Lansoprazole chemical structure
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Lansoprazole

Lansoprazole, marketed as Takepron® (in Japan), Prevacid® and Zoton®, is a proton pump inhibitor which prevents the stomach from producing acid. more...

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Pharmacology

Lansoprazole is a proton-pump inhibitor similar to omeprazole. Lansoprazole's plasma elimination half-life is not proportional to the duration of the drug's effects (i.e. gastric acid suppression). The plasma elimination half-life is two hours or less, and the effects of the drug last for over 24 hours.

Indications

Lansoprazole is indicated for:

  • Treatment of ulcers of the stomach and duodenum, and NSAID-induced ulcers
  • Treatment of gastroesophageal reflux disease (also known as acid reflux disease)
  • Treatment of Zollinger-Ellison Syndrome
  • Treatment of Barrett's esophagus
  • Adjunctive treatment of H. pylori infection, alongside antibiotics

Contraindications

  • Absorption of lansoprazole is reduced by antacids.
  • PPI’s reduce absorption of antifungals (itraconazole and ketoconazole) and possibly increase in plasma
  • Increases plasma conc of Cilostazol (risk of toxicity)
  • Absorption of lansoprazole possibly reduced by:
    • sucralfate
    • ampicillin
    • bisacodyl
    • delavirdine
    • fluvoxamine
    • iron salts
    • theophylline
    • voriconazole

Side Effects

  • Infrequent: dry mouth, insommnia, drowsiness, blurred vision, rash, pruritus

Rarely and very rarely, taste disturbance, liver dysfunction, peripheral oedema, hypersensitivity reactions (including bronchospasm, urinary, angiodema, anaphylaxis), photosensitivity, fever, sweating, depression, interstitial nephritis, blood disorders (including leucopoenia, leucocytosis, pancytopenia, thrombocytopenia), athralgia, myalgia, skin reactions (including stevens-Johnson syndrome, toxic epidermal necrolysis, bullous eruption) Increase the risk of gastric-intestinal infections by reducing gastric acidity.

  • Severe: Gastro-intestinal disturbances (such as nausea, vomiting, abdominal pain, flatulence, diarrhea, constipation), headache, dizziness


Read more at Wikipedia.org


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Lansoprazole Beats Ranitidine for NSAID-Related Gastric Ulcers - Brief Article
From Family Pratice News, 3/15/01 by Bruce Jancin

NEW YORK -- Lansoprazole is superior to ranitidine for healing NSAID-related gastric ulcers in patients who must continue their anti-inflammatory medication, Dr. Jay L. Goldstein reported at the annual meeting of the American College of Gastroenterology.

He reported on a 47-site randomized double-blind clinical trial in which 342 such patients received 8 weeks of lansoprazole at 15 or 30 mg daily, or ranitidine at 150 mg b.i.d. All had an endoscopically proved gastric ulcer at least 5 mm in size.

Patients on either dose of lansoprazole had significantly greater endoscopic healing rates at both 4 and 8 weeks than those on ranitidine. They also reported fewer days or nights with abdominal pain. (See chart below.) Self-reported pain scores were significantly lower with the proton pump inhibitor, too, said Dr. Goldstein of the University of Illinois, Chicago.

The bigger the ulcer at baseline, the lower the healing rate with ranitidine. In contrast, ulcer size didn't have a significant impact on lansoprazole healing rates.

Helicobacter pylori status did not affect lansoprazole's ulcer healing rate. An earlier large trial of omeprazole for NSAID-related ulcer healing showed greater success in H. pylori-positive patients.

"I can't explain the difference between the two studies," he said. "In my practice, I do test for H. pylori if I find an ulcer, and if the patient is positive, I eradicate it. Whether that influences the healing rate is yet to be determined."

The prevalence of endoscopic ulcers among chronic NSAID users is 10-30 times greater than in the general population, while the risk of symptomatic adverse GI events is from three to eight times higher.

NSAID users present with symptomatic ulcers at a rate of 1%-2% per year. And many need to continue NSAID therapy during ulcer therapy, placing them at increased risk for nonhealing.

COPYRIGHT 2001 International Medical News Group
COPYRIGHT 2001 Gale Group

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