Dexlansoprazole (Oral)

Overview

Classified as a proton pump inhibitor, Dexlansoprazole is used to treat patients who have been diagnosed with stomach or esophageal conditions. When the stomach produces too much acid, it can cause various ailments. If excess acid is only produced occasionally, it may cause sporadic instances of heartburn. Often, mild heartburn can be treated with over the counter medications, providing it does not occur frequently.

If the stomach produces too much acid regularly, however, more serious health complications can occur. Gastroesophageal reflux disease (GERD) occurs when the lower esophageal sphincter doesn't work properly. The lower esophageal sphincter is essentially a ring of muscle between the stomach and esophagus. If it doesn't close completely, acid from the stomach can travel to the esophagus and cause uncomfortable symptoms.

Over time, excess stomach acid in the esophagus can cause the lining to become irritated or worn away. Known as erosive esophagitis, the conditions tends to cause pain, severe heartburn and nausea. Patients may also suffer from sore throats, bad breath, coughing and vomiting.

By binding to the proton pump, Dexlansoprazole inhibits the production of gastric acids. As stomach acid is reduced, less damage occurs to both the esophagus and the stomach itself. Once the medication has taken effect, patients should notice a significant decrease in their symptoms.

As excess stomach acid can cause serious conditions, such as Barrett's esophagus, to occur, it's important that it is treated as early as possible. By prescribing proton pump inhibitors, such as Dexlansoprazole, physicians can prevent the patient from producing too much stomach acid. In turn, this stops the esophagus from being damaged due to gastroesophageal reflux and helps to heal the damage caused by erosive esophagitis.

Conditions Treated

  • Gastroesophageal reflux disease (GERD)
  • Erosive esophagitis
  • Barrett's esophagus
  • Excess gastric/stomach acid

Type Of Medicine

  • Proton Pump Inhibitor

Side Effects

When taking any medication, patients can sometimes experience side effects. In many cases, these side effects are more prominent when patients first start taking Dexlansoprazole. Once they become used to the medication, the side effects may decline or wear off. These side effects may include:

  • Full or bloated feeling
  • Body pains or aches
  • Abnormal dreams
  • Itching or burning around the anus
  • Painful urination
  • Unusual, unpleasant or bad after taste
  • Continuing buzzing, ringing or other unexplained noise in the ears
  • Difficulty urinating
  • Changes to taste
  • Difficulty moving
  • Excess gas or air in the intestines or stomach
  • Congestion in ears
  • Falls
  • Ear pain
  • Feeling of constant movement of surroundings or self
  • Loss of voice
  • Bone or muscle pain
  • Passing gas
  • Nasal congestion
  • Sneezing
  • Loss of sexual desire, performance, drive or ability
  • Sunburn
  • Metallic taste
  • Redness of the necks, face arms and sometimes, upper chest
  • Spinning sensation
  • Runny nose
  • Trouble sleeping
  • Sore throat

Unless patients are concerned about these side effects, they won't necessarily need to seek medical help for them. If they do not diminish or are severe, however, patients should contact their physician for advice.

In some cases, patients may experience more serious side effects when taking Dexlansoprazole. If patients suffer from any other following adverse effects when taking this medication, they should seek medical help as soon as possible:

  • Numbness, crawling, burning, prickling, itching, tingling or 'pins and needles' feeling
  • Chest discomfort or pain
  • Incoherent speech
  • Labored or difficult breathing
  • Chest heaviness or tightness
  • Diarrhea
  • Confusion
  • Fever
  • Continuing stomach pain
  • Irregular, fast, racing or pounding pulse or heartbeat
  • Headache
  • Joint stiffness, pain or swelling
  • Fainting, dizziness or lightheadedness
  • Muscle weakness, pain or cramps
  • Tingling or numbness in the feet, hands or lips
  • Nausea or vomiting
  • Discomfort or pain in the jaw, leg, back, arm, or neck
  • Hives or rash on the skin
  • Pounding in ears
  • Shakiness in the arms, hands, legs or feet
  • Chills
  • Sweating
  • Cough
  • Swelling of the face, hands, lips, hands, eyelids or feet
  • Drowsiness
  • Tender, swollen or painful lymph glands in the armpit, neck or groin
  • Muscle twitching or spasms
  • Unusual bruising and/or bleeding
  • Red lesions on skin, sometimes with a purple center
  • Vomiting of material that looks like coffee grounds
  • Vomiting of blood
  • Bloody or watery diarrhea
  • Seizures
  • Irritated, red eyes
  • Peeling, loosening or blistering of the skin
  • Ulcers, white spots or sores on the lips or in the mouth
  • Trembling
  • Unusual weight gain
  • Swelling of the feet, body or ankles

In addition to this, patients should seek medical advice if they experience any other side effects that are not listed here. If they choose to, patients can inform the Food and Drug Administration if they experience side effects that are not commonly associated with Dexlansoprazole. To do this, contact the FDA on 1-800-FDA-1088.

