What is the difference between pantoprazole and lansoprazole

Two studies of esomeprazole Nexium 40 mg versus omeprazole 20 mg found a small difference. The six remaining studies were a hodge-podge group of trials comparing various PPIs at different doses, none of which demonstrated any superiority.

Andrea : All of the studies, except for the two that compared esomeprazole and omeprazole, found that there were no differences among any of the drugs in the treatment of GERD. As for the two studies that suggested esomeprazole was better than omeprazole, the studies were not fair comparisons.

Both studies used higher dosages of esomperazole compared with omeprazole. This cannot be considered a true comparison of effectiveness. In the study comparing esomeprazole with omeprazole, esomeprazole did better. Well, that's no surprise—esomeprazole is the active isomer of omeprazole, and the study authors used a dosage four times that of omeprazole. Breaking this down, they used 40 mg of active drug esomeprazole versus 10 mg of active drug omeprazole the dosage is actually 20 mg, but since omeprazole is a racemic mixture, that is only 10 mg of active drug , and guess what?

The drug not going off patent did better! And who sponsored the study? Astra-Zeneca, the manufacturer. Bob : I knew you would jump on the inappropriate comparison of esomeprazole with omeprazole. Another problem with this comparison is that a true clinical end point is not being measured. But I have the same complaints as I did with the GERD studies regarding the use of unequal dosages and using endoscopic cure rates as the end point.

And do I even have to do the H. Sixteen studies with no differences noted among any PPIs. Bob : Meta-analysis can be tricky.

A series of principles needs to be followed for the results to be valid. In this study, the authors appropriately identified a clear study question, performed a fairly comprehensive review of available databases although they did not include any abstracts from presentations at symposia or obtain unpublished clinical trials from the FDA or the drug companies , and used clear end points to determine cure or failure—so far, so good. The most obvious faux pas the authors made was not grading the quality of the studies they incorporated in this meta-analysis.

They did, however, redeem them-selves slightly by incorporating only randomized prospective trials. Mark : This faux pas is a problem.

How do we know that the studies they included were any good? We don't. I like their conclusions and I am sure they are correct, but they need to grade the papers included in their analysis; other-wise, we have no assurance that they were any good. Bob : I feel comfortable saying there are no differences in efficacy among any PPIs for the above conditions. It also has been suggested that PPIs are associated with increased rates of community-acquired pneumonia 1 and Clostridium difficile colitis.

Andrea : There are no differences among PPIs except cost, so go with the cheapest. However, the cheapest is not what ends up in our sample cabinet. Aim: To compare the efficacy of double the standard doses of omeprazole, lansoprazole or pantoprazole for maintenance treatment of severe oesophagitis complicated by a stricture. Methods: Thirty-six patients with reflux oesophagitis and stricture confirmed by endoscopy were included in a prospective study comparing three maintenance therapies.

In all cases weekly dilatation of the stenosis was performed and patients were treated with omeprazole 20 mg b. Pantoprazole and omeprazole can cause side effects such as headache, dizziness, nausea, and vomiting. They can also cause other gastrointestinal side effects, such as diarrhea, constipation, abdominal pain, and gas. Other possible side effects may include joint pain, upper respiratory tract infections, and asthenia, or lack of energy.

Omeprazole can also cause side effects such as back pain and coughing. Pantoprazole has not been found to cause these particular side effects as often as omeprazole. Source: DailyMed pantoprazole , DailyMed omeprazole. Both pantoprazole and omeprazole can interact with the same drugs.

They both can interact with antiretroviral medications such as rilpivirine, atazanavir, and saquinavir. Taking these medications together can alter the effectiveness of the antiretroviral drug and increase its toxicity.

Some drugs that affect blood clotting should not be taken with certain PPIs. Taking pantoprazole or omeprazole with warfarin can increase the risk of bleeding. While clopidogrel, an antiplatelet drug, may not be affected by pantoprazole, it should be avoided with omeprazole. Pantoprazole and omeprazole can interact with methotrexate, an antimetabolite medication, and cause an increased risk of methotrexate toxicity.

Pantoprazole and omeprazole should not be taken at the same time as iron salts and other drugs that depend on stomach acid for absorption. Other medications that depend on stomach acid for absorption include chemotherapy drugs, such as erlotinib and dasatinib, and antifungals, such as ketoconazole and itraconazole. Because both PPIs are metabolized in the liver, they may interact with other drugs that are processed by similar enzymes, including the CYP2C19 enzyme.

However, according to the pantoprazole FDA label , some drugs that are metabolized in the liver, including phenytoin, citalopram, and diazepam, have not been shown to have significant interaction with pantoprazole. Still, it is important to discuss any medications you take with a doctor before taking a PPI. PPIs can also affect the results of certain lab tests. Consult a doctor with all medications you may be taking. Pantoprazole and omeprazole are not recommended for long-term use since there may be an increased risk of bone fractures.

Those with osteoporosis should monitor or avoid the use of PPIs. Long-term use of pantoprazole and omeprazole can worsen or increase the risk of systemic lupus erythematosus, a rare autoimmune disease.

Treatment with PPIs can increase the risk of diarrhea from Clostridium difficile infections. This risk may be higher in those who are hospitalized for a long time.

PPIs can interfere with the absorption of vitamin B12 in the body, which can lead to vitamin B12 deficiency over time. PPIs can also affect the absorption of magnesium, which can lead to low levels of magnesium in the body hypomagnesemia. Both pantoprazole and omeprazole are in Pregnancy Category C and may cause harm to an unborn baby. Consult a doctor or healthcare provider if you are pregnant or breastfeeding before using a PPI. It is often taken as a 40 mg delayed-release tablet for up to 8 weeks.

It can be taken in adults and children 5 years and older. It is also FDA approved for H. It can be taken as a 20 mg delayed-release capsule for 4 to 8 weeks in adults and children 1 year and older. Pantoprazole and omeprazole are in the same class of medications.