Curbside Consultation in GERD: 49 Clinical Questions

Philip O. Katz, MD

Question 33: Are There Differences Among Ppis In Clinical Practice? Should I Ever Consider Switching Among Different Ppis For Patients Who Fail To Respond? (continued)

Careful examination of the many published pharmacodynamic studies reveals an often undiscussed but large interindividual and intraindividual variability in intragastric pH control with the various proton pump inhibitors (PPIs), either given once or even twice daily. This variability with twice-daily dosing is highlighted by a randomized crossover study in which healthy volunteers were given omeprazole 20 mg twice daily and lansoprazole 30 mg twice daily for 7 days separated by at least a 1-week washout period (Figure 33-1). Intragastric pH monitoring was performed on day 7. Subjects were…