Intragastric pH effect of 20 mg of levo-pantoprazole versus 40 mg of racemic pantoprazole the first seven days of treatment in patients with gastroesophageal reflux disease

Abstract Introduction/aim Levo-pantoprazole, the S-enantiomer of pantoprazole, is a proton pump inhibitor that has been shown in animal studies to be faster and stronger than its racemic formulation. There are no studies on humans and therefore our aim was to evaluate the effects of levo-pantoprazole versus racemic pantoprazole on intragastric pH. Materials and methods A randomized controlled study was conducted on patients with erosive gastroesophageal reflux disease that were given 20 mg of levo-pantoprazole (n = 15) versus 40 mg of racemic pantoprazole (n = 15) for 7 days. Baseline and end-of-treatment symptom evaluation and intragastric pH measurement were carried out. Results There were no differences between the groups in the baseline evaluations. From 40 to 115 min after the first dose of levo-pantoprazole, the mean intragastric pH was higher, compared with that of racemic pantoprazole (p Conclusions The S enantiomer of pantoprazole (levo-pantoprazole) had a faster and stronger effect with respect to acid suppression, compared with its racemic formulation. Although the effect on symptoms was faster with levo-pantoprazole, occurring within the first days of treatment, it was equivalent to that of the racemate at one week of treatment.