Lansoprazole: a proton pump inhibitor.
OBJECTIVE
To summarize the published data on lansoprazole, a proton pump inhibitor approved by the Food and Drug Administration for use in the treatment of duodenal ulcer, erosive esophagitis, and pathologic hypersecretory conditions (e.g., Zollinger-Ellison syndrome).


METHODS
Published data on lansoprazole identified by MEDLINE searches (1985-1996), as well as other pertinent literature.


METHODS
Clinical efficacy trials discussed were limited to multicenter, double-blind, parallel group, prospective studies, where possible.


RESULTS
Lansoprazole inhibits gastric acid secretion via inhibition of gastric hydrogen/potassium adenosine triphosphatase (H+,K(+)-ATPase), an enzyme of the gastric parietal cell membrane that forms part of the proton pump that performs the final step in the acid secretory process. Lansoprazole binds covalently to parietal cell H+,K(+)-ATPase, rendering it nonfunctional and inhibiting the secretion of gastric acid. In clinical trials, lansoprazole has been shown to be more effective than placebo and standard doses of histamine (H)2-receptor antagonists and as effective as standard doses of omeprazole for the treatment of peptic ulcer disease, gastroesophageal reflux, Zollinger-Ellison syndrome, and nonsteroidal antiinflammatory drug-induced lesions.


CONCLUSIONS
Lansoprazole is safe and effective for the treatment of acid-related disorders. It is more effective than the H2-receptor antagonists and comparable to omeprazole for these indications. The choice between lansoprazole and omeprazole is likely to be institution-specific and pharmacoeconomic.
Garnett
W R
WR
Department of Pharmacy and Pharmaceutics, School of Pharmacy, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298, USA.
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents / Q000494:pharmacology* / Q000627:therapeutic use; D004347:Drug Interactions; D004941:Esophagitis / Q000188:drug therapy*; D006801:Humans; D064747:Lansoprazole; D009853:Omeprazole / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D010437:Peptic Ulcer / Q000188:drug therapy*; D011355:Prodrugs / Q000494:pharmacology* / Q000627:therapeutic use; D054328:Proton Pump Inhibitors; D016032:Randomized Controlled Trials as Topic; D015043:Zollinger-Ellison Syndrome / Q000188:drug therapy*
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D011355:Prodrugs; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D009853:Omeprazole