Lansoprazole and Omeprazole Challenge H2-Receptor Antagonists in Acid-Related Disorders

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IN BRIEFLansoprazole and omeprazole are acid-pump inhibitors acting at the final stage of the acid secretory pathway and, therefore, inhibiting gastric acid secretion regardless of the primary stimulus. In comparison with H2-receptor antagonists, acid-pump inhibitors generally heal peptic ulcers more rapidly and in a slightly higher percentage of patients.Acid-pump inhibitors are also useful in the treatment of ulcers refractory to H2-receptor antagonists and as maintenance therapy, and they are superior to H2-receptor antagonists in the treatment of reflux oesophagitis and Zollinger-Ellison syndrome.Lansoprazole and omeprazole are well tolerated, being associated with similar incidences of adverse effects to those observed with placebo or H2-receptor antagonists. The long term tolerability of omeprazole is now well established.The acid-pump inhibitors represent a major advance in the treatment of acidrelated disorders and should be considered for formulary status. Local pricing considerations will dictate the extent of their use.

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