lansoprazole

Lansoprazole is in a class of drugs called proton pump inhibitors (PPI) which block the production of acid by the stomach. Other drugs in the same class include

• rabeprazole (Aciphex),
• omeprazole (Prilosec),
• pantoprazole (Protonix), and
• esomeprazole (Nexium).

Proton pump inhibitors are used for the treatment of conditions such as ulcers, gastroesophageal reflux disease (GERD) and Zollinger-Ellison syndrome that are caused by stomach acid. Lansoprazole, like other proton-pump inhibitors, blocks the enzyme in the wall of the stomach that produces acid. By blocking the enzyme, the production of acid is decreased, and this allows the stomach and esophagus to heal.

Heartburn Relief 24 Hour, Heartburn Treatment 24 Hour, Prevacid 24HR, Prevacid, Prevacid SoluTab

GENERIC AVAILABLE: Yes, No (Prevacid OTC)

Yes

Lansoprazole like other PPIs is well-tolerated. The most common side effects are:

• diarrhea,
• nausea,
• vomiting,
• constipation,
• rash and
• headaches.

Other important side effects include:

• Dizziness,
• nervousness,
• abnormal heartbeat,
• muscle pain,
• weakness,
• leg cramps, and
• water retention.

Proton pump inhibitors may increase the risk of Clostridium difficile infection. High doses and long-term use (1 year or longer) may increase the risk of osteoporosis-related fractures of the hip, wrist, or spine. Prolonged use also reduces absorption of vitamin B12 (cyanocobalamin).

Long-term use of PPIs has also been associated with low levels of magnesium (hypomagnesemia). Analysis of patients taking PPIs for long periods of time showed an increased risk of heart attacks.

Therefore, it is important to use the lowest doses and shortest duration of treatment necessary for the condition being treated.

For initial treatment of duodenal ulcers the recommended dose for adults is 15 mg daily for 4 weeks.

For the treatment of GERD, the recommended initial treatment is 15 mg for up to 8 weeks.

For maintaining healing (long-term) in duodenal ulcer and GERD the recommended treatment is 15 mg daily.

For initial treatment of severe (erosive) esophagitis and gastric ulcer, the recommended dose for adults is 30 mg daily for 4-8 weeks.

For the management of Zollinger-Ellison Syndrome, the starting dose for adults is 60 mg daily, and the dose is adjusted based on response. Doses up to 180 mg have been used in some patients with Zollinger-Ellison syndrome.

Intravenous lansoprazole is approved for patients who are unable to take oral lansoprazole. The approved intravenous dose is 30 mg daily for up to 7 days.

It is recommended that capsules be taken before meals for maximum effect. Capsules should be swallowed whole and should not be crushed, split or chewed.

For those with difficulty swallowing, the capsule should be opened and the granular contents sprinkled on a tablespoon of apple sauce, ENSURE pudding, cottage cheese, yogurt or strained pears and swallowed immediately. Granules also may be mixed in two ounces (60 ml) of apple, orange or tomato juice and swallowed immediately. For patients with a nasogastic tube, mix the granules can be mixed in two ounces of apple juice and injected through the nasogastric tube.

Lansoprazole is less likely than omeprazole (Prilosec, Zegerid) to interact with other drugs.

The absorption of certain drugs may be affected by stomach acidity, and, as a result, lansoprazole and other PPIs that reduce stomach acid also reduce the absorption and concentration in blood of ketoconazole (Nizoral) and increase the absorption and concentration in blood of digoxin (Lanoxin). This may lead to reduced effectiveness of ketoconazole or increased digoxin toxicity, respectively.

Lansoprazole may increase blood levels of methotrexate (Trexall) and tacrolimus (Prograf).

Proton pump inhibitors may also increase the action of warfarin (Coumadin), increasing the risk of bleeding.

Use of lansoprazole in pregnant women has not been adequately evaluated.

Lansoprazole has not been studied in nursing women.

What preparations of lansoprazole are available?

Capsules: 15 and 30 mg. Oral suspension: in 15 and 30 mg unit dose cartons of 30. Lansoprazole also is available in 15 and 30 mg tablets that disintegrate when placed under the tongue (Prevacid SoluTab). Lansoprazole is available for intravenous injection in vials containing 30 mg of powdered lansoprazole (30 mg/5 ml when mixed with sterile water).

How should I keep lansoprazole stored?

Store at room temperature between 15 C and 30 C (59 F and 86 F). Keep away from moisture.