Esomeprazole

Summary

Esomeprazole (CHEMBL1201320) is an approved small-molecule histamine antagonist (ATC A02BC05) targeting ATP4A; indicated across 32 conditions including peptic ulcer disease and gastroesophageal reflux disease.

At a glance

• Status: Approved (max clinical phase 4)
• Modality: Small molecule
• ATC class: A02BC05
• Targets: 1 (ATP4A)
• Indications: 32 conditions
• Clinical trials: 640
• Chemistry: 345.4 Da · C17H19N3O3S

Identifiers

Drug identity and classification

Field	Value
ChEMBL ID	CHEMBL1201320
Name	Esomeprazole
Type	Small molecule
Max phase	4
FDA approved	yes
PubChem CID	9568614
ChEBI	CHEBI:50275
ATC	A02BC05
Molecular formula	C17H19N3O3S
Molecular weight	345.4
InChIKey	SUBDBMMJDZJVOS-DEOSSOPVSA-N

SMILES: CC1=CN=C(C(=C1OC)C)C[S@](=O)C2=NC3=C(N2)C=C(C=C3)OC

IUPAC name: 6-methoxy-2-[(S)-(4-methoxy-3,5-dimethyl-2-pyridinyl)methylsulfinyl]-1H-benzimidazole

ChEBI definition: A 5-methoxy-2-{[(4-methoxy-3,5-dimethylpyridin-2-yl)methyl]sulfinyl}-1H-benzimidazole that has S configuration at the sulfur atom. An inhibitor of gastric acid secretion, it is used (generally as its sodium or magnesium salt) for the treatment of gastro-oesophageal reflux disease, dyspepsia, peptic ulcer disease, and Zollinger-Ellison syndrome.

Pharmacological roles (ChEBI): histamine antagonist, EC 3.6.3.10 (H+/K+-exchanging ATPase) inhibitor, anti-ulcer drug, EC 1.4.3.4 (monoamine oxidase) inhibitor.

Also known as: A02BC05, Esomeprazol, Esomeprazole, Inexium paranova, Omeprazole s-form, Omeprazole, (s)-, ESOMEPRAZOLE, OMEPRAZOLE, esomeprazole, OMEPRAZOLE/ESOMEPRAZOLE, NEXIUM (esomeprazole magnesium)

Parent form; salt/anhydrous children: CHEMBL1200470, CHEMBL2105642, CHEMBL2146140, CHEMBL5279304, CHEMBL5314366

Patent coverage: 12,902 distinct patent families (37,518 SureChEMBL compound mentions), from 6 matched compound structure(s). One matched structure accounts for 22,666 (60%) of the total. Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Primary targets (GtoPdb curated mechanism): the Cancer dependency column is the DepMap CRISPR fitness signal (% of screened cell lines dependent on the target).

Gene	Target	Action	pAffinity	Cancer dependency	UniProt
ATP4A	ATP4A	Inhibition		0.2%	P20648

Broader ChEMBL bioactivity targets: 1 (assay-derived). Sample: Histone-lysine N-methyltransferase 2A/WDR5.

Bioactivity

ChEMBL activities: 1 potent at pChembl ≥ 5 of 1 total. Top 30 by potency (10 = 0.1 nM, 6 = 1 µM):

Target	pChembl	Type	Value	Unit	Activity ID
WDR5	5.75	IC50	1800	nM	CHEMBL_ACT_22463503

Target pathways

Aggregated over 1 target gene(s): ATP4A.

Top Reactome pathways

3 total, by targets touching each:

Pathway	Targets	Genes
Transport of small molecules	1	ATP4A
Ion transport by P-type ATPases	1	ATP4A
Ion channel transport	1	ATP4A

Dominant GO biological processes

GO term	Targets
intracellular sodium ion homeostasis	1
response to xenobiotic stimulus	1
regulation of proton transport	1
intracellular potassium ion homeostasis	1
monoatomic ion transmembrane transport	1
sodium ion export across plasma membrane	1
pH reduction	1
potassium ion transmembrane transport	1
proton transmembrane transport	1
potassium ion import across plasma membrane	1
monoatomic ion transport	1
potassium ion transport	1
establishment or maintenance of transmembrane electrochemical gradient	1

Indications & clinical

Indications

32 indications (0 at ChEMBL trial phase 4). Phase below is the highest clinical-trial phase recorded for this drug against each disease — not the molecule’s overall approval status (that is in the Summary).

