Comparing Pariet and Nexium | Determining the best drug

Updated: 04/23/2021 15:11:06

Expert: Abramova Tsilya

The drugs Pariet and Nexium belong to the group of PPIs, which are used to treat stomach and duodenal ulcers. The composition and effect of drugs are different, so before starting treatment you need to take into account the differences and choose the most effective and safe remedy.

Comparison of the effectiveness of Omeprazole and Pariet

Pariet is more effective than Omeprazole - this means that the ability of the drug substance to provide the maximum possible effect is different.
For example, if the therapeutic effect of Pariet is more pronounced, then with Omeprazole it is impossible to achieve this effect even in large doses.

Also, the speed of therapy is an indicator of the speed of therapeutic action; Pariet and Omeprazole are also different, as is bioavailability - the amount of a drug substance reaching the site of its action in the body. The higher the bioavailability, the less it will be lost during absorption and use by the body.

The main differences, advantages and disadvantages of these drugs

The mechanism of action of these drugs is similar. They both suppress the activity of the same enzyme, but they also have their own characteristics.

Thus, rabeprazole is characterized by a longer action with a single dose, as well as a lower frequency of administration - in many treatment regimens this drug is prescribed once a day.

Also noteworthy is the lower incidence of side effects, which is due to the lower dose of rabeprazole required to achieve the desired effect. When treated with this drug, there is no effect of increasing the secretion of hydrochloric acid at the end of the course of therapy.

Omeprazole has a slightly less convenient dosage schedule, as well as a lower cost, which for many patients is a decisive factor. The specific disease should also be taken into account.

Thus, in the treatment of peptic ulcers, any of the drugs does not have a clear advantage, however, in the case of gastroesophageal reflux disease, many authors tend to consider the use of rabeprazole more appropriate and effective.

Comparison of the safety of Omeprazole and Pariet

The safety of a drug includes many factors.

At the same time, it is higher for Pariet than for Omeprazole. It is important where the drug is metabolized: drugs are excreted from the body either unchanged or in the form of products of their biochemical transformations. Metabolism occurs spontaneously, but most often involves major organs such as the liver, kidneys, lungs, skin, brain and others. When assessing metabolism in Pariet, as well as in Omeprazole, we look at which organ is the metabolizing organ and how critical the effect on it is.

The risk-benefit ratio is when the prescription of a drug is undesirable, but justified under certain conditions and circumstances, with the obligatory observance of caution in use. At the same time, Pariet has fewer risks when used than Omeprazole.

Also, when calculating safety, it is taken into account whether only allergic reactions occur or possible dysfunction of the main organs. In other matters, as well as the reversibility of the consequences of using Pariet and Omeprazole.

Which drug is better

Both PPIs are effective for peptic ulcers, GERD and other disorders associated with increased acid secretion. They are available with a doctor's prescription.

Pariet often causes undesirable symptoms, but there is a possibility of their appearance during treatment with Nexium. The latter drug will be more convenient to take, since it can be taken in the form of a suspension and administered by injection, which is important for patients with swallowing problems. Pariet is available only in tablet form.

During pregnancy, Pariet is strictly contraindicated, and Nexium can be prescribed according to indications. This also applies to children.

The doctor should choose a medicine for the treatment of pathologies against the background of hypersecretion of gastric juice. Self-medication is dangerous and can lead to serious side effects.

Comparison of addiction between Omeprazole and Pariet

Like safety, addiction also involves many factors that must be considered when evaluating a drug.

So, the totality of the values ​​of such parameters as “o syndrome” in Omeprazole is quite similar to the similar values ​​in Pariet. Withdrawal syndrome is a pathological condition that occurs after the cessation of intake of addictive or dependent substances into the body. And resistance is understood as initial immunity to a drug; in this it differs from addiction, when immunity to a drug develops over a certain period of time. The presence of resistance can only be stated if an attempt has been made to increase the dose of the drug to the maximum possible. At the same time, Omeprazole has a fairly low “syndrome” value, just like Pariet.

Mode of application

Omez belongs to the first generation drugs, and Pariet is already a fourth generation drug. That is why the high clinical effectiveness and normalization of the patient’s condition, rapid and reliable relief of symptoms with the second drug are better than with the first. In this case, this is the advantage of Pariet.

To achieve improvement, Pariet must be taken in a smaller dosage than Omez. The active ingredient Pariet rabeprazole immediately enters the circulatory system as an active compound, so it begins to act much faster. Due to this, it is less susceptible to metabolism in the liver, and the drug is well tolerated by patients. The positive effect of Omez and Omeprazole is achieved only after its activation in hydrochloric acid.

How much to take

For duodenal ulcer during exacerbation:

• Omez take 1 tablet per day, 2-4 weeks;
• Pariet is taken in the morning, 1 tablet per day, for 4-6 weeks.

For stomach ulcers during exacerbation:

• Omez - 1-2 capsules for 6-8 weeks;
• Pariet - 1 tablet in the morning, course - 4-6 weeks.

To destroy the pathogenic Helicobacter:

• Omez 1 capsule twice a day + antibacterial therapy;
• Takes 1 tablet twice a day + a combination of antibiotics.

In each individual case, the dosage of medication is determined by the attending physician.

Comparison of side effects of Omeprazole and Pariet

Side effects or adverse events are any adverse medical event that occurs in a subject after administration of a drug.

Omeprazole's side effects are almost the same as Pariet's. They both have few side effects. This implies that the frequency of their occurrence is low, that is, the indicator of how many cases of an undesirable effect of treatment are possible and registered is low. The undesirable effect on the body, the strength of influence and the toxic effect of Omeprazole are similar to Pariet: how quickly the body recovers after taking it and whether it recovers at all.

