Comparative Pharmacology
Head-to-head clinical analysis: NEXIUM versus PRILOSEC OTC.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NEXIUM versus PRILOSEC OTC.
NEXIUM vs PRILOSEC OTC
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 (proton pump) in gastric parietal cells, suppressing gastric acid secretion.
20-40 mg orally once daily; IV: 20 mg once daily.
20 mg orally once daily for 14 days for frequent heartburn; may repeat 14-day course every 4 months.
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.
Approximately 0.5–1 hour in healthy subjects; longer (up to 3 hours) in slow metabolizers or hepatic impairment. Clinically, the duration of acid suppression exceeds the half-life 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; about 80% of metabolites are excreted in urine, and the remainder in feces via bile. Less than 1% of unchanged drug is excreted in urine.
Category C
Category C
Proton Pump Inhibitor
Proton Pump Inhibitor