Journal
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
Volume 18, Issue 11-12, Pages 1149-1157Publisher
WILEY
DOI: 10.1046/j.1365-2036.2003.01804.x
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Background: Omeprazole 10 mg is used as maintenance therapy for gastro-oesophageal reflux disease, but previous reports have not mentioned the potency of its acid suppression. Aim: To evaluate the potency of acid suppression with omeprazole 10 mg, in relation to CYP2C19 genotypes. Methods: Eighteen healthy subjects without Helicobacter pylori participated. After a 7-day regimen of omeprazole 10 mg, 20 mg, lafutidine 20 mg (a novel H-2-receptor antagonist) or water only (baseline data), intragastric pH was measured for 24 h. Results: With omeprazole 10 mg, greater differences were observed than 20 mg in median pH values and pH > 4 holding time ratios between poor metabolizers (PMs, n = 6) and the others [homozygous extensive metabolizers (homo-EMs, n = 6) and heterozygous extensive metabolizers (hetero-EMs, n = 6)]. With lafutidine 20 mg, these parameters were not influenced by the genotype. The potency of acid suppression was: omeprazole 20 mg approximate to lafutidine 20 mg > omeprazole 10 mg in homo-EMs, omeprazole 20 mg > omeprazole 10 mg approximate to lafutidine 20 mg in hetero-EMs, and omeprazole 20 mg approximate to omeprazole 10 mg > lafutidine 20 mg in PMs. Conclusions: Omeprazole 10 mg strongly suppresses acid secretion, but depending on the CYP2C19 genotypes shows greater interindividual variations in suppression than 20 mg.
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