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Esomeprazole's successful predecessor, omeprazole, is a mixture of two mirror-imaged molecules (esomeprazole which is the S-enantiomer, and R-omeprazole); critics said the company was trying to "evergreen" its omeprazole patent by patenting the pure esomeprazole and aggressively marketing to doctors that it is more effective than the mixture. [50]
Esomeprazole is the (S)-(−)-enantiomer of omeprazole and provides higher bioavailability and improved efficacy, in terms of stomach acid control, over the (R)-(+)-enantiomer of omeprazole. In theory, by using pure esomeprazole the effects on the proton pump will be equal in all patients, eliminating the "poor metabolizer effect" of the ...
Esomeprazole (OTC and Rx-only in the US and Australia) [86] Ilaprazole (not FDA-approved as of July 2019) Lansoprazole (OTC and Rx-only in the US) [85] Omeprazole (over-the-counter drug) [86] Pantoprazole [87] Rabeprazole [88] There is no clear evidence that one proton pump inhibitor works better than another. [1] [89]
AstraZeneca also developed esomeprazole (Nexium) which is a eutomer, purely the (S)-enantiomer, rather than a racemate like omeprazole. [medical citation needed] Omeprazole undergoes a chiral shift in vivo which converts the inactive (R)-enantiomer to the active (S)-enantiomer, doubling the concentration of the active form. [59]
Naproxen/esomeprazole, sold under the brand name Vimovo, is a pain reliever medication in the form of a tablet for oral consumption, containing naproxen, a nonsteroidal anti-inflammatory drug (NSAID), and a delayed release formulation of esomeprazole, a stomach acid–reducing proton-pump inhibitor (PPI). [2] [3] It is produced by AstraZeneca. [4]
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