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lansoprazole (Rx, OTC)Brand and Other Names:Prevacid, Prevacid Solu Tab, more...Prevacid 24HR

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule/tablet

  • 15mg
  • 30mg

tablet, oral-disintegrating

  • 15mg
  • 30mg

oral suspension

  • 3 mg/mL
more...

Duodenal Ulcer

Active: 15 mg PO qDay for 4 weeks

Maintenance: 15 mg PO qDay

Gastric Ulcer

30 mg PO qDay for 8 weeks

NSAID-associated GU

Treatment: 30 mg PO qDay for 8 weeks

Prevention: 15 mg PO qDay for 12 weeks

Gastroesophageal Reflux Disease

15 mg PO qDay for 8 weeks

Erosive Esophagitis

30 mg PO qDay for 8-16 weeks

Maintenance: 15 mg PO qDay

Hypersecretory Condition (eg, Zollinger-Ellison Syndrome)

60 mg PO qDay initially; up to 180 mg q12hr used

If dose >120 mg/day PO, administer in divided doses q12hr

Helicobacter Pylori Infection

Triple therapy: Lansoprazole 30 mg + amoxicillin 1 g + clarithromycin 500 mg PO q12hr for 10-14 days

Dual therapy (clarithromycin resistant): Lansoprazole 30 mg + amoxicillin 1 g PO q8hr for 14 days

Penicillin allergy: Lansoprazole 30 mg + clarithromycin 500 mg + metronidazole 500 mg q12hr for 10-14 days

Heartburn

OTC product: 15 mg PO qDay for 14 days; may repeat q4Months

Administration

Administer before meals

Swallow capsule whole; do not chew, crush, or split

Do not chew orally disintegrating tablets

Powder for oral suspension: dissolve packet contents in 30 mL of water; do not use any other liquid; stir well and drink immediately

Safety and efficacy of maintenance therapy past 1 year not established

Dosing Modifications

Severe hepatic impairment: Administer a lower dose

Dosage Forms & Strengths

capsule/tablet

  • 15mg
  • 30mg

oral suspension

  • 3mg/mL
more...

GERD, Erosive Esophagitis

<1 year

  • Safety and efficacy not established

1-12 years

  • <30 kg: 15 mg PO qDay for 8-12 weeks
  • >30 kg: 30 mg PO qDay for 8-12 weeks
  • May increase dose to 30 mg PO q12hr after >2 weeks of initial therapy if still symptomatic

>12 years

  • 30 mg PO qDay for up to 8 weeks

Nonerosive GERD

<12 years: Safety and efficacy not established

≥12 years: 15 mg PO qDay for up to 8 weeks

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Interactions

Interaction Checker

lansoprazole and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            1-10%

            Headache (3-7%)

            Diarrhea (1-5%)

            Constipation (1-5%)

            Nausea (1-3%)

            Abdominal pain (1-3%)

            <1%

            Anxiety

            Angina

            Palpitations

            Syncope

            Edema

            Anorexia

            Dry mouth

            Tenesmus

            Flatulence

            Melena

            Myalgia

            Tinnitus

            Allergic reaction

            Postmarketing Reports

            Bone fracture

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            Warnings

            Contraindications

            Hypersensitivity to lansoprazole or other proton pump inhibitors

            Cautions

            Proton pump inhibitors (PPIs) are possibly associated with increased incidence of Clostridium difficile-associated diarrhea (CDAD); consider diagnosis of CDAD for patients taking PPIs who have diarrhea that does not improve

            Liver disease may require dosage reduction

            Contains enteric coated granules (acid labile); do not chew or crush

            Published observational studies suggest that PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist, or spine, particularly with prolonged (>1 yr), high-dose therapy

            Decreased gastric acidity increases serum chromogranin A (CgA) levels and may cause false-positive diagnostic results for neuroendocrine tumors; temporarily discontinue PPIs before assessing CgA levels

            Hypomagnesemia may occur with prolonged use (ie, >1 year); adverse effects may result and include tetany, arrhythmias, and seizures; in 25% of cases reviewed, magnesium supplementation alone did not improve low serum magnesium levels and the PPI had to be discontinued

            PPIs may decrease the efficacy of clopidogrel by reducing the formation of the active metabolite

            Gastric atrophy reported with long-term use of another PPI

            Relief of symptoms does not eliminate the possibility of a gastric malignancy

            Therapy increases risk of Salmonella, Campylobacter, and other infections

            Acute interstitial nephritis reported in patients taking proton pump inhibitors

            Daily long-term use (e.g., longer than 3 years) may lead to malabsorption or a deficiency of cyanocobalamin

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            Pregnancy & Lactation

            Pregnancy category: B

            Lactation: Not known whether distributed into breast milk; do not nurse

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Mechanism of Action

            Proton pump inhibitor; binds to H+/K+-exchanging ATPase (proton pump) in gastric parietal cells, resulting in suppression of basal and stimulated acid secretion

            Absorption

            Bioavailability: 81-91%; decreased 50-70% if given 30 min after meals

            Peak plasma time: 1.7 hr; food increases time to 3.7 hr

            Duration (at steady state): >24 hr (PUD, esophagitis); 40 hr (Zollinger-Ellison syndrome)

            AUC: Food decreases AUC by 50%

            Onset

            • Gastric acid suppression: 1-3 hr
            • PUD: 1 week (initial); 4-8 days (peak)
            • Esophagitis: 1-4 weeks (initial); 8 weeks (peak)

            Distribution

            Protein bound: 97-99%

            Vd: 14-18 L

            Metabolism

            Metabolized by hepatic CYP2C19; slow metabolizers are deficient in CYP2C19 enzyme and can have plasma concentration increase of 5-fold or higher

            Gastric parietal cells: Acidic pH converts lansoprazole to its active sulfenamide metabolites

            Active metabolites: Cyclic sulfenamide and disulfide metabolite

            Inactive metabolites: 5-hydroxy-lansoprazole, sulfide metabolite, omeprazole sulfone, sulfone metabolite, hydroxysulfide metabolite, hydroxysulfone metabolite

            Enzymes inhibited: CYP2C19

            Elimination

            Half-life: 0.9-1.5 hr

            Dialyzable: No

            Total renal clearance: 517 mL/min

            Total body clearance: 0.7 L/hr/kg

            Excretion: feces (bile), 67%; urine, 33%

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            Administration

            IV Preparation

            Inject 5 mL sterile water for injection (SWI) into vial and gently dissolve to obtain a 6 mg/mL solution; can be stored at 77°F (25°C) for 1 hr

            Dilute in 50 mL NS, LR, or D5W; resulting solution can be stored at 77°F (25°C) for 24 hr (NS, LR) or 12 hr (D5W); refrigeration not necessary.

            Alternatively, can be reconstituted directly into 50 mL NS, LR, or D5W using Baxter's MINI-BAG Plus Container

            Prime in-line filter as directed in manufacturer's package insert

            IV Administration

            In-line filter must be used (supplied)

            Administer over 30 min

            Flush IV line with NS, LR, or D5W before and after use

            Do not administer with other drugs

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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            • View the formulary and any restrictions for each plan.
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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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