Lansoprazole

BRAND NAMES:

Prevacid – It consists of Lansoprazole as the active ingredient and is available as Prevacid Lansoprazole delayed-release capsules 15mg and 30mg are used in treating related stomach acidity diseases.

Prevpac – Prevpac capsules are antibiotics consisting of three active ingredients Lansoprazole 30mg, amoxicillin 500mg, and clarithromycin 500mg.

MECHANISM OF ACTION:

As it is a proton pump inhibitor, it 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.

PHARMACOKINETICS:

Absorption:  It reaches The peak plasma concentration about 1.7 hours after oral administration. The bioavailability of lansoprazole is 80 – 90%.

Distribution: The volume of distribution of lansoprazole is 0.4L/Kg.

Metabolism:  CYP3A4 and CYP2C19 are the primary liver enzymes responsible for its metabolism. The major metabolites produced are 5-hydroxy lansoprazole and its sulfone derivative.

Excretion: 14 – 23% of lansoprazole is eliminated through urine with conjugated and unconjugated hydroxylated metabolites

PHARMACODYNAMICS:

Lansoprazole was found to dramatically reduce baseline acid output while significantly increasing mean stomach pH and the percentage of times the gastric pH was greater than 3 or greater than 4. Lansoprazole, like pentagastrin, significantly reduced meal-stimulated gastric acid output and secretion volume. In patients with acid hypersecretion, lansoprazole dramatically reduced basal and pentagastrin-stimulated stomach acid production. Lansopazole reduced the typical increases in secretion volume, acidity, and acid production caused by insulin. Following the initial dose, higher stomach pH was observed within 1 to 2 hours with 30mg of lansoprazole and 2 to 3 hours with 15mg of lansoprazole. After numerous daily doses, higher stomach pH was observed within the first hour with 30mg of lansoprazole and within 1 to 2 hours with 15 mg of lansoprazole. Acid suppression may improve the efficacy of antimicrobials in eliminating Helicobacter pylori. 

DOSAGE AND ADMINISTRATION:

The dosage of this medicine will be different for different patient conditions. The amount of medicine that is prescribed for a patient depends on the strength of the medicine and also the number of doses taken each day. In general, lansoprazole tablets are available as capsules or orally disintegrating tablets.

Erosive Esophagitis:

For adults suffering from erosive esophagitis, the recommended dose is 30mg once a day before a meal.

Children 12 years and above are recommended 30mg before meals. For children between 1 to 11 years of age weighing over 30kg, 30mg a day before meal was recommended.For children between 1 to 11 years of age weighing over 30kgs or less, 15mg once a day before meal was prescribed.

Duodenal ulcers with H.Pylori infection:

30 mg before meals. Adults are advised to take this medication twice or three times per day. Typically, the dose is taken in conjunction with amoxicillin or clarithromycin.

Gastric ulcers:

 15 to 30mg dose once a day is recommended for adults before their meal.

Benign gastric ulcers:

30mg once a day before meals is prescribed for patients suffering from benign gastric ulcers.

Zollinger Ellison syndrome:

In adults, 60mg once a day before meal is prescribed.

Duodenal ulcers:

15mg once a day before meal is prescribed in adults suffering from duodenal ulcers.

Gastroesophageal reflux disease:

In adults and children 12 years of age, 15mg once a day before a meal is recommended. For children between 1 and 11 years of age weighing 30kg or more, 30mg once a day before a meal should be taken. For children between 1 and 11 years of age weighing 30 kg or less, 15mg once a day before a meal is prescribed.

If we miss a dose then it should be taken immediately as soon as possible. If it is time for the next dose then skip the missing dose and follow the regular dose. Do not take the double dose.

CONTRAINDICATIONS:

It is not recommended for those who have hypersensitivity to any of its components.

DRUG INTERACTIONS:

Drug interactions can alter how a medication works or increase the likelihood of major side effects. Before taking this medicine the patient must need to discuss with the health care provider the medication that is previously being used in other treatments. Below are some of the drugs mentioned that interact with Lansoprazole.

• Blood thinners -  Warfarin

• Irregular heartbeat and heat failure – Digoxin(Lanoxin)

• Methotrexate

• Lung diseases- Theophylline

• Organ transplant rejection  - Tacrolimus

• Antibiotics used for infections – Clarithromycin

• Antiretroviral medicines – Rilpivirine, Nelfinavir,saquinavir

• Tuberculosis -  Rifampin

FOOD INTERACTIONS:

Avoid alcohol. Tablet should be taken at least 30 minutes before the meal.

ADVERSE EFFECTS:

• Swollen glands

• Hoarseness

• Headache

• Swelling of eyes, mouth, face, throat, lips and tongue

• Difficulty in breathing and swallowing

• Constipation

• Diarrhea

• Worsening joint pains

• Increased or decreased urination

• Loss of appetite

• Blood in urine

• Diarrhea with watery stools

• Hives

• Seizures

• Fatigue

• Nausea

TOXICITY:

Taking overdose leads to toxicity which is shown in symptoms like 

• Seizure

• Trouble breathing

• Can’t be awakened

• Sometimes the patient may collapse

STORAGE:

Maintain a room temperature between 68℉ and 77℉ (20℃ to 25℃). Keep in a cool and dry place. Temperatures during transportation range from 59℉ to 86℉ (15℃ to 30℃).