Lansoprazole

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Lansoprazole is a proton-pump inhibitor (PPI) which inhibits the stomach's production of gastric acids. Lansoprazole is indicated for treatment of ulcers of the stomach and duodenum (including NSAID-induced ulcers), acid reflux, Helicobacter pylori infection and Zollinger-Ellison Syndrome.

Contents

[edit] BRAND NAMES

[edit] STRUCTURE

Lansoprazole.jpg

[edit] MECHANISM OF ACTION

Lansoprazole is a proton pump inhibitors. it decreases the amount of acid produced in the stomach by inhibition of H+/K+ ATPase located in the luminal membrane of gastric parietal cells

[edit] INDICATIONS

  • Treatment of Gastroesophageal reflux disease (GERD)
  • Treatment of Duodenal Ulcers
  • Treatment of Benign Gastric Ulcers
  • Treatment and prevention of ulcers caused by NSAIDs.
  • H. Pylori bacteria eradication
  • Pathological Hypersecretory Conditions like Zollinger-Ellison syndrome

[edit] DOSAGE

  • Gastroesophageal Reflux Disease:
    • Adults: 15-30mg/day
    • 12 to 17 Year Olds: 15-30mg/day
    • Less than 30 kg 15 mg once daily
    • More than 30 kg 30 mg once daily
  • Duodenal Ulcers: Short-Term Treatment 15 mg Once daily for 4 weeks. Maintenance of Healed, 15 mg Once daily
  • Benign Gastric Ulcer: 30 mg Once daily up to 8 weeks
  • Treatment and prevention of ulcers caused by NSAIDs: Healing, 30 mg/day for 8 weeks. Prevention, 15 mg/day for up to 3 months
  • H. pylori Eradication (Triple Therapy): Lansoprazole (30 mg) twice daily + Amoxicillin (1000 mg) Twice Daily + Clarithromycin (500 mg) Twice Daily, for 14 days
  • H. pylori Eradication (Dual Therapy): Lansoprazole (30 mg) Three times daily + Amoxicillin (1000 mg) Three times daily for 10-14 days
  • Zollinger-Ellison syndrome: 60 mg once daily

[edit] DOSAGE FORMS AND STRENGTHS

Capsules and Tablets: 15 mg and 30 mg

[edit] CONTRAINDICATIONS

  • Known hypersensitivity to Lansoprazole

[edit] WARNINGS AND PRECAUTIONS

  • Symptomatic response with Lansoprazole does not preclude the presence of gastric malignancy.
  • PPI therapy may be associated with increased risk of Clostridium difficile associated diarrhea.
  • Bone Fracture: Long-term and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist or spine.
  • Hypomagnesemia has been reported rarely with prolonged treatment with PPIs.

[edit] INTERACTIONS

  • Atazanavir: Lansoprazole reduces plasma levels of Atazanavir. Concomitant use is not recommended.
  • Drugs with pH-Dependent Absorption: May interfere with the absorption of drugs where gastric pH is important for bioavailability (e.g., itraconazole, ampicillin esters, iron salts, and digoxin). PPIs reduce absorption of itraconazole and and possibly increase Digoxin in plasma.
  • Warfarin: Patients taking concomitant warfarin may require monitoring for increases in international normalized ratio (INR) and prothrombin time.
  • Tacrolimus: Concomitant tacrolimus use may increase tacrolimus whole blood concentrations.
  • Theophylline: Titration of theophylline dosage may be required when concomitant Lansoprazole use is started or stopped.
  • Methotrexate: Lansoprazole may increase serum levels of methotrexate.

[edit] PREGNANCY AND LACTATION

  • Pregnancy Category B (US). Reproduction studies have been performed in pregnant rats at oral doses up to 40 times the recommended human dose and in pregnant rabbits at oral doses up to 16 times the recommended human dose and have revealed no evidence of impaired fertility or harm to the fetus due to lansoprazole. There are, however, no adequate or well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
  • Nursing Mothers: Lansoprazole or its metabolites are excreted in the milk of rats. It is not known whether lansoprazole is excreted in human milk. Because many drugs are excreted in human milk, because of the potential for serious adverse reactions in nursing infants from lansoprazole, and because of the potential for tumorigenicity shown for lansoprazole in rat carcinogenicity studies, a decision should be made whether to discontinue nursing or to discontinue lansoprazole, taking into account the importance of lansoprazole to the mother.

[edit] SIDE EFFECTS

Most commonly reported adverse reactions (≥1%): diarrhea, abdominal pain, nausea and constipation.

[edit] RELATED LINKS

[edit] BIBLIOGRAPHY

[edit] REFERENCES

Heartburn/Gastritis/Gastric ulcer/Duodenal ulcer/Gastroesophageal reflux
H2 antagonists Famotidine   Nizatidine   Ranitidine (Zantac)
Proton-pump inhibitors Dexlansoprazole (Dexilant)   Esomeprazole (Nexium)   Lansoprazole (Prevacid)   Omeprazole (Losec, Prilosec)   Omeprazole/Sodium bicarbonate (Zegerid)   Pantoprazole (Controloc, Pantecta, Pantoloc, Protonix) (  Rabeprazole (Aciphex, Pariet)
Prostaglandins Misoprostol (Cytotec)
Other drugs Alginic acid   Magaldrate   Sucralfate
Combination Regimens Bismuth Subcitrate Potassium/Metronidazole/Tetracycline (Pylera)   Lansoprazole/Amoxicillin/Clarithromycin (Prevpac)