Lansoprazole, (Lansoprazole, Amoxicillin, and Clarithromycin)

Today's med: Lansoprazole  (lan SOE pra zole)

(brand name: Prevacid, when combined with Amoxicillin, and Clarithromycin: Prevpac)

Drug Class: Proton-Pump Inhibitor (PPI), (Antibiotic, Macrolide Combination)

Other Drugs in this class: Omeprazole (Prilosec), Esomeprazole (Nexium), Pantoprazole (Protonix), Dexlansoprazole, Rabeprazole, Omeprazole magnesium, Pantoprazole sodium, Rabeprazole sodium, Esomeprazole magnesium,Naproxen/Esomeprazole, Esomeprazole sodium, Omeprazole/Bicarbonate ion

Indications: Short-term (4 weeks) treatment of active duodenal ulcers; maintenance treatment of healed duodenal ulcers; as part of a multidrug regimen for H. pylori eradication to reduce the risk of duodenal ulcer recurrence; short-term (up to 8 weeks) treatment of active benign gastric ulcer; treatment of NSAID-associated gastric ulcer; to reduce the risk of NSAID-associated gastric ulcer in patients with a history of gastric ulcer who require an NSAID; short-term treatment of symptomatic GERD; short-term (up to 8 weeks) treatment for all grades of erosive esophagitis; to maintain healing of erosive esophagitis; long-term treatment of pathological hypersecretory conditions, including Zollinger-Ellison syndrome. OTC labeling: Relief of frequent heartburn (≥2 days/week)

Prevpac: Eradication of H. pylori to reduce the risk of recurrent duodenal ulcer

Contraindications: Hypersensitivity to lansoprazole, amoxicillin, any penicillin, clarithromycin, any macrolide, or any component of the formulation; concurrent use with pimozide, cisapride, or ergot derivatives (eg, ergotamine, dihydroergotamine), astemizole, terfenadine, colchicine (if patient has concomitant renal or hepatic impairment), lovastatin, simvastatin; history of cholestatic jaundice or hepatic dysfunction with prior clarithromycin use; history of QT prolongation or ventricular arrhythmia, including torsade de pointes.

Adverse Effects: 1% to 10%: Central nervous system: Headache (children 1-11 years 3%, 12-17 years 7%), dizziness (children 12-17 years 3%; adults <1%), Gastrointestinal: Diarrhea (1% to 5%; 60 mg/day: 7%), abdominal pain (children 12-17 years 5%; adults 2%), constipation (children 1-11 years 5%; adults 1%), nausea (children 12-17 years 3%; adults 1%)

Prevpac: 3% to 10%: Central nervous system: Headache (6%), Gastrointestinal: Diarrhea (7%), taste perversion (5%); <3% (Limited to important or life-threatening): Abdominal pain, candidiasis (oral and vaginal), confusion, dark stools, dermatologic reactions, dizziness, dry mouth, glossitis, myalgia, nausea, rectal itching, stomatitis, thirst, tongue discoloration, vaginitis, vomiting

Standard Dosing:  Oral: Administer before food; best if taken before breakfast. The intact granules should not be chewed or crushed; however, several options are available for those patients unable to swallow capsules: Capsules may be opened and the intact granules sprinkled on 1 tablespoon of applesauce, Ensure® pudding, cottage cheese, yogurt, or strained pears. The granules should then be swallowed immediately. Capsules may be opened and emptied into ~60 mL orange juice, apple juice, or tomato juice; mix and swallow immediately. Rinse the glass with additional juice and swallow to assure complete delivery of the dose.

Oral: Adult: Duodenal ulcer: Short-term treatment: 15 mg once daily for 4 weeks; maintenance therapy: 15 mg once daily; Gastric ulcer: Short-term treatment: 30 mg once daily for up to 8 weeks; NSAID-associated gastric ulcer (healing): 30 mg once daily for 8 weeks; controlled studies did not extend past 8 weeks of therapy; NSAID-associated gastric ulcer (to reduce risk): 15 mg once daily for up to 12 weeks; controlled studies did not extend past 12 weeks of therapy; Symptomatic GERD: Short-term treatment: 15 mg once daily for up to 8 weeks; Erosive esophagitis: Short-term treatment: 30 mg once daily for up to 8 weeks; continued treatment for an additional 8 weeks may be considered for recurrence or for patients who do not heal after the first 8 weeks of therapy; maintenance therapy: 15 mg once daily; Hypersecretory conditions: Initial: 60 mg once daily; adjust dose based upon patient response and to reduce acid secretion to <10 mEq/hour (5 mEq/hour in patients with prior gastric surgery); doses of 90 mg twice daily have been used; administer doses >120 mg/day in divided doses. Heartburn: OTC labeling: 15 mg once daily for 14 days; may repeat 14 days of therapy every 4 months. Do not take for >14 days or more often than every 4 months, unless instructed by healthcare provider.

Children 1-11 years: GERD, erosive esophagitis: ≤30 kg: 15 mg once daily for up to 12 weeks; >30 kg: 

30 mg once daily for up to 12 weeks.  Note: Doses were increased in some pediatric patients if still

symptomatic after 2 or more weeks of treatment (maximum dose: 30 mg twice daily)

Children 12-17 years: Nonerosive GERD: 15 mg once daily for up to 8 weeks; Erosive esophagitis: 30 mg

once daily for up to 8 weeks.

Nasogastric tube administration: Capsule: Capsule can be opened, the granules mixed (not crushed) with

40 mL of apple juice and then injected through the NG tube into the stomach, then flush tube with additional

apple juice. Do not mix with other liquids.

Prevpac: Oral: Adults: Lansoprazole 30 mg, amoxicillin 1 g, and clarithromycin 500 mg taken together twice daily for 10 or 14 days

Drug interactions: LINK: http://www.drugs.com/drug-interactions/lansoprazole.html

CYP2C19 Inducers (Strong): May increase the metabolism of CYP2C19 Substrates. Management: Consider an alternative for one of the interacting drugs. Some combinations may be specifically contraindicated. Consult appropriate manufacturer labeling. Consider therapy modification

CYP3A4 Inducers (Strong): May increase the metabolism of CYP3A4 Substrates. Management: Consider an

alternative for one of the interacting drugs. Some combinations may be specifically contraindicated. Consult

appropriate manufacturer labeling. Consider therapy modification.

A total of 262 drugs (1607 brand and generic names) are known to interact with lansoprazole.

• 9 major drug interactions (23 brand and generic names)
• 173 moderate drug interactions (1119 brand and generic names)
• 80 minor drug interactions (465 brand and generic names)

Show all medications in the database that may interact with lansoprazole.

Bad heartburn sufferers "Prazole" PPIs....:)