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