Table 2.

Summary of Characteristics of Proton Pump Inhibitors^a

Proton pump inhibitor	Characteristic
Dexlansoprazole	R-enantiomer of lansoprazole
	Dual delayed release formulation
	Dual-peaked pharmacokinetic profile
	24-hour symptom control
	Administration without regard to food
	Hepatic metabolism: CYP2C19, CYP3A4
	Weak inhibition of CYP2C19
	No clinically important effect on exposure to the active metabolite of clopidogrel or clopidogrel-induced platelet inhibition
Esomeprazole	S-isomer of omeprazole
	Low initial oral bioavailability increasing over time
	Hepatic metabolism: CYP2C19, CYP3A4
	Potent inhibition of CYP2C19
	Possible interaction with clopidogrel via CYP2C19
	Delayed absorption with food
Lansoprazole	Constant high bioavailability at therapeutic doses
	Rapid onset of maximal acid suppression
	Delayed absorption with food
	Concurrent antacid therapy reduces bioavailability
	Increased theophylline metabolism
	Hepatic metabolism: CYP2C19, CYP3A4
	Weak inhibition of CYP2C19
	No clinically important effect on exposure to the active metabolite of clopidogrel or clopidogrel-induced platelet inhibition
Omeprazole	Low initial oral bioavailability (35–40%) increasing to ~65% over time
	Dose-dependent kinetics
	Delayed absorption with food
	Hepatic metabolism: CYP2C19
	Potent inhibition of CYP2C19
	Interaction with clopidogrel via CYP2C19
Pantoprazole	Constant bioavailability (~77%)
	Delayed absorption with food
	Hepatic metabolism: CYP2C19, CYP3A4
	Weak inhibition of CYP2C19
	No clinically important effect on exposure to the active metabolite of clopidogrel or clopidogrel-induced platelet inhibition

^aRabeprazole has a non-enzymatic pathway so it is not considered here.

CYP, cytochrome P450.