Pariet®

Cytochrome 450 system

Rabeprazole sodium, like other proton pump inhibitors (PPIs), is metabolized by the cytochrome P450 (CYP450) system in the liver. In vitro studies on human liver microsomes have shown that rabeprazole sodium is metabolized by the isoenzymes CYP2C19 and CYP3A4.

Studies in healthy volunteers have shown that rabeprazole sodium has no pharmacokinetic or clinically significant interactions with drugs that are metabolized by the cytochrome P450 system - warfarin, phenytoin, theophylline and diazepam (regardless of whether patients metabolize diazepam extensively or poorly).

A study of combination therapy with antibacterial drugs was conducted.

This four-way crossover study involved 16 healthy volunteers who received rabeprazole 20 mg, amoxicillin 1000 mg, clarithromycin 500 mg, or a combination of these three drugs (RAC - rabeprazole, amoxicillin, clarithromycin). AUC and Cmax values ​​for clarithromycin and amoxicillin were similar when combination therapy was compared with monotherapy. AUC and Cmax for rabeprazole increased by 11% and 34%, respectively, and for 14-hydroxy-clarithromycin (the active metabolite of clarithromycin), AUC and Cmax increased by 42% and 46%, respectively, for combination therapy compared with monotherapy. This increase in exposure rates for rabeprazole and clarithromycin was not considered clinically significant.

Interactions due to inhibition of gastric acid secretion

Rabeprazole sodium provides a stable and long-lasting suppression of gastric acid secretion. Thus, interactions may occur with substances for which absorption is pH dependent. When taken simultaneously with rabeprazole sodium, the absorption of ketoconazole is reduced by 30%, and the absorption of digoxin is increased by 22%. Therefore, some patients should be monitored to determine whether dose adjustments are necessary when taking rabeprazole sodium concomitantly with ketoconazole, digoxin, or other drugs for which absorption is pH dependent.

Atazanavir

When atazanavir 300 mg/ritonavir 100 mg was coadministered with omeprazole (40 mg once daily) or atazanavir 400 mg with lansoprazole (60 mg once daily) in healthy volunteers, a significant reduction in atazanavir exposure was observed. Absorption of atazanavir is pH dependent. Although concomitant use with rabeprazole has not been studied, similar results are expected for other proton pump inhibitors. Therefore, concomitant use of atazanavir with proton pump inhibitors, including rabeprazole, is not recommended.

Antacids

In clinical studies, antacid substances were used in conjunction with rabeprazole sodium. Clinically significant interactions of rabeprazole sodium with aluminum hydroxide gel or magnesium hydroxide were not observed.

Eating

In a clinical study, no clinically significant interactions were observed when rabeprazole sodium was taken with a low-fat meal. Taking rabeprazole sodium simultaneously with a fat-enriched meal may slow down the absorption of rabeprazole by up to 4 hours or more, but Cmax and AUC do not change.

Cyclosporine

In vitro experiments using human liver microsomes showed that rabeprazole inhibits the metabolism of cyclosporine with an IC50 of 62 μmol, i.e., at a concentration 50 times the Cmax for healthy volunteers after 14 days of administration of 20 mg rabeprazole. The degree of inhibition is similar to that of omeprazole for equivalent concentrations.

Methotrexate

Adverse event reports, published pharmacokinetic studies, and retrospective analyzes suggest that concomitant use of PPIs and methotrexate (primarily at high doses) may result in increased concentrations of methotrexate and/or its metabolite hydroxymethotrexate and prolong the elimination half-life. However, no specific drug interaction studies have been conducted between methotrexate and PPIs.

Impact on laboratory results

The use of PPIs leads to a decrease in gastric acidity, which can lead to an increase in serum chromogranin A (CgA). Elevated CgA levels may lead to misinterpretation of laboratory results for the presence of a neuroendocrine tumor. To avoid this effect, the use of Pariet® should be temporarily discontinued at least 14 days before assessing CgA levels; repeating the test should be considered if the initial CgA level is high.

Comparison of ease of use of Omeprazole and Pariet

This includes dose selection taking into account various conditions and frequency of doses. At the same time, it is important not to forget about the release form of the drug; it is also important to take it into account when making an assessment.

The ease of use of Omeprazole is approximately the same as Pariet. However, they are not convenient enough to use.

The drug ratings were compiled by experienced pharmacists who studied international research. The report is generated automatically.

Last update date: 2020-12-04 13:43:43

Contraindications

General contraindications for these medications are:

• pregnancy period;
• breast-feeding;
• intolerance to drug components.

Omez is not prescribed to children under 4 years of age and weighing less than 20 kg. There is no data on the effect of Pariet on the children's body.

Side effects

After taking both drugs, you may experience:

• disorders of the digestive system (constipation, diarrhea, dry mouth, nausea, vomiting, etc.);
• disturbances in the functioning of the nervous system (headache, insomnia, dizziness);
• allergic reactions (rashes, swelling);
• other effects (visual impairment, lack of taste, etc.).

The list of these side effects is for informational purposes only. Typically, the effects of both Omez and Pariet are well tolerated by patients. If side effects occur, they are short-term and passing.

When choosing a drug, be guided by its spectrum of action and severity of side effects. Omez and Pariet are similar products in this regard. They have approximately the same effect on the gastrointestinal tract and have the same side effects. The most significant difference between these drugs is only in price. However, we advise you not to experiment and seek help from a competent gastroenterologist. He knows exactly which medicine is right for you.