Ilaprazole: Distinctive pharmacokinetic and pharmacodynamic properties among proton pump inhibitors

Abstract

Ilaprazole is a new proton pump inhibitor (PPI) that provides effective and sustained intragastric acid suppression. As PPIs are foundational medications in the treatment of acid-related disorders, the introduction of new PPIs into clinical practice is encouraged. Despite dose and frequency adjustments of standard PPIs, 15–30 ​% of Gastroesophageal reflux disease (GERD) patients remain resistant to acid suppression therapy. Persistent symptoms may result from inadequate acid inhibition or other causes, such as non-acid reflux. Most existing benzimidazole PPIs, such as omeprazole, lansoprazole, and pantoprazole, have a short plasma half-life (less than 2 ​h), leading to the need for new medications that provide consistent and prolonged acid suppression. This study aims to highlight the unique pharmacokinetic and pharmacodynamic characteristics of ilaprazole. Unlike other PPIs, ilaprazole does not exhibit genetic polymorphism effects on drug metabolism. Incorporating ilaprazole into standard triple therapy for Helicobacter pylori infection enhances eradication rates and improves clinical outcomes. Studies have shown that ilaprazole possesses superior H. pylori eradication and ulcer-healing properties. Additionally, this study examines how drug interactions with ilaprazole differ from those of other PPIs. Initial findings indicate that ilaprazole has fewer interactions compared to commonly used PPIs. This review suggests that ilaprazole could be a better alternative compared to other PPI.