Review article: dual delayed release formulation of dexlansoprazole MR, a novel approach to overcome the limitations of conventional single release proton pump inhibitor therapy.
BACKGROUND
Proton pump inhibitors (PPIs) provide the most effective pharmacotherapy for treating acid-related disorders. However, PPIs do not completely control acid over 24 h with once-daily dosing.


OBJECTIVE
To discuss limitations inherent in the pharmacokinetics (PK) and pharmacodynamics of conventional PPI formulations, which provide a single drug release. Also, to consider approaches to extending the duration of acid suppression focusing on dexlansoprazole MR, a PPI with a novel Dual Delayed Release (DDR) formulation.


METHODS
We reviewed the available literature regarding marketed and investigational PPIs.


RESULTS
Non-standard dosing of currently marketed PPIs has produced incremental advances in acid control. Multiple approaches are being evaluated to enhance acid suppression with PPIs. Dexlansoprazole MR is a DDR formulation of dexlansoprazole, an enantiomer of lansoprazole, with two distinct drug release periods to prolong the plasma dexlansoprazole concentration-time profile and extend duration of acid suppression. Clinical studies show that dexlansoprazole MR produces a dual-peak PK profile that maintains therapeutic plasma drug concentrations longer than lansoprazole, with a single-peak PK profile, and increases the percentage of time that intragastric pH >4.


CONCLUSIONS
Novel drug delivery platforms, including the dexlansoprazole MR DDR formulation, may improve acid suppression and offer benefits over conventional single release PPI formulations.
Metz
D C
DC
University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Vakily
M
M
Dixit
T
T
Mulford
D
D
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000494:pharmacology* / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000493:pharmacokinetics* / Q000494:pharmacology / Q000627:therapeutic use; D018592:Cross-Over Studies; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology; D064748:Dexlansoprazole; D006801:Humans; D064747:Lansoprazole; D054328:Proton Pump Inhibitors / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000494:pharmacology; D016032:Randomized Controlled Trials as Topic
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000897:Anti-Ulcer Agents; D003692:Delayed-Action Preparations; D054328:Proton Pump Inhibitors; D064747:Lansoprazole; D064748:Dexlansoprazole