Dosage

When patients are prescribed Dexlansoprazole, they will be given a dose of medication that reflects their condition, medical history, age and weight. However, there are standard dosing strategies that may be used.

If patients are suffering from gastroesophageal reflux disease (GERD) and are given delayed-release Dexlansoprazole capsules or disintegrating tablets, for example, they may be prescribed 30mg to be taken once per day. Typically, this treatment will last for four weeks, but may be extended, if necessary.

Alternatively, if patients are given delayed-release Dexlansoprazole capsules for the treatment of erosive esophagitis, they may be given 60mg per day for a period of eight weeks. Following this, patients may be advised to take 30mg of Dexlansoprazole once per day for six months, as this can prevent the symptoms of erosive esophagitis from returning. If oral disintegrating tablets are prescribed for patients with erosive esophagitis, they may simply be prescribed 30mg to be taken once per day for a period of up to six months.

Although these are standard treatment strategies for GERD and erosive esophagitis, patients will be given individual treatment plans. They should, therefore, follow their doctor's instructions when taking Dexlansoprazole and other medications.

Typically, patients over the age of twelve can be prescribed Dexlansoprazole in accordance with standard dosing regimes. As the efficacy of Dexlansoprazole has not been tested on patients under the age of twelve years, an alternative medication may be prescribed if they are suffering from erosive esophagitis or GERD.

If patients are prescribed delayed-release Dexlansoprazole capsules, they will normally be advised to take the capsule whole and swallow it with water. If this isn't possible, patients may be able to open the capsule and swallow the powder with food, such as applesauce. However, patients should seek advice from their physician before doing this.

Generally, the delayed-release Dexlansoprazole capsule can be taken with or without food, but the Dexlansoprazole disintegrating tablet should be taken at least thirty minutes before a meal. When patients are taking the disintegrating tablet, they should allow the tablet to dissolve on their tongue, before swallowing it without water. The granules should not be chewed before they are swallowed. If patients prefer to swallow the tablet whole, before it disintegrates, they can do this using water.

If patients have concerns about taking either form of Dexlansoprazole, they should seek advice from their physician.

If patients have difficulty swallowing medication, they may be advised to use delayed-release Dexlansoprazole capsules or disintegrating tablets with an oral syringe or feeding tube. If using an oral syringe, patients should open the capsule and place the medication in a clean container with 20ml of water. Patients should then draw the mixture into the syringe and place it in their mouth. After swallowing the medicine, patients should draw up another 10ml of water into the syringe and swallow this, too. This ensures that no medicine is left in the syringe and that patients get the full dose of Dexlansoprazole.

If a feeding tube is used, the Dexlansoprazole capsule should be opened and the contents mixed with 20ml of water. Alternatively, the disintegrating tablet can be mixed with the same amount of liquid. This solution should then be placed into a catheter-tipped syringe, before being injected into an NG tube. Again, more water should be placed into the syringe and administered into the feeding tube so that the patient receives the full dose of medication.

Patients should not attempt to use an oral syringe or feeding tube unless they have been advised to do so and given clear instructions from a healthcare practitioner. If a family member or caregiver is administering medicine to the patient, they should be shown how to use the relevant equipment when Dexlansoprazole is prescribed. If they are unsure, it's vital that they seek medical advice.

If a dose of Dexlansoprazole is missed, it should be taken as soon as possible. However, if the next dose of Dexlansoprazole is due soon, the missed dose should be skipped. It isn't appropriate to take double doses of Dexlansoprazole, even if a dose has been missed.

If patients have missed a dose of Dexlansoprazole and are unsure how to continue with treatment, they should seek advice from their doctor or pharmacist.

Interactions

When patients are taking more than one medication, physicians must ensure that they won't interact with each other and cause adverse effects. Due to this, patients will not be prescribed Dexlansoprazole if they are also taking Rilpivirine.

