| Theme | PPI Therapy | |
|---|---|---|
| Title | Evaluation of Three Proton Pump Inhibitors in Long-Term Treatment of Acid-Related Disease | |
| Publish Date | 2002/02 | |
| Author | Tomohiko Shimatani | Department of General Medicine, Hiroshima University Hospital |
| Author | Masaki Inoue | Department of Community and Geriatric Nursing, Institute of Health Sciences, Hiroshima University School of Medicine |
| [ Summary ] | Proton pump inhibitors (PPIs) have influenced the management of acid-related diseases over the last 10 years. In Japan, three PPIs are now available; omeprazole, lansoprazole and rabeprazole. Acid suppression studies comparing these agents suggest equivalent potency. Most studies have not shown significant differences, when used in standard doses for maintenance therapy of reflux esophagitis. All PPIs may interact with other medications by increasing gastric pH, thereby changing drug absorption. They are metabolized by cytochrome P450(CYP) 2C19 and 3A4. Minor mutations in CYP2C19 affect its activity in the liver, and, in turn, the metabolic and pharmacokinetic profiles of them. Omeprazole may inhibit CYP2C19, and omeprazole and lansoprazole may induce CYP1A1 and 1A2, resulting in some drug-drug interactions. Rabeprazole has been shown to be the least affected by the CYP2C19-related polymorphism. |
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