GERD		Lansoprazole
Acid Reflux; Gastroesophageal Reflux; Gastroesophageal Reflux (GERD); Gastroesophageal Reflux Disease; Gastroesophageal ...		Prevacid

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DOSING For initial treatment of duodenal ulcers the recommended dose for adults is 15 mg daily for 4 weeks For the treatment of GERD the recommended initial treatment is 15 mg for up to 8

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Prevacid Lansoprazole 30 mg 30 caps Prevacid is a heartburn medication used to treat GERD

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part of the stomach bulges into the chest cavity through an opening in the diaphragm hiatus The diaphragm is a sheet of muscle that separates the stomach cavity from the chest cavity What are the symptoms of GERD Heartburn is the most common symptom of

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food from the mouth to the stomach Reflux means to back up or flow backwards GERD is a condition in which acid bile and partially digested food in the stomach back up into the esophagus

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more difficult Rabeprazole and lansoprazole have a more rapid onset of relief than omeprazole and pantoprazole in the first few days of therapy Esomeprazole is more rapid than omeprazole Slide 6 Satisfactory Heartburn Relief With Rabeprazole 20 mg Daily We can look at the Fass trial in which patients had EE and you can see this dramatic relief of symptoms in the first day

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Omeprazole pantoprazole and lansoprazole have high values while rabeprazole has a value near 1 Therefore it is not affected by the difference between extensive and poor metabolizers Slide 8 PPIs CYP2C19 Genotype and Gastric pH What is the consequence of that on gastric pH It is immediately evident that in contrast to lansoprazole which shows major differences between

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20 mg lansoprazole 30 mg and pantoprazole 40 mg in 18 healthy H pylori negative volunteers Slide 26 Antisecretory Effect of RAB 20 mg vs Conventional PPIs Gastric pH Metry on Day 1 Slide 27 Antisecretory Effect of RAB 20 mg vs Conventional PPIs Nighttime pH After First Dose Here are the data of our study Rabeprazole with a 3 4 median intragastric pH is statistically

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Slide 20 Conclusions For EE there s a symptomatic response and it occurs rapidly with PPI therapy This early response may reflect some pharmacologic differences with lansoprazole and

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in a distant second by lansoprazole gave you a much better inhibition of gastric acid secretion on day 1 than did either pantoprazole or omeprazole or the omeprazole in the pellet suspension Slide Rabeprazole vs Omeprazole Rapidity of Symptom Relief We re starting to see some literature now that these agents that do have better day 1 efficacy and in particular rabeprazole does

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to lansoprazole which shows major differences between extensive metabolizers and poor metabolizers the gastric pH with rabeprazole is independent of the polymorphism of the hepatic enzyme Slide 9 Conclusion 1 PPIs Differ With Respect to Influence of Genetic Polymorphism of CYP2C19 Conclusion number one therefore is that PPIs differ with respect to the influence of the

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in 1997 in Gastroenterology and this was a meta analysis of 43 trials of which 93 were randomized controlled trials Both of these are valid given the rules and the guidelines of EBM Slide 14 Healing of Esophagitis The first one from Caro et al showed that rabeprazole omeprazole lansoprazole and pantoprazole when compared to ranitidine were statistically

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are quite different Omeprazole and pantoprazole are mostly metabolized by 2C19 lansoprazole is metabolized by 2C19 and 3A4 while rabeprazole is mostly metabolized by nonenzymatic pathways Slide 6 Genetic Polymorphism of CYP2C19 It is relevant because we know now that there is an important genetic polymorphism of CYP2C19 We can differentiate between rapid metabolizers with a

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trial using rabeprazole 20 mg omeprazole 20 mg omeprazole MUPS multiple unit pellet system 20 mg lansoprazole 30 mg and pantoprazole 40 mg in 18 healthy H pylori negative volunteers Slide 26 Antisecretory Effect of RAB 20 mg vs Conventional PPIs Gastric pH Metry on Day 1 Slide 27 Antisecretory Effect of RAB 20 mg vs Conventional PPIs Nighttime pH After First Dose Here

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