Lansoprazole Vs Omeprazole: Differences And Similarities
Heartburn

Lansoprazole Vs Omeprazole: Differences & Similarities

Medications that work similarly to each other have differences too. Know similarities and differences about Lansoprazole and Omeprazole.

October 09, 2020
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Post Highlights

In today's post, We will contrast the two most popular Proton Pump Inhibitors (PPIs) prescribed in the UK. Not only Lansoprazole and omeprazole are the two most common PPIs, but they are also one of the most popular prescribed drugs in the UK.

We will review the essential facts to highlight the similarity and differences between each medication. Lansoprazole vs omeprazole.

Lansoprazole Vs Omeprazole: Drug Classification

Lansoprazole and Omeprazole belong to a group of drugs called Proton Pump Inhibitors (PPIs). PPIs are the most effective drug in stopping the production of stomach acid.

PPIs, therefore, are used in the treatment of the following conditions:

Verdict: Lansoprazole and omeprazole have the same licensed use as listed above.

Lansoprazole Vs Omeprazole: Mechanism Of Action

Stomach acid production can be stimulated by three different chemicals (hormones). However, there is only one way for the acid to leave the cells (where it was produced) into the stomach.

A proton pump action is the last stage of stomach acid production. As the name suggests proton pump inhibitors stop proton pumps, consequently reducing stomach acid and helping with symptoms of indigestion and heartburn.

Because they act on the last stage of stomach acid production, PPIs are the most effective anti-acid drugs compared to the h2-receptor antagonist (ranitidine) or antacid drugs, which only neutralise the stomach acid.

Verdict: both Lansoprazole and Omeprazole have the same mechanism of action.

When you take omeprazole with food, the amount of omeprazole that reaches the bloodstream is reduced.
No, but check with your doctor immediately if you have an unusual weight gain.
Preferably in the morning, take omeprazole capsules or delayed-release capsules before a meal. Omeprazole pills can be taken on an empty stomach or with food.

Lansoprazole Vs Omeprazole: Common Side Effects

PPIs have some common side effects (SE) as a class of drugs. The table below compares common side effects for Lansoprazole and Omeprazole:

Drugs

Lansoprazole

Omeprazole

Nervous system

Headache, dizziness

Headache

Gastrointestinal SE

Nausea, diarrhoea, stomach pain, constipation, vomiting, flatulence, dry mouth or throat,

Abdominal pain, constipation, diarrhoea, flatulence, nausea/vomiting

Liver

Increased liver enzymes

 

Skin

itching, rash

 uncommon side effect

General

Fatigue

_

*eMC (2020);**eMC (2019)

The list of common side effects shows that Omeprazole has a smaller number of common side effects. However, liver and skin side effects are also listed in the product information for Omeprazole, but as uncommon side effects.

Long-term use of PPIs has been associated with reduced calcium absorption, which can increase the risk of fractures, mainly when used in high doses in the elderly population for at least over a year (NICE, 2020).

Verdict: patients taking Lansoprazole and Omeprazole may experience similar side effects.

Availability Of Different Forms Of Lansoprazole And Omeprazole

The most common forms of Lansoprazole And Omeprazole drugs are capsules; however, both drugs are available in different forms in the UK.

Forms

Lansoprazole

Omeprazole

Capsules

Yes

Yes

Tablets

No

Yes

Orodispersible tablets

Yes

Yes

Liquid forms

No

Yes

Lansoprazole and Omeprazole have different strengths; for example, the most prescribed form of omeprazole is omeprazole 20mg capsules (standard dose for an adult). Lansoprazole is commonly prescribed as Lansoprazole 30mg capsules (standard dose for an adult).

The strength of drugs prescribed is not interchangeable between different medicines. Lansoprazole 30mg capsules are not necessarily better or more effective than 20mg of omeprazole, simply because it has more of the active ingredient.

The potency and effectiveness of the drug is a more complicated matter beyond the scope of this post. When looking at the strength of the same medicine, it can be suggested that omeprazole 20mg is stronger or more effective than omeprazole 10mg.

Over The Counter Availability (OTC) Of Lansoprazole And Omeprazole

Omeprazole can be purchased over the counter without a prescription. Omeprazole 10g and 20mg tablets are available as pharmacy-only medications, for example, Boots Acid Reflux 10 mg and 20mg Gastro-Resistant Tablets.

Pyrocalm Control 20mg Gastro-Resistant Tablets (omeprazole 20mg tablets) are general sale items available for self-selection in pharmacies and supermarkets.

Lansoprazole is unavailable over the counter and comes only as a prescription-only medication.

