PPIs Are Better Taken Before Meals

Despite morning dosing recommendations for proton-pump inhibitors (PPIs), there is considerable inter- and intrapatient variation as to when these medications actually are taken. Given that activation of the H⁺/K⁺ ATPase enzyme is necessary for optimal effects of PPIs, it has been suggested that meal-induced stimulation of acid production may be necessary to optimize acid suppression. In this randomized, crossover study, researchers compared the effect on intragastric acidity of omeprazole (20 mg) and lansoprazole (30 mg) taken either 15 minutes before breakfast or without ingestion of a meal.

Twenty-one healthy subjects were assigned to receive 1 of the 2 drugs for 2 separate 7-day periods (at least 7 days apart). During 1 period, the PPI m…