Acid-suppressive effects of various regimens of omeprazole in Helicobacter pylori-negative CYP2C19 homozygous extensive metabolizers: which regimen has the strongest effect?
To achieve more potent and long-lasting acid suppression, omeprazole was administered for 7 days in 5 regimens: 10, 20, and 40 mg once daily (od), and 10 and 20 mg twice daily (bid), in 7 healthy Helicobacter pylori-negative CYP2C19 homozygous extensive metabolizers, and intragastric pH was continuously measured. The median intragastric pH and percent time pH > 4.0 for 24 hours increased dose dependently with 10, 20, and 40 mg od. Ten and 20 mg bid wre comparable to 20 and 40 mg od, respectively. Concerning percent time pH > 4.0 in the nighttime (20:00-8:00 hours), 20 mg bid was significantly superior to 40 mg od (P < .05). In 4 of the 5 regimens, all 7 subjects had nocturnal acid breakthrough, whereas with 20 mg bid it occurred in only 3. We concluded that, considering nighttime acid suppression, omeprazole 20 mg bid had the strongest effect.
Shimatani
Tomohiko
T
Department of General Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
Kuroiwa
Tomoko
T
Moriwaki
Mutsuko
M
Xu
Jing
J
Tazuma
Susumu
S
Inoue
Masaki
M
D000328:Adult; D000907:Antibodies, Bacterial / Q000032:analysis*; D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics* / Q000378:metabolism; D018592:Cross-Over Studies; D065731:Cytochrome P-450 CYP2C19; D004247:DNA / Q000235:genetics*; D004791:Enzyme Inhibitors / Q000494:pharmacology; D005091:Exons; D005500:Follow-Up Studies; D005744:Gastric Acid / Q000378:metabolism; D005745:Gastric Acidity Determination; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism; D016480:Helicobacter pylori / Q000276:immunology*; D006720:Homozygote; D006801:Humans; D008297:Male; D006899:Mixed Function Oxygenases / Q000235:genetics* / Q000378:metabolism; D009154:Mutation; D009853:Omeprazole / Q000494:pharmacology*; D016133:Polymerase Chain Reaction; D011379:Prognosis; D011446:Prospective Studies; D012016:Reference Values
D000907:Antibodies, Bacterial; D004791:Enzyme Inhibitors; D004247:DNA; D006899:Mixed Function Oxygenases; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D009853:Omeprazole