BRAND NAMES
 MECHANISM OF ACTION
Dexlansoprazole, the dextrorotatory enantiomer of lansoprazole, is a proton pump inhibitors. Dexlansoprazole decreases the amount of acid produced in the stomach by inhibition of H+/K+ ATPase located in the luminal membrane of gastric parietal cells.
- Healing and maintaining healing of erosive esophagitis (EE).
- Treating heartburn associated with symptomatic non-erosive gastroesophageal reflux disease (GERD).
- Erosive Esophagitis (EE):
- Treatment: 60 mg once daily without regard to food, for up to 8 weeks.
- Maintenance of healed EE: 30 mg once daily without regard to food for up to 6 months.
- Gastroesophageal Reflux Disease: Adults: 30mg/day without regard to food for 4 weeks
 DOSAGE FORMS AND STRENGTHS
- Delayed-Release Capsules: 30 mg and 60 mg
- Known hypersensitivity to Dexlansoprazole
 WARNINGS AND PRECAUTIONS
- Symptomatic response to therapy with Dexlansoprazole does not preclude the presence of gastric malignancy
- Proton pump inhibitor (PPI) therapy may be associated with increased risk of Clostridium difficile associated diarrhea.
- 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
- Drugs for which gastric pH can affect bioavailability (e.g.,ketoconazole, ampicillin esters, iron salts, and digoxin): Dexlansoprazole may interfere with absorption due to inhibition of gastric acid secretion.
- Atazanavir: Dexlansoprazole reduces plasma levels of Atazanavir. Concomitant use is not recommended
- Warfarin: Patients taking concomitant warfarin may require monitoring for increases in international normalized ratio (INR) and prothrombin time.
- Tacrolimus: Dexlansoprazole may increase serum levels of tacrolimus
- Methotrexate: Dexlansoprazole may increase serum level of methotrexate
 PREGNANCY AND LACTATION
- Pregnancy Category B (US). There are no adequate and well-controlled studies with dexlansoprazole in pregnant women. There were no adverse fetal effects in animal reproduction studies of dexlansoprazole in rabbits. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.
- Nursing mothers: It is not known whether dexlansoprazole is excreted in human milk. However, lansoprazole and its metabolites are present in rat milk following the administration of lansoprazole. As many drugs are excreted in human milk, 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 the drug, taking into account the importance of the drug to the mother.
 SIDE EFFECTS
Most commonly reported adverse reactions (≥2%): diarrhea, abdominal pain, nausea, upper respiratory tract infection, vomiting, and flatulence.
 RELATED LINKS
|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)|
|Other drugs||Alginic acid • Magaldrate • Sucralfate|
|Combination Regimens||Bismuth Subcitrate Potassium/Metronidazole/Tetracycline (Pylera) • Lansoprazole/Amoxicillin/Clarithromycin (Prevpac)|