BMA Concise Guide to Medicine & Drugs

Lansoprazole

Brand name Zoton

Used in the following combined preparations None

QUICK REFERENCE

Drug group Anti-ulcer drug

Overdose danger rating Low

Dependence rating Low

Prescription needed Yes

Available as generic No

GENERAL INFORMATION

Lansoprazole belongs to a group of drugs called proton pump inhibitors. It is used to treat gastro-oesophageal reflux (rising of stomach acid into the oesophagus), Zollinger-Ellison syndrome (production of large quantities of stomach acid, leading to ulceration), and to prevent or treat peptic ulcers. It works by reducing the amount of stomach acid produced.

Lansoprazole may be used alone, or in combination with antibiotics as a 7-day course to eradicate Helicobacter pylori bacteria, which is the main cause of peptic ulcers.

Because lansoprazole may mask the symptoms of stomach cancer, it is prescribed only when the possibility of this disease has been ruled out.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Capsules, dispersible tablets, liquid (suspension).

Frequency and timing of doses Usually once, sometimes twice, daily before food in the morning.

Dosage range Peptic ulcer/gastro-oesophageal reflux 30mg daily. NSAID-induced ulcer 15–30mg daily. Acid-related dyspepsia 15–30mg daily. Zollinger-Ellison syndrome 60mg daily initially, adjusted according to response. H. pylori-associated ulcer 60mg daily, half the dose in the morning and half in the evening.

Onset of effect 1–2 hours.

Duration of action 24 hours.

Diet advice None, although spicy foods and alcohol may exacerbate the condition being treated.

Storage Keep in original container at room temperature out of the reach of children. Do not refrigerate.

Missed dose Take as soon as you remember. If your next dose is due within 8 hours, take a single dose now and skip the next.

Stopping the drug Do not stop taking the drug without consulting your doctor; symptoms may recur.

Exceeding the dose An occasional unintentional extra dose is unlikely to be a cause for concern. But if you notice any unusual symptoms, or if a large overdose has been taken, notify your doctor.

POSSIBLE ADVERSE EFFECTS

Common adverse effects include headache, dizziness, diarrhoea or constipation, flatulence, indigestion, nausea, and vomiting. Discuss with your doctor if these are severe or if you also experience unusual fatigue or malaise. If a rash or itching occur, stop taking the drug and contact your doctor. A sore throat, mouth, or tongue are very rare adverse effects but should be reported to your doctor at once; you should also stop taking the drug if they occur. Long-term use of lansoprazole may also increase the risk of intestinal infections and hip fractures in women (see Prolonged use).

INTERACTIONS

Antifungals (ketoconazole and flucanazole) and theophylline Lansoprazole may reduce the effect of these drugs.

Antacids and sucralfate These drugs may reduce the absorption of, and should not be taken within an hour of, lansoprazole.

Digoxin Lansoprazole may increase blood levels of digoxin.

Cilostazol Lansoprazole may increase the effect of cilostazol; the two drugs should not be taken together.

Tacrolimus Lansoprazole may increase blood levels of tacrolimus.

Atazanavir Lansoprazole may decrease the effect of atazanavir; the two drugs should not be taken together.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have liver problems.

· You are taking other medicines.

Pregnancy Safety not established. Discuss with your doctor.

Breast-feeding Safety not established. Discuss with your doctor.

Infants and children Not recommended.

Over 60 No special problems.

Driving and hazardous work No special problems.

Alcohol Avoid. Alcohol irritates the stomach.

PROLONGED USE

Long-term use of lansoprazole may increase the risk of certain intestinal infections (such as Salmonella and Clostridium difficile) because of the loss of the natural protection against such infections provided by stomach acid. Prolonged use also increases the risk of hip fractures in women and may increase the risk of low levels of magnesium in the blood.