lansoprazole (redirected from Takepron)

lansoprazole /lan·so·pra·zole/ (lan-so´prah-zol) a proton pump inhibitor used to inhibit gastric acid secretion for the treatment of duodenal or gastric ulcer, gastroesophageal reflux disease, and hyperchlorhydria.

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lan·so·pra·zole (ln-spr-zl)

n.

A drug of the proton pump inhibitor class.

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lansoprazole

(lansō´przōl´),
n brand name: Prevacid;
drug class: antisecretory, proton pump inhibitor;
action: suppresses gastric secretion by inhibiting hydrogen/potassium ATPase enzyme system in gastric parietal cell;
uses: short-term treatment for healing and symptomatic relief of active duodenal ulcer and erosive esophagitis.

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lansoprazole

Prevacid, Prevacid I.V., Prevacid SoluTab, Prevpac, Zoton (UK)

Pharmacologic class: Gastric acid pump inhibitor

Therapeutic class: Antiulcer drug

Pregnancy risk category B

Action

Inhibits activity of proton pump in gastric parietal cells, decreasing gastric acid production

Availability

Capsules (delayed-release): 15 mg, 30 mg

Granules for oral suspension (delayed-release, enteric-coated): 15 mg, 30 mg

Powder for injection: 30 mg/vial

Prevpac (combination product for Helicobacter pylori infection): daily pack containing two 30-mg lansoprazole capsules, four 500-mg amoxicillin capsules, and two 500-mg clarithromycin tablets

Prevacid NapraPAC 375 (combination product for reducing risk of ulcers from nonsteroidal anti-inflammatory drugs [NSAIDs]): weekly pack containing seven 15-mg Prevacid capsules and fourteen 375-mg Naprosyn tablets

Prevacid NapraPAC 500 (combination product for reducing risk of ulcers from NSAIDs): weekly pack containing seven 15-mg Prevacid capsules and fourteen 500-mg Naprosyn tablets

Prevacid SoluTab (delayed-release, orally disintegrating tablet): 15 mg, 30 mg

⊘Indications and dosages

➣ Active duodenal ulcer

Adults: 15 mg P.O. daily for 4 weeks

➣H. pylori eradication, to reduce risk of duodenal ulcer recurrence

Adults: In triple therapy, 30 mg lansoprazole P.O., 1 g amoxicillin P.O., and 500 mg clarithromycin P.O. q 12 hours for 10 or 14 days. In dual therapy, 30 mg lansoprazole P.O. and 1 g amoxicillin P.O. q 8 hours for 14 days.

➣ Benign gastric ulcer

Adults: 30 mg P.O. daily for up to 8 weeks

➣ Gastric ulcer associated with NSAIDs

Adults: 30 mg P.O. once daily for up to 8 weeks

➣ To reduce risk of NSAID-associated gastric ulcer

Adults: 15 mg P.O. daily for up to 12 weeks

➣ Gastroesophageal reflux disease

Adults and children ages 12 to 17: 15 mg P.O. daily for up to 8 weeks

Children ages 1 to 11 weighing more than 30 kg (66 lb): 30 mg P.O. daily for up to 12 weeks

Children ages 1 to 11 weighing 30 kg (66 lb) or less: 15 mg P.O. daily for up to 12 weeks

➣ Erosive esophagitis

Adults and children ages 12 to 17: 30 mg P.O. daily for up to 8 weeks. Some patients may require 8 additional weeks.

Children ages 12 to 17: 30 mg P.O. daily for up to 8 weeks

Children ages 1 to 11 weighing more than 30 kg (66 lb): 30 mg P.O. daily for up to 12 weeks

Children ages 1 to 11 weighing 30 kg (66 lb) or less: 15 mg P.O. daily for up to 12 weeks

➣ Erosive esophagitis in patients who can't take drugs orally

Adults: 30 mg/day I.V. infused over 30 minutes for up to 7 days

➣ To maintain healing of erosive esophagitis

Adults: 15 mg P.O. daily

➣ Pathologic hypersecretory conditions (including Zollinger-Ellison syndrome)

Adults: Initially, 60 mg P.O. daily, to a maximum of 90 mg P.O. b.i.d. Divide daily dosages over 120 mg.

