Efficacy and safety of dexlansoprazole: a comprehensive review

C. C. Chaubal, P. Lawate, Sujit Chaudhury, Ajay Gupta, B. R. Shankar, Sandip Pal, Sharath Kote, Dinesh Patil, Onkar Swami
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Abstract

Gastroesophageal reflux disease (GERD) remains prevalent in medical practice. Proton pump inhibitors (PPIs) are the primary treatment, yet limitations exist. Dexlansoprazole modified release (MR), an R-enantiomer of lansoprazole, offers high efficacy. Its dual release in the duodenum and small intestine yields two peak concentrations at different times (2- and 5-hours post-administration), ensuring the longest maintenance of drug concentration and proton pump inhibitory effect among all PPIs. Dexlansoprazole MR effectively heals erosive esophagitis, maintains healed esophageal mucosa, and controls NERD symptoms. It also improves nocturnal heartburn, GERD-related sleep disturbances, and bothersome regurgitation. Importantly, it maintains good plasma concentration regardless of food intake, enabling flexible dosing. Furthermore, it does not significantly affect clopidogrel metabolism or platelet inhibition, eliminating the need for dose adjustments when co-prescribed. This review highlights dexlansoprazole's unique attributes, pharmacokinetics, advantages, and safety in comparison to traditional PPIs.
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右兰索拉唑的疗效和安全性:全面综述
胃食管反流病(GERD)在医疗实践中仍然很普遍。质子泵抑制剂(PPIs)是主要的治疗手段,但也存在局限性。作为兰索拉唑的R-对映体,右兰索拉唑改良释放(MR)具有很高的疗效。它在十二指肠和小肠中的双重释放可在不同时间(用药后 2 小时和 5 小时)产生两种峰值浓度,从而确保在所有 PPIs 中药物浓度和质子泵抑制作用维持时间最长。右兰索拉唑 MR 能有效治疗侵蚀性食管炎,维持痊愈的食管粘膜,控制非胃食管反流症状。它还能改善夜间胃灼热、胃食管反流相关的睡眠障碍和令人烦恼的反胃。重要的是,无论进食与否,它都能保持良好的血浆浓度,从而实现灵活用药。此外,它不会明显影响氯吡格雷的代谢或血小板抑制作用,因此在联合用药时无需调整剂量。本综述重点介绍了右兰索拉唑与传统 PPIs 相比的独特属性、药代动力学、优势和安全性。
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