Lansoprazole
Indications
Lansoprazole is used for:
Peptic ulcer, H.pylori infection, Gastro-oesophageal reflux disease, Hypersecretory conditions, Acid-related dyspepsia, NSAID-induced ulcers, Erosive oesophagitis
Adult Dose
Oral
Peptic ulcer
Adult: 30 mg once daily in the morning given for up to 4 wk (duodenal ulcer) or for up to 8 wk (gastric ulcer). Maintenance: 15 mg/day.
Zollinger-Ellison syndrome
Adult: Initially, 60 mg once daily in the morning and adjust as required. Daily doses >120 mg should be given in 2 divided doses.
Acid-related dyspepsia
Adult: 15-30 mg once daily in the morning for 2-4 wk.
Gastro-oesophageal reflux disease
Adult: 15-30 mg once daily in the morning for 4-8 wk. Maintenance: 15-30 mg once daily according to response.
Prophylaxis of NSAID-induced ulcers
Adult: 15-30 mg once daily in the morning.
H.pylori infection
Adult: 1-wk triple therapy: 30 mg bid combined w/ clarithromycin 500 mg bid and amoxicillin 1 g bid or combined w/ clarithromycin 250 mg bid and metronidazole 400 mg bid.
Erosive oesophagitis
Adult: 30 mg once daily in the morning for up to 8 wk, additional 8 wk if not healed. Maintenance: 15 mg once daily.
NSAID-associated ulceration
Adult: 30 mg once daily in the morning for 4-8 wk.
Elderly: No dosage adjustment needed.
Hepatic impairment: Severe: Max: 30 mg/day.
Child Dose
Oral
Gastro-oesophageal reflux disease
1-11 yr
<30 kg: 15 mg once daily in the morning for up to 12 wk;
>30 kg: 30 mg once daily in the morning for up to 12 wk. May increase doses up to 30 mg bid if patient is still symptomatic after 2 or more wk of treatment.
12-17 yr
15 mg once daily for up to 8 wk.
Erosive oesophagitis
1-11 yr
<30 kg: 15 mg once daily in the morning for up to 12 wk;
>30 kg: 30 mg once daily in the morning for up to 12 wk. May increase doses up to 30 mg bid if patient is still symptomatic after 2 or more wk of treatment.
12-17 yr 30 mg once daily for up to 8 wk.
Renal Dose
Renal impairment: No dosage adjustment needed.
Administration
Should be taken on an empty stomach. Take before meals.
Contra Indications
Hypersensitivity.
Precautions
Hepatic impairment. Gastric malignancy should be ruled out. Pregnancy and lactation.
Lactation: Not known whether distributed into breast milk; do not nurse
Pregnancy-Lactation
Interactions
Increased risk of hypomagnesaemia w/ diuretics and digoxin. May decrease plasma concentration of erlotinib, dasatinib and lapatinib. May decrease the bioavailability of itraconazole and ketoconazole. May increase plasma concentration of cilostazol and methotrexate. Reduced bioavailability w/ antacids and sucralfate.
Potentially Fatal: May decrease serum levels and pharmacological effects of rilpivirine and atazanavir.
Adverse Effects
Side effects of Lansoprazole :
1-10%
Headache (3-7%),Diarrhea (1-5%),Constipation (1-5%),Nausea (1-3%),Abdominal pain (1-3%)
<1%
Anxiety,Angina,Palpitations,Syncope,Edema,Anorexia,Dry mouth,Tenesmus,Flatulence,Melena,Myalgia,Tinnitus,Allergic reaction
Mechanism of Action
Lansoprazole is a substituted benzimidazole, and is also known as PPI due to its property to block the final step of acid secretion by inhibiting H+/K+ ATPase enzyme system in gastric parietal cell. Both basal and stimulated acid are inhibited.