From the FDA Drug Label
Dexlansoprazole is the R-enantiomer of lansoprazole (a racemic mixture of the R- and S-enantiomers). The main difference between Dexlansoprazole and Lansoprazole is that dexlansoprazole is the R-enantiomer of lansoprazole, which is a racemic mixture of the R- and S-enantiomers.
- Key points:
- Dexlansoprazole has a dual delayed-release formulation.
- Lansoprazole is a racemic mixture of R- and S-enantiomers. No direct comparison of efficacy or safety between dexlansoprazole and lansoprazole is provided in the given text. 1
From the Research
Dexlansoprazole is generally more effective for longer periods due to its dual delayed-release formulation, making it a better choice for patients with nighttime heartburn or GERD symptoms, despite being more expensive than lansoprazole 2.
Key Differences Between Dexlansoprazole and Lansoprazole
- Dexlansoprazole has a dual delayed-release formulation, providing two separate releases of medication, whereas lansoprazole typically requires more careful timing with meals.
- Dexlansoprazole is the R-enantiomer of lansoprazole, making it more potent at the same dose.
- Typical dosing for dexlansoprazole is 30-60mg once daily, while lansoprazole is usually 15-30mg once daily.
Efficacy and Safety
- Dexlansoprazole has been shown to be effective in the treatment of symptoms and lesions associated with erosive oesophagitis caused by gastroesophageal reflux disease (GERD) 2.
- Both medications have similar side effect profiles, including headache, diarrhea, and abdominal pain, and both carry the same long-term risks associated with PPI use 3.
Long-term Risks
- Long-term use of PPIs, including dexlansoprazole and lansoprazole, has been associated with an increased risk of osteoporotic fracture, including hip, spine, and wrist fractures 4.
- The US FDA has issued a warning regarding fractures and impaired magnesium absorption associated with the use of PPIs 3.
Recommendation
- Based on the most recent and highest quality study, dexlansoprazole is recommended for patients with nighttime heartburn or GERD symptoms due to its dual delayed-release formulation and improved efficacy 2.
- However, the choice between dexlansoprazole and lansoprazole should be made on a case-by-case basis, taking into account the patient's individual needs and medical history, as well as the potential long-term risks associated with PPI use.