A comparison of the acid-inhibitory effects of esomeprazole and pantoprazole in relation to pharmacokinetics and CYP2C19 polymorphism

Hunfeld, N. G., Touw, D. J., Mathot, R. A., Mulder, P. G. H., Van Schaik, R. H., Kuipers, E. J., Kooiman, J. C. & Geus, W. P., Jan-2010, In : Alimentary Pharmacology & Therapeutics. 31, 1, p. 150-159 10 p.

Research output: Contribution to journalArticleAcademicpeer-review

  • N.G. Hunfeld
  • D.J. Touw
  • R.A. Mathot
  • P.G.H. Mulder
  • R.H. Van Schaik
  • E.J. Kuipers
  • J.C. Kooiman
  • W.P. Geus
Background: Esomeprazole and pantoprazole are metabolized in the liver and the polymorphic CYP2C19 enzyme is involved in that process. This genetic polymorphism determines fast (70% of Caucasians), intermediate (25-30% of Caucasians) and slow (2-5% of Caucasians) metabolism of PPIs. Aim To compare the acid-inhibitory effects of esomeprazole 40 mg and pantoprazole 40 mg at 4, 24 and 120 h after oral administration in relation to CYP2C19 genotype and pharmacokinetics. Methods CYP2C19*2, *3, *4, *5 and *17 genotypes were determined in healthy Helicobacter pylori-negative Caucasian subjects. 7 wt/wt, 7 wt/*2, 2 wt/*17, 2 *2/*17 and 1 *2/*2 were included in a randomized investigator-blinded cross-over study with esomeprazole 40 mg and pantoprazole 40 mg. Intragastric 24-h pH-monitoring was performed on days 0, 1 and 5 of oral dosing. Results A total of 19 subjects (mean age 24 years, 7 male) completed the study. At day 1 and 5, acid-inhibition with esomeprazole was significantly greater and faster than with pantoprazole. Differences in acid-inhibition and pharmacokinetics between wt/wt and wt/*2 genotype were significant for pantoprazole at day 1 and 5. Conclusions Esomeprazole provides acid-inhibition faster than and superior to pantoprazole after single and repeated administration. The acid-inhibitory effect and the kinetics of pantoprazole are influenced by CYP2C19 genotype. © 2010 Blackwell Publishing Ltd.
Original languageEnglish
Pages (from-to)150-159
Number of pages10
JournalAlimentary Pharmacology & Therapeutics
Issue number1
Publication statusPublished - Jan-2010


  • cytochrome P450 2C19, esomeprazole, pantoprazole, adult, article, Caucasian, clinical article, clinical trial, controlled clinical trial, controlled study, drug mechanism, drug metabolism, female, genetic polymorphism, genotype, human, male, pH, pH measurement, priority journal, randomized controlled trial, treatment response

ID: 13429851