Comparative Pharmacology
Head-to-head clinical analysis: NEXIUM versus OMEPRAZOLE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NEXIUM versus OMEPRAZOLE.
NEXIUM 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 (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.
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.
20-40 mg orally once daily; IV: 20 mg once daily.
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
moderateApproximately 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.
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).
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.
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."