Comparative Pharmacology
Head-to-head clinical analysis: NEXIUM 24HR versus PREVACID IV.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NEXIUM 24HR versus PREVACID IV.
NEXIUM 24HR vs PREVACID IV
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.
Lansoprazole 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. This action is dose-related and leads to inhibition of both basal and stimulated 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.
30 mg intravenous infusion over 30 minutes once daily for up to 7 days; may switch to oral therapy when patient can tolerate oral intake.
None Documented
None Documented
The 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 1.5–2 hours in healthy individuals; however, the pharmacodynamic half-life (duration of acid suppression) is longer (up to 24 hours) due to accumulation in parietal cell canaliculi.
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.
Primarily hepatic metabolism via CYP2C19 and CYP3A4; approximately 75% excreted in urine as metabolites, with less than 1% as unchanged drug; about 20% eliminated in feces via bile.
Category C
Category C
Proton Pump Inhibitor
Proton Pump Inhibitor