Lansoprazole
Lansoprazole
Lansoprazole
(lan-SAHP-rah-zohl)
Pregnancy Category: B Prevacid (Rx)

Classification: GI drug, proton pump inhibitor

Action/Kinetics: Suppresses gastric acid secretion by inhibition of the (H⁺, K⁺)-ATPase system located at the secretory surface of the parietal cells in the stomach. Drug is a gastric acid (proton) pump inhibitor in that it blocks the final step of acid production. Both basal and stimulated gastric acid secretion are inhibited, regardless of the stimulus. May have antimicrobial activity against Helicobacter pylori. Absorption begins only after lansoprazole granules leave the stomach, but absorption is rapid. Peak plasma levels: 1.7 hr. Mean plasma t1/2: 1.5 hr. Over 97% bound to plasma proteins. Food does not appear to affect the rate of absorption, if given before meals. Metabolized in the liver with metabolites excreted through both the urine (33%) and feces (66%).

Uses: Short-term treatment (up to 4 weeks) for healing and symptomatic relief of active duodenal ulcer. Maintain healing of duodenal ulcer. With clarithromycin and/or amoxicillin to eradicate Helicobacter pylori infection in active or recurrent duodenal ulcers. Short-term treatment (up to 8 weeks) for healing and symptomatic relief of benign gastric ulcer. Short-term treatment (up to 8 weeks) for healing and symptomatic relief of all grades of erosive esophagitis. Maintain healing of erosive esophagitis. Long-term treatment of pathologic hypersecretory conditions, including Zollinger-Ellison syndrome. Early and continuous treatment of symptomatic GERD.

Contraindications: Lactation.

Special Concerns: Reduce dosage in impaired hepatic function. Symptomatic relief does not preclude the presence of gastric malignancy. Safety and efficacy have not been determined in children less than 18 years of age.

Side Effects: GI: Diarrhea, abdominal pain, nausea, melena, anorexia, bezoar, cardiospasm, cholelithiasis, constipation, dry mouth, thirst, dyspepsia, dysphagia, eructation, esophageal stenosis, esophageal ulcer, esophagitis, fecal discoloration, flatulence, gastric nodules, fundic gland polyps, gastroenteritis, GI hemorrhage, rectal hemorrhage hematemesis, increased appetite, increased salivation, stomatitis, tenesmus, vomiting, ulcerative colitis. CV: Angina, hypertension or hypotension, CVA, MI, shock palpitations, vasodilation. CNS: Headache, agitation, amnesia, anxiety, apathy, confusion, depression, syncope, dizziness, hallucinations, hemiplegia, aggravated hostility, decreased libido, nervousness, paresthesia, abnormal thinking. GU: Abnormal menses, breast enlargement, gynecomastia, breast tenderness, hematuria, albuminuria, glycosuria, impotence, kidney calculus. Respiratory: Asthma, bronchitis, increased cough, dyspnea, epistaxis, hemoptysis, hiccoughs, pneumonia, upper respiratory inflammation or infection. Endocrine: Diabetes mellitus, goiter, hypoglycemia or hyperglycemia. Hematologic: Anemia, eosinophilia, hemolysis. Musculoskeletal: Arthritis, arthralgia, musculoskeletal pain, myalgia. Dermatologic: Acne, alopecia, pruritus, rash, urticaria. Ophthalmologic: Amblyopia, eye pain, visual field defect. Otic: Deafness, otitis media, tinnitus. Miscellaneous: Gout, weight loss or gain, taste perversion, asthenia, candidiasis, chest pain, edema, fever, flu syndrome, halitosis, infection, malaise.

Laboratory Test Alterations: Abnormal LFTs. AST, ALT, creatinine, alkaline phosphatase, globulins, GGTP, glucocorticoids, LDH, gastrin. or of abnormal WBC and platelets. Abnormal AG ratio, RBC. Bilirubinemia, hyperlipemia. or Electrolytes or cholesterol.

Drug Interactions: Ampicillin / Ampicillin effect R/T absorption Digoxin / Digoxin effect R/T absorption Iron salts / Effect of iron salts R/T absorption Ketoconazole / Ketoconazole effect R/T absorption Sucralfate / Delayed absorption of lansoprazole

How Supplied: Enteric-coated capsule: 15 mg, 30 mg

Dosage
•Capsules, Delayed Release Treatment of duodenal ulcer.
Adults: 15 mg once daily before breakfast for 4 weeks.
Maintenance of healed duodenal ulcer.
Adults: 15 mg once daily.
H. pylori infections.
The following regimens may be used. (1) Lansoprazole, 30 mg b.i.d., plus clarithromycin, 500 mg b.i.d., plus amoxicilin, 1 g, b.i.d. for 10 days. (2) Lansoprazole, 30 mg b.id., plus clarithromycin, 500 mg b.i.d., plus metronidazole, 500 mg b.i.d. for 14 days. (3) Lansoprazole, 30 mg b.i.d., plus tetracycline, 500 mg q.i.d., plus metronidazole, 500 mg t.i.d. for 14 days.
Treatment of gastric ulcer.
30 mg once daily for up to 8 weeks.
Treatment of erosive esophagitis.
30 mg before eating for up to 8 weeks. If the client does not heal in 8 weeks, an additional 8 weeks of therapy may be given. If there is a recurrence, an additional 8-week course may be considered.
Maintenance of healed erosive esophagitis.
15 mg once daily for up to 12 months.
Pathologic hypersecretory conditions.
Initial: 60 mg once daily. Adjust the dose to client need. Dosage may be continued as long as necessary. Doses up to 90 or 120 mg (in divided doses) daily have been given.
Treatment of GERD.
15 mg once daily.