acid
"The therapeutic efficacy of Clodronic acid can be decreased when used in combination with Lansoprazole."
Clinical Note
moderateDexlansoprazole + Alendronic acid
"The therapeutic efficacy of Alendronic acid can be decreased when used in combination with Dexlansoprazole."
Clinical Note
moderateTerminal elimination half-life: 1.5-2 hours (increased to 3-6 hours in elderly, hepatic impairment).
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 (14-23% as metabolites); biliary/fecal (major route, ~60% as metabolites and parent drug).
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 A/B
Category C
Proton Pump Inhibitor
Proton Pump Inhibitor
Lansoprazole + Alendronic acid
"The therapeutic efficacy of Alendronic acid can be decreased when used in combination with Lansoprazole."