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The effects of dose and timing of esomeprazole administration on 24‐h, daytime and night‐time acid inhibition in healthy volunteers
Author(s) -
WilderSmith C.,
Röhss K.,
Bokelund Singh S.,
Sagar M.,
Nagy P.
Publication year - 2010
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2010.04469.x
Subject(s) - esomeprazole , bedtime , medicine , dosing , proton pump inhibitor , crossover study , gerd , pharmacodynamics , pharmacology , gastroenterology , reflux , pharmacokinetics , placebo , disease , alternative medicine , pathology
Aliment Pharmacol Ther 2010; 32: 1249–1256 Summary Background  Symptoms of gastro‐oesophageal reflux disease (GERD) may persist despite daily treatment with a proton pump inhibitor (PPI). Aim  To compare the pharmacodynamic effect of various esomeprazole dosage and timing regimens in healthy volunteers. Methods  The effect of different esomeprazole dosage regimens [20 mg once daily (od) before breakfast or dinner; 20 mg twice daily (b.d.); 40 mg od before breakfast, dinner or at bedtime; and 40 mg b.d.] on 24‐h, daytime and night‐time acid inhibition was evaluated in a randomized, seven‐way crossover study in healthy volunteers. Each regimen was taken for 5 days. Results  Over the 24‐h period (day 5), esomeprazole 20 mg b.d. was associated with superior acid inhibition vs. all 20 mg and 40 mg od regimens ( P  <   0.05), but was less effective than esomeprazole 40 mg b.d. ( P  <   0.05). Dosing with esomeprazole 20 mg or 40 mg od before breakfast gave improved 24‐h and daytime acid inhibition vs. the corresponding administration before dinner or at bedtime (all P  <   0.05). Night‐time acid inhibition was improved when esomeprazole 40 mg od was administered before dinner or at bedtime vs. before‐breakfast dosing ( P  <   0.05). Conclusion  Varying the dose and timing of esomeprazole administration may provide acid inhibition appropriate for the symptom pattern of individual patients with GERD.

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