Lansoprazole

lansoprazole

(lanz ah' pray zol)

Prevacid Pregnancy Category B
Drug classes
Antisecretory agent Proton pump inhibitor

Therapeutic actions
Gastric acid-pump inhibitor: Suppresses gastric acid secretion by specific inhibition of the hydrogenpotassium ATPase enzyme system at the secretory surface of the gastric parietal cells; blocks the final step of acid production.
Indications
Short-term treatment (up to 4 wk) of active duodenal ulcer Short-term treatment (up to 8 wk) of gastric ulcers Short-term treatment (up to 8 wk) of gastroesophageal reflux disease (GERD): Severe erosive esophagitis; poorly responsive symptomatic GERD Long-term treatment of pathological hypersecretory conditions (eg, ZollingerEllison syndrome, multiple adenomas, systemic mastocytosis) Maintenance therapy for healing of erosive esophagitis, duodenal ulcers Eradication of Helicobacter pylori infection in patients with active or recurrent duodenal ulcers in combination with clarithromycin and amoxicillin Short-term treatment (up to 8 wk) of symptomatic GERD and erosive esophagitis in children 111 yr Contraindicated with hypersensitivity to lansoprazole or any of its components. Use cautiously with pregnancy, lactation.
Contraindications and cautions
Available forms
DR capsules15, 30 mg; DR granules for oral suspension15, 30 mg

Dosages ADULTS
Active duodenal ulcer: 15 mg PO daily before eating for 4 wk. For maintenance, 15 mg PO daily. Gastric ulcer: 30 mg/day PO for up to 8 wk. Risk reduction of gastric ulcer with NSAIDS: 15 mg/day PO for up to 12 wk. Duodenal ulcers associated with H. pylori: 30 mg lansoprazole, 500 mg clarithromycin, 1 g amoxicillin, all given PO bid for 1014 days; or 30 mg lansoprazole and 1 g amoxicillin PO tid for 14 days. GERD: 15 mg/day PO for up to 8 wk.
Erosive esophagitis or poorly responsive GERD: 30 mg PO daily before eating for up to 8 wk. An additional 8-wk course may be helpful for patients who do not heal with 8-wk therapy. Maintenance of healing of erosive esophagitis: 15 mg/day PO. Pathological hypersecretory conditions: Individualize dosage. Initial dose is 60 mg PO daily. Doses up to 90 mg bid have been used. Administer daily doses of > 120 mg in divided doses.
PEDIATRIC PATIENTS 111 YR
Give as oral suspension, or capsules may be opened and the granules sprinkled on soft food. Do not cut, crush, or chew granules. < 30 kg: 15 mg/day PO. > 30 kg: 30 mg/day PO.
PATIENTS WITH HEPATIC DYSFUNCTION
Consider lowering dose and monitoring patient response.

Pharmacokinetics
Route Oral Onset Varies Peak 1.7 hr
Metabolism: Hepatic; T1/2: 2 hr Distribution: Crosses placenta; may enter breast milk Excretion: Bile
Adverse effects
CNS: Headache, dizziness, asthenia, vertigo, insomnia, anxiety, paresthesias, dream abnormalities Dermatologic: Rash, inflammation, urticaria, pruritus, alopecia, dry skin, acne GI: Diarrhea, abdominal pain, nausea, vomiting, constipation, dry mouth Respiratory: URI symptoms, cough, epistaxis Other: Gastric cancer in preclinical studies, back pain, fever
Interactions
Drug-drug Decreased serum levels if taken concurrently with sucralfate Decreased serum levels of ketoconazole, theophylline when taken with lansoprazole
Nursing considerations Assessment
History: Hypersensitivity to lansoprazole or any of its components; pregnancy; lactation Physical: Skin lesions; body T; reflexes, affect; urinary output, abdominal exam; respiratory auscultation
Interventions
Administer before meals. Caution patient to swallow capsules whole, not to open, chew, or crush. If patient has difficulty swallowing, open capsule and sprinkle granules on apple sauce, Ensure, yogurt, cottage cheese, or strained pears; for NG tube, mix granules from capsule with 40 mL apple juice and inject through tube, flush tube with additional apple juice; or granules for oral suspension can be added to 30 mL water, stir well, and have patient drink immediately. Arrange for further evaluation of patient after 4 wk of therapy for acute gastroreflux disorders if symptomatic improvement does not rule out gastric cancer, which did occur in preclinical studies. Take the drug before meals. Swallow the capsules wholedo not chew, open, or crush. If you are unable to swallow capsule, open and sprinkle granules on apple sauce, or use granules, which can be added to 30 mL water, stirred, and drunk immediately. Arrange to have regular medical follow-up while you are taking this drug. These side effects may occur: Dizziness (avoid driving a car or performing hazardous tasks); headache (medications may be available to help); nausea, vomiting, diarrhea (proper nutrition is important, consult with your dietitian to maintain nutrition); symptoms of upper respiratory tract infection, cough (reversible; do not self-medicate, consult with your health care provider if this becomes uncomfortable). Report severe headache, worsening of symptoms, fever, chills.
Teaching points
Adverse effects in Italic are most common; those in Bold are life-threatening.

Lansoprazole

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Lansoprazole

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Copyright:

Available Formats

lansoprazole

(lanz ah' pray zol)

Antisecretory agent Proton pump inhibitor

Contraindications and cautions

DR capsules15, 30 mg; DR granules for oral suspension15, 30 mg

PEDIATRIC PATIENTS 111 YR

Consider lowering dose and monitoring patient response.

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