Indication
Lansoprazole is indicated for:
Short term treatment of active duodenal ulcer
Maintenance of healed duodenal ulcers
Short term treatment of active benign gastric ulcers
Short term treatment of active erosive esophagitis
Maintenance of healing of erosive esophagitis
Pathological hypersecretory conditions including Zollinger- Ellison Syndrome
H. pylori eradication to reduce the risk of duodenal ulcer recurrence
Pharmacology
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.
Dosage
Benign gastric ulcer: 30 mg daily in the morning for 8 weeks.Duodenal ulcer: 30 mg daily in the morning for 4 weeks; maintenance 15 mg.NSAID-associated duodenal or gastric ulcer: 15-30 mg daily for 4 weeks, followed by a further 4 weeks if not fully healed.Zollinger-Ellison syndrome (and other hypersecretory conditions): Initially 60 mg once daily adjusted according to response; daily doses of 120 mg or more is given in two divided doses.Gastroesophageal reflux disease: 30 mg daily in the morning for 4 weeks, followed by a further 4 weeks if not fully healed; maintenance 15-30 mg daily.Acid-related dyspepsia: 15-30 mg daily in the morning for 2-4 weeks.
Interaction
Lansoprazole appears to be a selective inhibitor of the cytochrome P-450 monooxygenase system; there may be an effect on hepatic clearance, but there have been no reports to date of clinically relevant interactions. There is some uncertainty over the effect of Lansoprazole on the oral combined contraceptive pill. Further assessment is currently underway. Physiological changes similar to those found with Omeprazole are likely to take place because of the reduction in gastric acid, which is likely to influence the bacterial colonization of the stomach and duodenum and also vitamin B12 absorption.
Contradiction
Lansoprazole is contraindicated in patients with known hypersensitivity to any component of the formulation.
Side Effect
Severe or irreversible adverse effects: The possible induction of carcinoid tumors by profound acid suppression, and a rise in serum gastrin may occur. There is a rise in serum gastrin levels in the first 3 months of treatment, which are then maintained though at a lower level than those found in pernicious anaemia. Long term treatment with a proton pump inhibitor in patients with Helicobacter pylori infection may accelerate the development of atrophic gastritis.Symptomatic adverse effect: Dose dependent diarrhoea occurs with an incidence of about 4% at 30 mg per day, rising to 8% at 60 mg per day. Headache occurs in 2-3% of treated patients
Pregnancy
Lansoprazole should be avoided in pregnancy unless there are compelling reasons.
Precaution
Gastric malignancy should be ruled out. Hepatic impairment. Pregnancy and lactation.
Overdose
Storage
Store at 25?ø C.