Lansoprazole

Lansoprazole

Indication

• Management of erosive esophagitis associated with gastroesophageal reflux disease (GERD)
• Symptomatic management of GERD

Pharmacology

• Lansoprazole suppresses gastric acid secretion in the parietal cells through inhibition of the H+/K+ ATPase pump. It is therefore referred to as a proton pump inhibitor (PPI)
• Lansoprazole is metabolized in the liver by the following cytochrome P450 enzymes (CYP 450): CYP2C19, CYP3A4 (both major) as well as by CYP2C9 (minor)
• Biliary excretion is the major route of elimination; feces (67%) and urine 33% (mostly as inactive metabolites)

Side Effects

• Generally well tolerated
• GI: abdominal pain, cramps, bloating, constipation, diarrhea, vomiting, mildly elevated AST/ALT
• CV: hypertension, hypotension
• Dermatologic: urticaria, prutitus
• Hematologic: thrombocytopenia, leucopenia, leukocytosis, anemia
• Endocrine: hyperglycemia, hyperlipidemia

Drug Interactions

• Fluconazole: may increase the serum concentrations of PPIs (manage by monitoring therapy)
• Ferrous sulfate: the absorption of iron salts may be decreased because gastric acid secretion is inhibited by PPIs

Dose

• Oral liquid doses will be automatically dose standardized to one of the LHSC standard doses (0.25 mg, 0.5 mg, 0.75 mg, 1 mg, 1.5 mg, 2 mg, 2.5 mg, 5 mg, 7.5 mg, 10 mg, 15 mg, 20 mg, 30 mg, 45 mg, 60 mg)
• The appropriate pharmacy substituted dose will be determined by the pharmacist from the list to ensure the dose is still appropriate for the patient’s age and weight (New medical orders are not necessary to reflect the pharmacy rounded dose as this is a LHSC automatic substitution policy)

Supplied As

• 3.3 mg/mL oral suspension (keep refrigerated, Shake well before using), dispensed unit dose as one of the standard doses above
• This is an extemporaneous product which is specially prepared by the Department of Pharmacy.
• Please note that lansoprazole is the LHSC proton pump inhibitor of choice and all orders for other oral proton pump inhibitors will be automatically converted to lansoprazole at the appropriate dose.