Indication	Trial phase	MONDO	EFO
peptic ulcer disease	3	MONDO:0004247	HP:0004398
gastroesophageal reflux disease	3	MONDO:0007186	EFO:0003948
peptic esophagitis	3	MONDO:0006896	EFO:1001095
chronic gastritis	3	MONDO:0005001	EFO:0000337
preeclampsia	3	MONDO:0005081	EFO:0000668
Helicobacter pylori infectious disease	3	MONDO:0006781	EFO:1000961
gastritis	3	MONDO:0004966	EFO:0000217
gastric ulcer	3	MONDO:0001126	EFO:0009454
ulcer disease	3	MONDO:0043839	MONDO:0043839
osteoarthritis	3	MONDO:0005178	MONDO:0005178
duodenal ulcer	3	MONDO:0005412	EFO:0004607
eosinophilic esophagitis	2	MONDO:0005361	EFO:0004232
neuralgia	2	MONDO:0021667	EFO:0005762
autism	2	MONDO:0005260	EFO:0003758
dyspepsia	2	MONDO:0002268	EFO:0008533
autism spectrum disorder	2	MONDO:0005258	EFO:0003756
asthma	2	MONDO:0004979	MONDO:0004979
cystic fibrosis	2	MONDO:0009061	MONDO:0009061
lymphoma	1	MONDO:0005062	EFO:0000574
pulmonary arterial hypertension	1	MONDO:0015924	EFO:0001361
juvenile idiopathic arthritis	1	MONDO:0011429	EFO:0002609
breast neoplasm	1	MONDO:0021100	EFO:0003869
neoplasm	1	MONDO:0005070	EFO:0000616
chronic hepatitis B virus infection	1	MONDO:0005366	EFO:0004239
metabolic dysfunction-associated steatohepatitis	1	MONDO:0007027	EFO:1001249
fatty liver disease	1	MONDO:0004790	MONDO:0004790

6 further indication records had no mapped disease name (EFO/MeSH-only) or were duplicates, and are omitted.

Clinical trials

Total trials: 640.

Phase distribution

Phase	Trials
PHASE1	228
PHASE4	171
PHASE3	106
Not specified	71
PHASE2	43
EARLY_PHASE1	9
PHASE1/PHASE2	8
PHASE2/PHASE3	4