Dosage adjustment

• Significant hepatic insufficiency

Contraindications

• Hypersensitivity to drug or its components

Precautions

Use cautiously in:
• phenylketonuria (orally disintegrating tablets), severe hepatic impairment
• elderly patients
• pregnant or breastfeeding patients
• children younger than age 18.

Administration

• To reconstitute for I.V. infusion, inject 5 ml of sterile water for injection into 30-mg vial; resulting solution contains 6 mg/ml. Mix gently until powder dissolves; then dilute reconstituted solution in 50 ml of 0.9% sodium chloride injection, lactated Ringer's injection, or 5% dextrose injection.
• Infuse I.V. dose over 30 minutes (using in-line filter provided) within 24 hours if reconstituted drug was diluted with 0.9% sodium chloride injection or lactated Ringer's injection, or over 12 hours if 5% dextrose injection was used.
• Don't give I.V. with other drugs or with diluents other than those listed above.
• Give oral form before meals.
• If patient has difficulty swallowing delayed-release capsule, open it and sprinkle contents onto small amount of soft food, such as applesauce or pudding. Don't crush or let patient chew drug.
• When giving orally disintegrating tablet, place tablet on patient's tongue and let it disintegrate until particles can be swallowed.
• Know that orally disintegrating tablet contains phenylalanine.
• When giving oral suspension, empty packet contents into container with 2 tbsp water. Stir contents well, and have patient drink immediately. Don't give oral suspension through nasogastric (NG) tube.
• When injecting contents of delayed-release capsule through NG tube, open capsule and mix granules with 40 ml apple juice. Then rinse tube with additional apple juice to clear.

Route	Onset	Peak	Duration
P.O.	Rapid	Unknown	>24 hr

Adverse reactions

CNS: headache, confusion, anxiety, malaise, paresthesia, abnormal thinking, depression, dizziness, syncope, cerebrovascular accident

CV: chest pain, hypertension, hypotension, myocardial infarction, shock

EENT: visual field deficits, otitis media, tinnitus, epistaxis

GI: nausea, diarrhea, abdominal pain, cholelithiasis, ulcerative colitis, esophageal ulcer, hematemesis, stomatitis, dysphagia, GI hemorrhage

GU: renal calculi, erectile dysfunction, abnormal menses, breast tenderness, gynecomastia

Hematologic: anemia

Respiratory: cough, bronchitis, asthma

Skin: urticaria, alopecia, acne, pruritus, photosensitivity

Interactions

Drug-drug. Drugs requiring acidic pH (such as ampicillin esters, digoxin, iron salts, itraconazole, ketoconazole): decreased absorption of these drugs

Sucralfate: decreased lansoprazole absorption

Theophylline: increased theophylline clearance

Drug-food. Any food: decreased rate and extent of GI drug absorption

Drug-herbs. Male fern: inactivation of herb

St. John's wort: increased risk of photosensitivity

Patient monitoring

• Monitor for GI adverse reactions.
• Assess nutritional status and fluid balance to identify significant problems.

Patient teaching

• Instruct patient to take before meals.
• If patient has difficulty swallowing, tell him to open delayed-release capsule and sprinkle contents onto small amount of soft food (such as applesauce or pudding). Emphasize that he must not crush or chew drug.
• Tell patient to take orally disintegrating tablet by placing it on tongue and letting it disintegrate.
• Instruct patient to take oral suspension by emptying packet contents into container with 2 tbsp water. Tell him to stir contents well and drink immediately.
• Advise patient to minimize GI upset by eating small, frequent servings of food and drinking plenty of fluids.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, foods, and herbs mentioned above.