Lansoprazole (Prevacid): A Comprehensive Guide

Names of Medication

The medication under review is Lansoprazole, which is marketed in the United States under the brand name Prevacid.

Pharmacologic Category

Lansoprazole belongs to the class of medications known as Proton Pump Inhibitors (PPIs). Other medications in this category include Omeprazole (Prilosec), Esomeprazole (Nexium), Pantoprazole (Protonix), and Rabeprazole (Aciphex).

Dosing

Lansoprazole is used to treat various conditions related to the stomach’s excess acid. Here are the dosing guidelines for the mentioned conditions. Remember, these are general guidelines. Always consult with your healthcare provider for personalized dosing instructions.

Gastroesophageal reflux disease (GERD)

Adult patients with GERD usually take Lansoprazole 15 mg daily for up to 8 weeks.

Peptic ulcer disease

For peptic ulcer disease, the typical dosage is 15 mg or 30 mg once daily for 8 to 12 weeks.

Zollinger-Ellison syndrome

The initial dosage for Zollinger-Ellison syndrome is 60 mg once daily, but doses may be adjusted based on the patient’s response.

Erosive esophagitis

For erosive esophagitis, the dose is usually 30 mg daily for up to 8 weeks.

Nonerosive reflux disease

The standard dose for nonerosive reflux disease is 15 mg daily for up to 8 weeks.

Gastric ulcers

For gastric ulcers, a typical dosage is 30 mg once daily for up to 8 weeks.

Duodenal ulcers

The usual dosage for duodenal ulcer treatment is 15 mg once daily for 4 weeks.

Helicobacter pylori infection

To eradicate H. pylori, Lansoprazole is often used in combination with antibiotics. The usual dosage is 30 mg twice daily for 10 to 14 days.

Stress ulcers

For the prevention of stress ulcers, the dosage is typically 15 mg or 30 mg once daily.

Gastrinomas

For the treatment of gastrinomas and other pathological hypersecretory conditions, the starting dose is usually 60 mg once daily.
It’s important to note that you should never adjust the dose of medication without speaking with your healthcare provider first.

Dosage Forms and Strengths

Lansoprazole is available in delayed-release capsules in 15 mg and 30 mg strengths. It also comes in a delayed-release orally disintegrating tablet form, available in 15 mg and 30 mg strengths.

Administration Instructions

Lansoprazole should be taken before meals for optimal acid suppression. The capsules should not be crushed or chewed and should be swallowed whole. For patients who cannot swallow capsules, the contents can be sprinkled on a tablespoon of applesauce, Ensure pudding, or yogurt, or mixed with a small amount of juice and taken immediately.

Adverse Reactions and Side Effects

Headache (common)

Headache, a common side effect, can occur in patients taking Lansoprazole. It happens due to the change in acid production which may influence the body’s pain signaling pathways.

Diarrhea (common)

Diarrhea is a common side effect of Lansoprazole, likely due to the change in the stomach’s environment and its effects on the gut flora.

Nausea (common)

Nausea is another common side effect, potentially due to changes in stomach acidity influencing gut motility and overall digestive processes.

Abdominal Pain (common)

Abdominal pain can occur due to alterations in the digestive process, as changing the stomach’s acid levels can influence gut motility and potentially cause discomfort.

Flatulence (uncommon)

Some patients may experience flatulence, likely related to changes in gut flora and digestive processes due to altered stomach acid levels.

Contraindications to Taking Lansoprazole

A contraindication is a specific situation in which a drug, procedure, or surgery should not be used because it may be harmful to the patient. Lansoprazole is contraindicated in the following scenarios:

Allergy to Lansoprazole or Other PPIs

Patients who have had an allergic reaction to Lansoprazole or other proton pump inhibitors should not take Lansoprazole. An allergic reaction may include symptoms such as itching, rash, swelling, severe dizziness, or trouble breathing.

Combination with Certain Drugs

Lansoprazole should not be used in combination with certain HIV medications (like rilpivirine) and a tuberculosis medication (rifampin) due to potential drug interactions that can decrease the effectiveness of these drugs.

Drug to Drug Interactions

Lansoprazole can interact with several medications. Here are some significant interactions:
Methotrexate (Rheumatrex, Trexall): Lansoprazole can increase levels of methotrexate in the body, increasing the risk of side effects.
Warfarin (Coumadin): Lansoprazole may increase the effects of warfarin, leading to an increased risk of bleeding.
Digoxin (Lanoxin): Lansoprazole can increase digoxin levels in the body, potentially leading to toxicity.
Certain HIV medications: Lansoprazole can decrease the absorption of certain HIV medications (like atazanavir, nelfinavir), reducing their effectiveness.
Antifungal drugs: Lansoprazole can reduce the effectiveness of certain antifungal drugs (like itraconazole, ketoconazole) by decreasing their absorption.

Lansoprazole in Pregnancy

Lansoprazole is classified as a Category B drug during pregnancy. This means that studies in animals have not found risk to the fetus, but there are no adequate studies in pregnant women. Pregnant women should use Lansoprazole only if clearly needed and under a healthcare provider’s supervision.

Lansoprazole while Breastfeeding

Lansoprazole is excreted into breast milk in small amounts. While no adverse effects have been reported in infants, breastfeeding mothers should use Lansoprazole only under the guidance of a healthcare provider.

Estimated Cost of Medication

The estimated cost for a 30-day supply of Lansoprazole, assuming the patient does not have insurance and is using a GoodRX coupon, is approximately $20 for 15 mg strength and $30 for 30 mg strength. However, prices can vary depending on the pharmacy, location, and specific negotiated agreements between pharmacies and pharmaceutical companies. Always check with your local pharmacy for the most accurate price.

Brief Legal Disclaimer

This article is for informational purposes only and not intended as medical advice. Always consult a healthcare professional for diagnosis and treatment. Reliance on the information provided here is at your own risk.
Brief Legal Disclaimer: This article is for informational purposes only and not intended as medical advice. Always consult a healthcare professional for diagnosis and treatment. Reliance on the information provided here is at your own risk.