Famotidine vs omeprazole

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Comparative Analysis of Famotidine vs. Omeprazole

Introduction to Famotidine and Omeprazole

Famotidine and omeprazole are commonly used medications for treating acid-related disorders. Famotidine is a histamine-2 receptor antagonist (H2RA), while omeprazole is a proton pump inhibitor (PPI). Both drugs are used to reduce stomach acid production but work through different mechanisms.

Efficacy in Duodenal Ulcer Healing

Healing Rates and Pain Relief

Several studies have compared the efficacy of famotidine and omeprazole in the treatment of duodenal ulcers. Omeprazole has been shown to have higher healing rates compared to famotidine. In a study involving 60 patients, omeprazole achieved a 77% healing rate after 2 weeks and 93% after 4 weeks, compared to 40% and 80% for famotidine, respectively . Another study with 241 patients reported similar findings, with omeprazole showing superior healing rates at 2, 4, and 6 weeks . Additionally, omeprazole provided more rapid pain relief and reduced the need for antacids .

Impact on Intragastric pH

Acid Suppression

Omeprazole has been found to be more effective than famotidine in increasing intragastric pH. In a study with healthy dogs, omeprazole significantly increased the percentage of time that intragastric pH was ≥3 and ≥4 compared to famotidine . Similarly, in a study involving healthy male subjects, intravenous famotidine increased intragastric pH more rapidly than intravenous omeprazole, but omeprazole provided longer-lasting acid suppression .

Prevention of Gastrointestinal Injuries

Exercise-Induced Gastritis in Dogs

In the context of preventing exercise-induced gastritis in racing dogs, omeprazole was found to be more effective than high-dose famotidine. Omeprazole significantly decreased the severity and prevalence of gastric lesions compared to famotidine .

Gastroduodenal Injury in Low-Dose Aspirin Users

For high-risk users of low-dose aspirin, omeprazole was superior to famotidine in preventing gastroduodenal mucosal breaks. A study with 170 patients showed that the incidence of mucosal breaks was significantly lower in the omeprazole group compared to the famotidine group .

Gastrointestinal Adverse Events

Dogs with Cancer Treated with Piroxicam

In a study assessing the impact of prophylactic omeprazole and famotidine on gastrointestinal adverse events (AEs) in dogs with cancer treated with piroxicam, both drugs were associated with a higher incidence of GI AEs compared to placebo. However, the severity of GI AEs was higher in the omeprazole group .

Influence on Antiplatelet Therapy

Platelet Reactivity in Acute Coronary Syndromes

In patients with acute coronary syndromes (ACS) receiving clopidogrel and aspirin, there was no significant difference in platelet reactivity between those treated with omeprazole and those treated with famotidine. Both drugs had similar cumulative rates of adverse cardiovascular events at 12 months .

Conclusion

Overall, omeprazole appears to be more effective than famotidine in several clinical scenarios, including the healing of duodenal ulcers, increasing intragastric pH, and preventing gastroduodenal injuries in high-risk patients. However, omeprazole may be associated with more severe gastrointestinal adverse events in certain contexts. The choice between these medications should be based on the specific clinical situation and patient needs.

Sources and full results

Most relevant research papers on this topic

Influence of omeprazole and famotidine on the antiplatelet effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes: a prospective, randomized, multicenter study.

Concomitant use of low-dose omeprazole does not significantly attenuate the antiplatelet effects of clopidogrel in patients with acute coronary syndromes, especially in those with STEMI.

RCT

2012·

22citations

·H. Yano et al.

A prospective, randomized, placebo-controlled, double-blinded clinical trial comparing the incidence and severity of gastrointestinal adverse events in dogs with cancer treated with piroxicam alone or in combination with omeprazole or famotidine.

Omeprazole did not reduce gastrointestinal adverse events and may have increased them in dogs with cancer treated with single agent piroxicam, suggesting it should not be used as a prophylaxis with NSAIDs.

RCTAnimal Study

2021·

14citations

·Marejka H Shaevitz et al.

Efficacy of oral famotidine and 2 omeprazole formulations for the control of intragastric pH in dogs.

Oral omeprazole tablet and reformulated paste provide superior gastric acid suppression to famotidine, making them more effective for treating acid-related disorders in dogs.

RCTAnimal StudyHighly Cited

2011·

101citations

·M. K. Tolbert et al.

Efficacy of omeprazole versus high-dose famotidine for prevention of exercise-induced gastritis in racing Alaskan sled dogs.

Omeprazole is more effective than high-dose famotidine in preventing exercise-induced gastritis in dogs running 300 miles.

RCTAnimal Study

2010·

42citations

·K. Williamson et al.

Omeprazole versus famotidine in the healing and relapse of duodenal ulcer

Omeprazole is superior to famotidine in rapidly healing duodenal ulcers and providing more rapid pain relief, but does not influence subsequent ulcer relapse.

RCT

1993·

8citations

·S. Misra et al.

The comparative effects of single intravenous doses of omeprazole and famotidine on intragastric pH

In Helicobacter pylori-negative healthy male subjects, famotidine 20 mg increases intragastric pH more rapidly than omeprazole 20 mg, potentially benefiting patients with acid-related diseases.

RCT

2003·

32citations

·Y. Abe et al.

Acid aspiration prophylaxis in elective biliary surgery A comparison of omeprazole and famotidine using manually aided gastric aspiration

A single oral dose of omeprazole 40 mg given the night before surgery does not provide adequate prophylaxis for acid aspiration syndrome.

RCT

1994·

12citations

·P. Vila et al.

Omeprazole versus famotidine for the prevention of gastroduodenal injury in high-risk users of low-dose aspirin - a randomized controlled trial.

Proton pump inhibitors are superior to histamine-2 receptor antagonists in preventing gastroduodenal mucosal breaks in high-risk low-dose aspirin users, with smoking being an independent risk factor for such breaks.

RCTRigorous Journal

2020·

0citations

·Zhi-Fu Tseng et al.

Randomized comparative study of omeprazole and famotidine in reflux esophagitis

Background: Although proton pump inhibitors (PPI) and H2‐receptor antagonists (H2‐RA) are routinely used in the treatment of reflux esophagitis (RE), no consensus has been reached yet as to whether the first‐choice drug should be PPI or H2‐RA. In this study, the effects of omeprazole (OMP) and famotidine (FAM) on RE have been examined in a randomized comparative study.

RCT

2002·

27citations

·S. Kawano et al.

Omeprazole versus famotidine in the short‐term treatment of duodenal ulcer disease

Omeprazole (20mg o.m.) is superior to famotidine (40mg nocte) in duodenal ulcer healing compared to placebo.

RCT

1992·

6citations

·G. Fave et al.

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