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An equianalgesic chart is a conversion chart that lists equivalent doses of analgesics (drugs used to relieve pain). Equianalgesic charts are used for calculation of an equivalent dose (a dose which would offer an equal amount of analgesia) between different analgesics. [1]
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]
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]
As of 2006, a standard triple therapy is amoxicillin, clarithromycin, and a proton pump inhibitor such as omeprazole, [15] lansoprazole, pantoprazole, or esomeprazole. Protocols with metronidazole were also in use. [15] An example of a fixed-dose combination is PantoPac, containing pantoprazole, clarithromycin, and amoxicillin. [citation needed]
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]