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The worsening of symptoms in 52% of previously stabilized patients with heartburn or gastroesophageal reflux disease when their treatment is switched from omeprazole to lansoprazole therapy as described by Nelson et al¹ raises several disturbing issues. First, this switch was made after the Pharmacy and Therapeutics Committee of Unity Health Plans declared the 2 drugs to be "therapeutically interchangeable."¹ Even if it is assumed that omeprazole and lansoprazole have equivalent therapeutic efficacy, this does not mean the drugs will have similar efficacy in individual patients. Among other drug groups, switching treatment from therapeutically equivalent drugs such as ibuprofen to celecoxib or fluoxetine to sertraline frequently produces altered responses.

Furthermore, although the adverse effect profiles of omeprazole and lansoprazole may be similar, this does not ensure that patients tolerating one will necessarily tolerate the other. Again, experience with other therapeutically equivalent drugs reveals substantial differences in the number and nature of . . . [Full Text of this Article]

RELATED ARTICLE

Clinical and Humanistic Outcomes in Patients With Gastroesophageal Reflux Disease Converted From Omeprazole to Lansoprazole
Winnie W. Nelson, Lee C. Vermeulen, Eric A. Geurkink, David A. Ehlert, and Mark Reichelderfer
Arch Intern Med. 2000;160(16):2491-2496.
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