Verdict: in the UK, omeprazole is available over the counter without a prescription. Although Lansoprazole is not available as an OTC medication, many PPIs alternative to omeprazole and Lansoprazole are commonly available on the shelf.

Lansoprazole Vs Omeprazole: Which One Is More Popular In The NHS

The graph below shows prescribing information from August 2015 until June 2020 for five PPIs available in the UK. Omeprazole and Lansoprazole are clearly the most prescribed PPIs, with Omeprazole being the most commonly prescribed in the UK.

A considerable gap in prescribing can be observed between lansoprazole and omeprazole and 3rd most popular PPIs Esomeprazole.

Verdict: Omeprazole is more commonly prescribed than Lansoprazole.

Is lansoprazole Better Than Omeprazole?

There is no date to suggest that Lansoprazole is better than omeprazole and vice versa. National guidelines on gastro-oesophageal reflux disease (GERD) and dyspepsia (NICE) do not favour PPIs.

Omeprazole became the most prescribed PPI, perhaps because of its cost-effectiveness (low price & effectiveness of the treatment). Lansoprazole is not far off in terms of popularity.

All PPIs are effective in preventing gastro-oesophageal reflux disease (Horn, 2000).
Verdict: all PPIs have similar efficacy when used in treating acid-related conditions.

Drug Interactions For Omeprazole And Lansoprazole

Both drugs have the potential for interactions with other medicines. Lansoprazole and Omeprazole are metabolised (converted into the active form) in the liver by different enzymes (chemicals).

Omeprazole offers a greater potential for interactions with other drugs, whereas interactions are possibly less significant with Lansoprazole.

Lansoprazole, therefore, may be a drug of choice when interactions with other drugs are of concern. For example, in cardiovascular patients who take clopidogrel (an antiplatelet medication), Lansoprazole is usually a preferred drug as omeprazole has shown to interact with this drug (Strand et al., 2017).

Pantoprazole and Rabeprazole (two other PPIs) have less potential for drug interactions than Lansoprazole and Omeprazole (Horn, 2000).

To learn more about specific interactions which are possible with PPI therapy, read the product information leaflet or speak to a pharmacist. Verdict: Lansoprazole has less potential for drug interactions.

What Is The Cost Difference Between Lansoprazole And Omeprazole?

The following table represents prices for Lansoprazole and Omeprazole capsules, the most commonly prescribed form of both drugs.

Drug Strength

Pack size

Trade price

Omeprazole 10mg capsules

28 capsules

£1.15

Omeprazole 20mg capsules

28 capsules

£1.18

Lansoprazole 15mg capsules

28 capsules

£1.09

Lansoprazole 30mg capsules

28 capsules

£1.41

Source: AHH Branch Stock Code List. October 2020

Source: AHH Branch Stock Code List. October 2020.
The above prices are only relevant to private patients. Patients who get drugs prescribed on NHS pay a standard prescription fee (9.15, October 20) or get medication for free if they are exempt from paying.

Patients who get a private prescription need to pay for the supply of the drug (cost of the drug +any mark cost set by a pharmacy). In the above case, the cost of a private prescription for omeprazole or Lansoprazole may be significantly lower than the NHS prescription charge. Some pharmacies, however, have a minimum prescription charge of £5 or more.

Tesco pharmacy has one of the lowest minimum charges for private prescriptions, set at £2. A low minimum charge means that patients can get a supply of 28 omeprazole or lansoprazole capsules for around £2.
Learn more about private prescriptions.
Verdict: Lansoprazole and omeprazole are similar in price (trade price of prescribed drugs).

Lansoprazole Vs Omeprazole Vs Ranitidine

I touched a little bit on the differences between various anti-acid medicines at the beginning of the post. Both lansoprazole and Omeprazole are classified as PPIs.

On the other hand, Ranitidine belongs to a group of drugs called h2-receptor antagonists. As discussed earlier, stomach acid production can be triggered in three different ways. Ranitidine stops only one pathway of stomach acid production.

The h2-receptor antagonist can be useful in reducing stomach acid production; however, PPIs such as Omeprazole or Lansoprazole are more effective.
In 2019 and 2020, ranitidine was subject to a number of recalls due to the potential of being carcinogenic. As a result, ranitidine is the subject of an ongoing investigation into its safety. Ranitidine alternative drugs include mainly PPIs.
Verdict: PPIs such as Omeprazole and Lansoprazole are more effective in managing acid-related conditioCost Difference Betweens than H2 receptor antagonists such as Ranitidine.

Final Words from Druggis

PPIs are effective in the management of gastro-oesophageal reflux disease. Overall, omeprazole and Lansoprazole are similar in terms of side effect profile, efficacy, and cost and have a very favorable safety profile (Ito & Jensen, 2010).