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Friday, February 05, 2010

What is that you say? Your PPI doesn’t work?

Well, that’s OK, as you are in a lot of company. First, for those of you who don’t know, and still care to know, a PPI is a Proton Pump Inhibitor, like Prilosec, or Omeprazole (Prilosec), or Prilosec OTC (Prilosec again), or Nexium (Prilosec’s active metabolite), or Prevacid, or well, there’s quite a few of them. They are used for GERD (fancy for heartburn) and ulcers.

You might know that the regular dosing of one of these gems is once a day. You know how many times I see a Take one capsule twice a day dosing on a prescription? Lots. Many many times. Why is that?

These drugs though dosed at once a day intervals do not actually have long half lives. Some are quite short, four or five hours. So why do they last so long? Because they bind to an enzyme irreversibly and it takes a while for the body to come back on board. The drugs bind to ACTIVE receptors, which means that timing is crucial: take an hour before eating, so that the drug can bind to those receptors that are become active for the coming food-fest.

I suspect that for many of the people taking these PPIs on multiple dosing regiments that they could get away with once a day dosing if taken an hour before dinner. Thus saving themselves mucho denaros (or their insurance company, which really is the same thing).

Bon appetit.

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