Oral esomeprazole vs. intravenous pantoprazole: a comparison of the effect on intragastric pH in healthy subjects.
BACKGROUND
Intravenous (IV) proton-pump inhibitor therapy is used in patients who cannot take oral medications or require greater acid suppression. Oral esomeprazole produces greater acid suppression than oral pantoprazole; however, no comparative data exist for oral esomeprazole and i.v. pantoprazole.


OBJECTIVE
To compare acid suppression (time with pH>3.0, 4.0, 5.0 and 6.0) produced by standard doses of oral esomeprazole and i.v. pantoprazole in healthy subjects.


METHODS
A randomized, two-way crossover study in 30 subjects receiving oral esomeprazole (40 mg o.d.) or i.v. pantoprazole (40 mg o.d.) for 5 days followed by a 2-week washout period before the second 5-day drug administration period using the crossover drug regimen.


RESULTS
Oral esomeprazole produced greater acid suppression than i.v. pantoprazole on day 1 [pH>3.0 (56.9%, 35.8%; P<0.001), pH>4.0 (43.4%, 25.0%; P<0.001) and pH>5.0 (28.7%, 15.6%; P<0.001)] and on day 5 [pH>3.0 (70.4%, 45.9%; P<0.001), pH>4.0 (59.2%, 33.9%; P<0.001), pH>5.0 (45.5%, 23.9%; P<0.001) and pH>6.0 (19.6%, 12.6%; P=0.045)]. The adverse event profiles indicated both treatments to be safe and well tolerated.


CONCLUSIONS
In healthy subjects, esomeprazole, 40 mg o.d. dispersed in water, produces greater acid suppression than pantoprazole 40 mg i.v. o.d. after 1 and 5 days of medication.
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000284:Administration, Oral; D000328:Adult; D000897:Anti-Ulcer Agents / Q000008:administration & dosage* / Q000494:pharmacology; D001562:Benzimidazoles / Q000008:administration & dosage* / Q000494:pharmacology; D002940:Circadian Rhythm; D018592:Cross-Over Studies; D064098:Esomeprazole / Q000008:administration & dosage* / Q000494:pharmacology; D005260:Female; D005744:Gastric Acid / Q000378:metabolism*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007262:Infusions, Intravenous; D008297:Male; D000077402:Pantoprazole; D013454:Sulfoxides / Q000008:administration & dosage* / Q000494:pharmacology
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D001562:Benzimidazoles; D013454:Sulfoxides; D000077402:Pantoprazole; D064098:Esomeprazole