Zoton


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Related to Zoton: lansoprazole

lansoprazole

Prevacid, Prevacid SoluTab, Prevacid 24HR, 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

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

Maintenance of healed duodenal ulcer

Adults: 15 mg P.O. daily

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 1b): 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 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

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.

Frequent heartburn (two or more times a week)

Adults: 15 mg P.O. (delayed-release capsule) daily up to 14 days

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

• 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.

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

Musculoskeletal: hip, wrist, spine fractures (with long-term daily use)

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.

Zoton

A brand name for LANSOPRAZOLE.

proton pump inhibitors

drugs (e.g. lanzoprazole and omeprazole [Losec]) inhibiting gastric acid secretion (by blocking gastric parietal cell 'proton pump'); used to prevent gastric ulceration in patients on long-term non-steroidal anti-inflammatory drugs
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References in periodicals archive ?
The Zoton tablets he has been prescribed should reduce the acid secretion in his stomach but will not necessarily prevent the regurgitation.
Worldwide pharmaceutical sales increased 9% for the 1997 second quarter and 8% for the first half due primarily to higher sales of Premarin products, Effexor, Cordarone and Zoton offset, in part, by lower sales of other pharmaceutical products.
Higher international sales of Zoton and Effexor for the 1997 first quarter were offset by lower sales of anti-infectives and other mental health and pharmaceutical products.
International sales gains for the 1996 fourth quarter and full year were due primarily to higher sales of Effexor (which was launched in additional international markets), Zoton, veterinary products and infant nutritionals offset, in part, by the unfavorable effect of foreign exchange.