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.