Comparative Pharmacology
Head-to-head clinical analysis: PREVACID NAPRAPAC 500 COPACKAGED versus PRILOSEC OTC.
Peer-Reviewed Evidence
Head-to-head clinical analysis: PREVACID NAPRAPAC 500 COPACKAGED versus PRILOSEC OTC.
PREVACID NAPRAPAC 500 (COPACKAGED) vs PRILOSEC OTC
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Lansoprazole inhibits gastric acid secretion by irreversibly binding to the H+/K+ ATPase (proton pump) in gastric parietal cells. Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2), reducing prostaglandin synthesis.
Proton pump inhibitor that irreversibly inhibits the H+/K+ ATPase enzyme (proton pump) in gastric parietal cells, suppressing gastric acid secretion.
One tablet of naproxen 500 mg and one capsule of lansoprazole 15 mg taken together orally once daily. Naproxen component: 500 mg orally twice daily. Lansoprazole component: 15 mg orally 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
Naproxen: 12–17 hours (mean ~14 h), prolonged with renal impairment. Esomeprazole: 1–1.5 hours (increase to 2–3 h with CYP2C19 poor metabolizers or hepatic impairment).
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.
Naproxen: 95% renal (primarily as unchanged drug and metabolites, including 6-O-desmethyl naproxen), <5% biliary/fecal. Esomeprazole: 80% renal (as metabolites, primarily hydroxyesomeprazole and desmethyl-esomeprazole, with ~1% unchanged), 20% fecal (via bile).
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/NSAID Combination
Proton Pump Inhibitor