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Pharmacokinetics of Immediate-Release vs. Delayed-Release Omeprazole in Gastroparesis

Phase 4
Completed
Conditions
Gastroparesis
Gastroesophageal Reflux Disease
Interventions
Registration Number
NCT00492622
Lead Sponsor
University of Louisville
Brief Summary

The purpose of this study is to compare the blood drug levels of two prescribed medications, immediate-release omeprazole 40 mg powder and delayed-release omeprazole 40 mg capsule to determine which drug is better absorbed in patients with a slow stomach emptying (gastroparesis). Delayed-release omeprazole has a protective coating to prevent the drug omeprazole from being neutralized by stomach acid. Immediate-release omeprazole has sodium bicarbonate (antacid) which neutralizes the stomach acid, eliminating the need for a protective coating. Immediate-release omeprazole suspension may have a more rapid pharmacokinetic profile and greater overall drug absorption in gastroparesis.

Detailed Description

Hypothesis: Immediate-release omeprazole suspension may have a more rapid pharmacokinetic profile and greater overall drug absorption in gastroparesis. This will result in shorter time to maximal drug concentration, greater maximal concentration, and greater total area under the curve of the concentration vs. time plot.

Primary Objective: To compare the pharmacokinetics of omeprazole between immediate-release suspension and delayed-release capsules in patients with heartburn associated with gastroparesis.

Study design: randomized, open-labeled, crossover treatment for 7 days with 10-14 days washout. Pharmacokinetic studies will be performed after 7 days on study drug.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
12
Inclusion Criteria
  • Symptoms of heartburn >2 days per week off antireflux therapy, defined by "a burning feeling rising from the stomach or lower chest up towards the neck"
  • Symptoms of gastroparesis >1 month in duration, defined by nausea, vomiting, bloating, dyspepsia, early satiety, or effortless regurgitation.
  • Prior abnormal 4-hour gastric emptying scan within the past 3 years
Exclusion Criteria
  • History of esophageal or gastric surgery
  • Severe gastroparesis with any of the following: vomiting with dehydration requiring IV hydration, hospitalization, weight loss >10 % pre-illness weight, requiring feeding jejunostomy tubes
  • Presence of gastric electrical stimulator
  • Symptoms of retching with vomiting more than 2 days per week
  • Diagnosis of diabetes
  • Disorders of small bowel motility (such as pseudo-obstruction or dumping syndrome)
  • Disorders of small bowel absorption
  • Diagnosis of gastric outlet, small bowel or colon mechanical obstruction
  • Diagnosis of acid hypersecretory syndrome
  • Disorders affecting proton pump inhibitor metabolism (such as liver failure)
  • Known allergy or side effects to proton pump inhibitor
  • Non-ambulatory patients: bed-ridden, nursing home resident, etc.
  • Pregnancy

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Immediate-release omeprazole release firstImmediate-release omeprazolesubjects receive immediate release omeprazole for 7 days then delayed release for 7 days
Delayed-release omeprazole firstImmediate-release omeprazolesubjects receive delayed release omeprazole for 7 days then immediate release for 7 days
Immediate-release omeprazole release firstDelayed-release omeprazolesubjects receive immediate release omeprazole for 7 days then delayed release for 7 days
Delayed-release omeprazole firstDelayed-release omeprazolesubjects receive delayed release omeprazole for 7 days then immediate release for 7 days
Primary Outcome Measures
NameTimeMethod
Maximal Concentration of Omerazole10, 20, 30, 45, 60, 90, 120, 150, 180, 210, 240 and 300 min after the study drug was ingested on day 7 of treatment

Maximal concentration of immediate-release vs. delayed-release omeprazole

Area Under the Curve for Omeprazole Plasma Concentration0 to 5 hrs after the study drug was ingested on treatment day 7

The area under the curve for omeprazole concentration-time curve for immediate release and delayed release omeprazole.

Time to Maximal Omeprazole Concentration (Tmax)10, 20, 30, 45, 60, 90, 120, 150, 180, 210, 240 and 300 min after the study drug was ingested on day 7 of treatment

Time to max concentration for Immediate release vs. Delayed release omeprazole

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Digestive Health Center, University of Louisville Hospital

🇺🇸

Louisville, Kentucky, United States

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