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A Critical Appraisal of Enantiomer Concept of Proton Pump Inhibitors

Yusuf Serdar Sakın, Serhat Bor

Journal of Gastrointestinal and Liver Diseases, 2025

Abstract

Proton pump inhibitors (PPIs) one of the most prescribed drugs worldwide, inhibit acid secretion in the stomach by irreversible hydrogen/potassium adenosine triphosphatase (H+/K+ ATPase) blocking. Currently conventional PPIs in markets are mainly in racemic forms (containing both R- and S- forms). It has been suggested that the beneficial effects of racemic PPIs mostly depend on one of the enantiomers, and a drug containing pure enantiomers might be superior to racemic PPIs. Enantiomers are mirror image stereoisomers of a molecule. In this article, we aim to analyze the comparative studies of the enantiomers of PPIs with non-racemic counter-parts and to assess whether enantiomers, as suggested by certain studies and primarily promoted by some pharmaceutical companies, demonstrate superior efficacy.

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