Lansoprazole Brand And Generic Names
What is Lansoprazole?
Lansoprazole is an antiulcer agent suppressing the activity of the enzyme, accelerating the exchange of hydrogen ions. Acting in the final phase of secretion of hydrochloric acid in the stomach, the drug reduces acid production. The agent blocks the final stage of HCl secretion, lowering both basal and stimulated secretion regardless of the nature of the stimulus. With its high lipophilicity, it easily penetrates the parietal cells of the stomach, while showing a cytoprotective effect by increasing oxygenation of the gastric mucosa and increasing the secretion of bicarbonate. The agent does not affect the motility of the gastrointestinal tract. In tubules of gastric parietal cells the drug is transformed into an active form – sulfonamide.
It also inhibits the growth of Helicobacter pylori, promotes the formation of specific IgA to these bacteria in the mucosa, increases the activity of other drugs. Lansoprazole significantly reduces the growth of Helicobacter pylori (bacterium that causes the development of peptic ulcer disease). The inhibitory effect increases during the first 4 days of admission. Secretory activity normalizes after 3-4 days after taking the drug. Patients with Zollinger-Ellison syndrome experience more lasting effect. The drug increases the concentration of serum pepsinogen and inhibits the production of pepsin. Inhibition of stomach secretion is accompanied by an increase in the number of nitrate concentrations in the gastric secretion. The agent increases the concentration of gastrin in the serum of 50-100%. Lansoprazole is effective in the treatment of gastric ulcer and 12 duodenal ulcers resistant to H2-blockers of histamine receptors.
Lansoprazole is a non-acid tolerant agent; therefore it is usually applied in the form of granules having an acid-resistant coating which prevents degradation in the stomach. It is almost completely absorbed from the intestine and enters the systemic circulation. Underlying cirrhosis slows absorption of this agent.
Although food decreases the absorption and bioavailability of Lansoprazole, the inhibitory effect on the formation of hydrochloric acid remains the same before and after ingestion.
Indications for use
Peptic and duodenal ulcer (exacerbation), erosive or ulcerative esophagitis, reflux esophagitis, Zollinger-Ellison syndrome, stress gastrointestinal ulcers, eradication of Helicobacter pylori (in combination therapy), non-ulcer dyspepsia. Lansoprazole retains gastric pH at 4.0 more firmly and continuously, promoting healing of peptic ulcers and earlier reduction of clinical symptoms.
Hypersensitivity, pregnancy (I trimester), lactation, malignancy. Lansoprazole should be used with caution in hepatic failure, pregnancy (II-III trimester), elderly age, age under 18.
Lansoprazole Side effects
From the digestive system: less often - the increase or decrease of appetite, nausea, abdominal pain, rarely - diarrhea or constipation, and in some cases - ulcerative colitis, gastrointestinal candidiasis, increased activity of "liver" transaminases, hyperbilirubinemia.
From the nervous system: headache, rarely - malaise, dizziness, drowsiness, depression, anxiety. From the respiratory system: rarely - cough, pharyngitis, rhinitis, upper respiratory tract infection, flu-like symptoms.
From the side of hematopoiesis: rarely - thrombocytopenia (with hemorrhagic manifestations), in some cases - anemia.
Allergic reactions: skin rash, in some cases - photosensitivity, erythema multiforme.
Other reactions: rarely - myalgia, alopecia.
The drug can cause induction (activation) of various enzyme systems of cytochrome P-450.
Pregnancy and breastfeeding
The drug usage is contraindicated in I trimester. In II and III trimester it can be taken if prescribed by your doctor. At the time of treatment you should stop breastfeeding.
Lansoprazole Dosage and Administration
For oral administration. The capsule is swallowed without chewing. The highest bioavailability of Lansoprazole is observed in the morning. In case of a peptic or duodenal ulcer and stress ulcers - 30 mg/day for 1 reception in the morning, for 2-4 weeks. A single daily dose of Lansoprazole (30 mg) allows healing of duodenal ulcers in 2 weeks in 75-80% of patients, and within 4 weeks - in 93-95% of patients. In gastric ulcer and erosive and ulcerative esophagitis - 30 mg/day for 4-8 weeks, if necessary – up to 60 mg/day. In reflux esophagitis - 30 mg/day for 4 weeks. With Zollinger-Ellison syndrome the dose is adjusted individually. For eradication of Helicobacter pylori - 30 mg 2 times a day, in combination with antibiotics (clarithromycin and amoxicillin), for at least 7 days. Non-ulcer dyspepsia: 15-30 mg/day for 2-4 weeks. When liver failure and in elderly patients, the treatment is initiated with half doses, gradually increasing to the recommended doses, but not more than 30 mg/day.
Endoscopic control is required before and after treatment to exclude malignancy because treatment can mask symptoms and delay the correct diagnosis. It is mandatory prior to treatment with Lansoprazole to exclude the presence of a malignant tumor in the stomach and duodenum, because the drug hides clinic tumors and leads to a running disease process.
Alcohol does not affect the action of the drug. However, during treatment patients should refrain from taking it because it slows down the healing of the mucosa.
Lansoprazole agent slows the elimination of drugs metabolized in the liver by microsomal oxidation (including diazepam, phenytoin, and anticoagulants). The drug reduces by 10% the clearance of theophylline, changes the pH-dependent absorption of drugs belonging to the group of weak acids. It is compatible with ibuprofen, indomethacin, propranolol, warfarin, oral contraceptives, phenytoin, prednisolone. Antacids slow down and reduce the absorption of this drug (they should be administered 1 hour before or 1-2 hours after administration of Lansoprazole). Sucralfate reduces the bioavailability of the drug by 30% (there should be an interval of 30-40 minutes between doses of these drugs). Lansoprazole inhibits the absorption of ampicillin, digoxin, ketoconazole, cyanocobalamin, iron salts. When applied simultaneously with carbamazepine, the decrease in the concentration of carbamazepine in plasma is not excluded due to reducing its absorption from the gastrointestinal tract due to a decrease in pH of gastric contents under the influence of Lansoprazole. This may lead to a decrease of clinical efficacy of carbamazepine.
It is believed that the use of Lansoprazole may increase the toxicity of methotrexate.
Symptoms have not been described (single dose of 600 mg was not accompanied by clinical signs of overdose).
Treatment: symptomatic therapy is recommended. Hemodialysis is ineffective.
However, if you have any symptoms due to excess of the recommended dosage, you should consult your doctor.