Review article

Immediate-release proton-pump inhibitor therapy - Potential advantages

Research output: Contribution to journalReview article

56 Citations (Scopus)

Abstract

The absorption of most oral proton-pump inhibitors is delayed by the enteric coating required to protect the acid-labile proton-pump inhibitor from degradation in the stomach and, as a result, antisecretory effect is also delayed. This article provides an overview of the pharmacokinetics and pharmacodynamics of a new immediate-release omeprazole [(IR-OME) Zegerid power for oral suspension; Santarus Inc., San Diego, CA, USA] and its potential advantages over delayed-release proton-pump inhibitors. Immediate-release omeprazole has a higher mean peak plasma omeprazole concentration (C max) and a significantly shorter mean time to reach Cmax (tmax) than delayed-release omeprazole. Immediate-release omeprazole 40 mg has a prolonged antisecretory effect with median intragastric pH above 4.0 for 18.6 h/day at steady-state, after 7 days of once daily dosing. The sodium bicarbonate in immediate-release omeprazole protects the uncoated omeprazole from degradation by gastric acid. The accelerated antisecretory action of immediate-release omeprazole compared with delayed-release omeprazole may be due to the activation of proton pumps by the rapid neutralization of intragastric acid by the sodium bicarbonate. The faster onset of action seen with immediate-release omeprazole is not achieved by using an antacid with a delayed-release proton-pump inhibitor, because administering antacids with conventional delayed-release proton-pump inhibitors does not significantly enhance absorption of the proton-pump inhibitor. In conclusion, immediate-release omeprazole is associated with rapid absorption of omeprazole and rapid onset of antisecretory effect, without compromising the duration of acid suppression.

Original languageEnglish (US)
Pages (from-to)25-30
Number of pages6
JournalAlimentary Pharmacology and Therapeutics, Supplement
Volume22
Issue number3
StatePublished - Dec 2005
Externally publishedYes

Fingerprint

Omeprazole
Proton Pump Inhibitors
Therapeutics
Antacids
Sodium Bicarbonate
Acids
Proton Pumps
Gastric Acid
Stomach
Suspensions
Pharmacokinetics

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Review article : Immediate-release proton-pump inhibitor therapy - Potential advantages. / Howden, Colin.

In: Alimentary Pharmacology and Therapeutics, Supplement, Vol. 22, No. 3, 12.2005, p. 25-30.

Research output: Contribution to journalReview article

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