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Which Has Superior Acid-Suppressive Effect, 10 Mg Omeprazole Once Daily or 20 Mg Famotidine Twice Daily? Effects of Single or Repeated Administration in Japanese Helicobacter Pylori-Negative CYP2C19 Extensive Metabolizers

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Abstract

Low-dose omeprazole is superior to full-dose famotidine in maintenance therapy for gastroesophageal reflux disease, whereas “on-demand” famotidine is more effective for relief of episodes of heartburn. To explain this apparent discrepancy, intragastric pH was measured for 24-hr seven times in eight Japanese Helicobacter pylori-negative cytochrome P450 2C19 extensive metabolizers; on Days 1, 8, and 15 of repeated administration of 10 mg of omeprazole once daily and of 20 mg of famotidine twice daily and before medication. During repeated administration of omeprazole, mean intragastric pH and % time that intragastric pH > 4.0 were significantly higher and became greater. With famotidine, although these parameters were significantly higher, the degrees became smaller. Consequently, acid-suppressive effect was in the order; omeprazole < famotidine on Day 1, omeprazole≈famotidine on Day 8, and omeprazole >famotidine on Day 15. This discrepancy possibly results from the “potentiation” of acid-suppressive effect of omeprazole and the “tolerance” phenomenon in respect to famotidine.

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Authors and Affiliations

  1. Department of General Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan

    Tomohiko Shimatani & Susumu Tazuma

  2. Department of Internal Medicine, Hiroshima Prefectural Akitsu Hospital, Akitsu-cho, Higashi-Hiroshima, Japan

    Masaki Inoue

  3. Department of Geriatric Health Sciences, Graduate School of Health Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan

    Tomoko Kuroiwa, Mutsuko Moriwaki & Jing Xu

  4. Department of Clinical Pharmacotherapy, Graduate School of Biomedical Sciences, Hiroshima University, Minami-ku, Hiroshima, Japan

    Kazuro Ikawa & Norifumi Morikawa

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  1. Tomohiko Shimatani
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Correspondence to Tomohiko Shimatani.

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Shimatani, T., Inoue, M., Kuroiwa, T. et al. Which Has Superior Acid-Suppressive Effect, 10 Mg Omeprazole Once Daily or 20 Mg Famotidine Twice Daily? Effects of Single or Repeated Administration in Japanese Helicobacter Pylori-Negative CYP2C19 Extensive Metabolizers. Dig Dis Sci 52, 390–395 (2007). https://doi.org/10.1007/s10620-006-9490-9

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  • DOI: https://doi.org/10.1007/s10620-006-9490-9

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