Top trials by phase / activity

NCT	Phase	Status	Title
NCT04448028	PHASE4	RECRUITING	Stop of Proton-pump Inhibitor Treatment in Patients With Liver Cirrhosis - a Double-blind, Placebo-controlled Trial
NCT04527055	PHASE4	ENROLLING_BY_INVITATION	The Efficacy of 10-day and 14-day Bismuth-based Quadruple Therapy in First-line H. Pylori Eradication
NCT05582174	PHASE4	RECRUITING	PPI Infusion Versus Oral Acid Pump Inhibitors for Bleeding Peptic Ulcers
NCT05799105	PHASE4	RECRUITING	OPEN Versus InTact Capsule Proton Pump Inhibitors for the Treatment of Marginal Ulcers
NCT05874570	PHASE4	RECRUITING	Doxycycline for Helicobacter Pylori Rescue Treatment
NCT06283381	PHASE4	RECRUITING	The ESG Integrity Study: Effect of Proton Pump Inhibitors on the Structural Integrity of Endoscopic Sleeve Gastroplasty
NCT06509139	PHASE4	ENROLLING_BY_INVITATION	Optimal Duration of Bismuth Quadruple Therapy for Helicobacter Pylori Eradication in Females As Compared with Males
NCT06523764	PHASE4	ACTIVE_NOT_RECRUITING	Efficacy and Safety of Tegoprazan and Minocycline Dual Therapy for Helicobacter Pylori Initial Treatment
NCT06526455	PHASE4	NOT_YET_RECRUITING	Efficacy and Safety of Vonorasan Versus Esomeprazole in the Treatment of Ulcers After Endoscopic Submucosal Dissection
NCT06720610	PHASE4	NOT_YET_RECRUITING	Indonesian Study of Vonoprazan Vs Esomeprazole in Erosive Esophagitis
NCT06943482	PHASE4	NOT_YET_RECRUITING	Comparing Effectiveness of Steroids and Methotrexate in Treatment of Chronic Inflammatory Breast Disease
NCT06999577	PHASE4	RECRUITING	The Mechanism Versus PPI Trial
NCT07037888	PHASE4	RECRUITING	Efficacy of Ketorolac for Postoperative Pain Management in Hip Arthroscopy: A Prospective Double-Blinded Randomized Controlled Trial
NCT07040839	PHASE4	NOT_YET_RECRUITING	Comparison of Omeprazole vs Vonoprazon in Treatment of H Pylori Infection
NCT07139366	PHASE4	RECRUITING	Saccharomyces Boulardii Combined With Bismuth Quadruple Therapy for Helicobacter Pylori Rescue Treatment
NCT07268820	PHASE4	RECRUITING	Heartburn, Gastroesophageal Reflux Disease
NCT00120315	PHASE4	COMPLETED	Proton Pump Inhibitor Treatment Stop
NCT00141102	PHASE4	COMPLETED	Study Of Celecoxib Or Diclofenac And Omeprazole For Gastrointestinal (GI) Safety In High GI Risk Patients With Arthritis
NCT00164866	PHASE4	COMPLETED	Administration of High-Dose Intravenous Proton Pump Inhibitor for Upper Gastrointestinal Bleeding Prior to Endoscopy
NCT00184522	PHASE4	COMPLETED	On Demand Treatment of Reflux Disease
NCT00206024	PHASE4	COMPLETED	Acid-Associated Heartburn Symptoms and Dose of Esomeprazole
NCT00206050	PHASE4	COMPLETED	Study of Intragastric pH Profile After 5 Days Pantoprazole 40 mg iv Followed by Oral Esomeprazole 40 mg po or Oral Pantoprazole 40 mg po
NCT00206180	PHASE4	COMPLETED	NEXIUM® in the Treatment of Moderate and Severe Erosive Esophagitis
NCT00225238	PHASE4	COMPLETED	The Effects of Nexium on the Side Effects Associated With a Colonoscopy Prep
NCT00228527	PHASE4	COMPLETED	Esomeprazole for Treatment of GERD in Pediatric Patients
NCT00242736	PHASE4	COMPLETED	An Open-Label Study of Once-Daily Oral Administration of Esomeprazole 40 mg in Patients With Symptoms of Gastroesophageal Reflux Disease (GERD)
NCT00247130	PHASE4	WITHDRAWN	Comparison of Intravenous Omeprazole to Ranitidine on Recurrent Bleeding After Endoscopic Treatment of Bleeding Ulcer
NCT00251030	PHASE4	COMPLETED	A Study To Estimate The Effect Of Omeprazole On The Pharmacokinetics Of Nelfinavir In Healthy Subjects
NCT00272467	PHASE4	COMPLETED	Healing Effects of Rebamipide and Omeprazole in Helicobacter Pylori-positive Gastric Ulcer After Eradication Therapy
NCT00272701	PHASE4	COMPLETED	Esomeprazole in PPI Failures - IMPROVE
NCT00287339	PHASE4	COMPLETED	The Utility of Nexium in Chronic Cough and Reflux Disease
NCT00291746	PHASE4	COMPLETED	Validation of RDQ Questionnaire
NCT00318084	PHASE4	COMPLETED	PPI Test in GP Patients
NCT00318968	PHASE4	COMPLETED	Nexium RESPONSE Trial
NCT00343161	PHASE4	COMPLETED	Symptom Adapted Therapy in GERD Patients
NCT00352261	PHASE4	COMPLETED	An Open Label pH Comparison of Esomeprazole and Lansoprazole in Barrett’s Esophagus Patients
NCT00361985	PHASE4	WITHDRAWN	Study of Proton Pump Inhibitors (PPI) to Prevent Strictures After Gastric Bypass Surgery
NCT00363701	PHASE4	UNKNOWN	Study of Long-Term Use of Proton-Pump-Inhibitors in General Practice
NCT00384592	PHASE4	COMPLETED	PPI Sequencing Study
NCT00392002	PHASE4	COMPLETED	Examine National Characteristics & Outcome Measures of GERD Patients Using the PPI Acid Suppression Symptom (PASS) Test for Response

Clinical evidence (CIViC)

No CIViC predictive evidence (expected for non-precision-medicine drugs).

Pharmacology

Pharmacogenomics

PharmGKB dosing guidelines (2) — CPIC / DPWG genotype-guided dosing for this drug (drug × pharmacogene):

Guideline	Source	Gene(s)	Dosing	Recommendation
Annotation of DPWG Guideline for esomeprazole and CYP2C19	DPWG	CYP2C19
Annotation of CPIC Guideline for esomeprazole, rabeprazole and CYP2C19	CPIC	CYP2C19

PharmGKB also curates 3 clinical and 32 variant annotation(s) for this drug (gene-keyed; see PharmGKB).

Related molecules

Related molecules

Molecules sharing ≥1 of this drug’s curated primary targets, merged from two biobtree sources and ranked by shared-target count, then clinical phase: ChEMBL clinical-stage candidates (development phase ≥2) and PubChem drug-class bioactivity (approved / known drugs acting on the target). Deduplicated by drug name; the drug’s own salt forms are excluded. Note: for a drug with few primary targets a shared-target match can reflect off-target / promiscuous binding rather than the same therapeutic mechanism — the phase ordering surfaces bona-fide therapeutics first.

5 molecules share ≥1 primary target. Top 5 by shared-target count:

Molecule	Source	Status	Shared targets
CIMETIDINE	ChEMBL + PubChem	Phase 4 (approved)	ATP4A
LANSOPRAZOLE	ChEMBL + PubChem	Phase 4 (approved)	ATP4A
PANTOPRAZOLE	ChEMBL + PubChem	Phase 4 (approved)	ATP4A
OMEPRAZOLE	ChEMBL	Phase 4 (approved)	ATP4A
RANITIDINE	ChEMBL	Phase 4 (approved)	ATP4A