Comparative Pharmacology
Head-to-head clinical analysis: NEXIUM versus PREVACID 24 HR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NEXIUM versus PREVACID 24 HR.
NEXIUM vs PREVACID 24 HR
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 (PPI) that irreversibly inhibits the H+/K+-ATPase enzyme system (proton pump) at the secretory surface of gastric parietal cells, suppressing basal and stimulated gastric acid secretion.
20-40 mg orally once daily; IV: 20 mg once daily.
15 mg orally once daily for 14 days.
None Documented
None Documented
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.
1.2-1.5 hours in healthy subjects; no accumulation with once-daily dosing.
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 66% renal (as metabolites), 33% fecal (primarily biliary); less than 1% unchanged in urine.
Category C
Category C
Proton Pump Inhibitor
Proton Pump Inhibitor