Comparative Pharmacology
Head-to-head clinical analysis: NEXIUM 24HR versus OMEPRAZOLE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NEXIUM 24HR versus OMEPRAZOLE.
NEXIUM 24HR vs OMEPRAZOLE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Esomeprazole is a proton pump inhibitor that suppresses gastric acid secretion by specific inhibition of the H+/K+ ATPase enzyme system at the secretory surface of gastric parietal cells. It is a weak base that accumulates in the acidic environment of the parietal cell canaliculus, where it is protonated and converted to the active achiral sulfenamide form, which forms a covalent disulfide bond with cysteine residues of the H+/K+ ATPase, irreversibly inhibiting the pump.
Proton pump inhibitor that irreversibly inhibits the H+/K+ ATPase enzyme system at the secretory surface of gastric parietal cells, blocking the final step of gastric acid secretion.
20 mg orally once daily for 14 days for frequent heartburn; for gastroesophageal reflux disease (GERD), 20 mg orally once daily for 4-8 weeks; for erosive esophagitis, 20-40 mg orally once daily for 4-8 weeks.
20-40 mg orally once daily before a meal for 4-8 weeks.
None Documented
None Documented
Clinical Note
moderateEsomeprazole + Clodronic acid
"The therapeutic efficacy of Clodronic acid can be decreased when used in combination with Esomeprazole."
Clinical Note
moderateOmeprazole + Clodronic acid
"The therapeutic efficacy of Clodronic acid can be decreased when used in combination with Omeprazole."
Clinical Note
moderateEsomeprazole + Alendronic acid
"The therapeutic efficacy of Alendronic acid can be decreased when used in combination with Esomeprazole."
Clinical Note
moderateThe terminal elimination half-life is approximately 1-2 hours in healthy individuals. However, the pharmacodynamic effect (acid suppression) lasts longer due to accumulation in the parietal cell canaliculus and irreversible binding to the proton pump. In poor CYP2C19 metabolizers, half-life may extend to 3-4 hours.
Terminal elimination half-life is approximately 0.5–1 hour. However, the pharmacodynamic effect (gastric acid suppression) lasts much longer due to irreversible binding to the proton pump. The half-life is prolonged in patients with hepatic impairment (up to 3–4 hours in cirrhosis) and in CYP2C19 poor metabolizers (up to 2–3 hours).
Approximately 77% of a single oral dose is excreted in urine as metabolites (primarily hydroxy- and desmethyl-omeprazole) and glucuronide conjugates, with less than 1% as unchanged drug. About 19% is eliminated in feces via biliary excretion. Renal clearance accounts for the majority of elimination.
Approximately 77% of a dose is excreted in urine (as metabolites, including hydroxyomeprazole and the corresponding carboxylic acid and sulfone derivatives), and about 18% is eliminated in feces via biliary excretion. Less than 1% of the parent drug is excreted unchanged in urine.
Category C
Category A/B
Proton Pump Inhibitor
Proton Pump Inhibitor
Omeprazole + Alendronic acid
"The therapeutic efficacy of Alendronic acid can be decreased when used in combination with Omeprazole."