Although Dexlansoprazole may interact if it is taken with the following medications, doctors may alter the dose of medication to prevent this from happening:

  • Atazanavir
  • Vismodegib
  • Bosutinib
  • Velpatasvir
  • Erlotinib
  • Mycophenolic Acid
  • Gefitinib
  • Nelfinavir
  • Ketoconazole
  • Pazopanib
  • Ledipasvir
  • Nilotinib
  • Methotrexate
  • Saquinavir
  • Mycophenolate Mofetil

Taking Dexlansoprazole with the following medicines may increase the risk of side effects occurring. If so, doctors may offer additional medication to relieve the side effects or alter the patient's dose of medication. These medications include:

  • Warfarin
  • Levothyroxine

When taking prescription medications, patients should also be aware that they could interact with other substances, such as over the counter medicines, supplements, vitamins and certain foods and drinks.

Patients should inform their physician if they are taking any other medicines, vitamins or supplements before taking Dexlansoprazole. Patients should also seek medical advice before taking any new medications, vitamins or supplements once they have begun taking Dexlansoprazole.

As Dexlansoprazole can interact with cranberries, patients should avoid consuming cranberries, cranberry juice or any cranberry-based products whilst taking this medication.

In addition to this, patients are normally advised to avoid alcohol whilst taking this medication.

Warnings

Existing medical conditions could affect the way Dexlansoprazole works, or the medication could worsen certain conditions. Patients should disclose their full medical history to their physician before they take Dexlansoprazole. The following conditions may be of particular relevance:

  • Liver disease
  • Low levels of magnesium in the blood (Hypomagnesemia)
  • System lupus erythematosus (SLE)
  • Seizures
  • Diarrhea
  • Osteoporosis and other bone conditions

If patients have existing liver problems, a lower dose of Dexlansoprazole may be prescribed. When the liver is not working normally, it can take longer for medicines to be processed. As a result, medication could theoretically build up to harmful levels. By prescribing a lower dose and monitoring the patient, physicians can ensure that Dexlansoprazole is not having any harmful effects.

When patients are taking Dexlansoprazole, they should attend regular consultations with their doctor. Regular blood and urine tests should also be carried out. These will enable physicians to assess whether the medication is working and whether the patient's dose should be modified.

Acute interstitial nephritis affects the working of the kidneys and is a serious condition. If patients experience any of the following symptoms when taking Dexlansoprazole, they should seek medical help straight away:

  • Joint pain
  • Fever
  • Unusual weight gain
  • Swelling of the feet, body and ankles
  • Rash on the skin

When taking Dexlansoprazole, patients may find it more difficult to absorb vitamin B12. As a vitamin B12 deficiency can cause a range of unpleasant symptoms and can result in dangerous complications, patients should have their vitamin levels checked on a regular basis. If necessary, patients may be given B12 injections or oral supplements. However, patients should contact their doctor regarding possible vitamin deficiencies, rather than purchasing supplements without seeking medical advice.

Taking Dexlansoprazole may increase the risk of bone fractures occurring. The wrist, hip and spine are most likely to be affected and patients over the age of fifty are more prone to these issues. Similarly, the risk of experiencing bone fractures increases if you take high doses of Dexlansoprazole or if you take the medication for over a year. If patients are concerned about the risk of suffering fractures, they should contact their physician for advice.

If patients experience stomach pains, fever and pass watery stools while taking Dexlansoprazole, they should contact their physician for medical assistance immediately.

Systemic or cutaneous lupus erythematosus may occur or worsen while patients are taking proton pump inhibitors, such as Dexlansoprazole. If patients experience joint pain or have a rash on their arms or cheeks which worsens after exposure to the sun, they should seek urgent medical advice.

Taking Dexlansoprazole can cause patients to develop low levels of magnesium in their blood. Also known as hypomagnesemia, this is more likely to occur in patients who have taken Dexlansoprazole for over a year. Patients who take digoxin or diuretics may also have an increased risk of developing hypomagnesemia. If patients exhibit any of the following symptoms, they should seek medical help:

  • Unusual weakness or tiredness
  • Tremors
  • Muscle spasms
  • Racing, fast or uneven heartrate
  • Seizures
  • Convulsions

Patients should not stop taking Dexlansoprazole unless they are advised to do so by a medical professional.

If patients consult any doctors, nurses or healthcare practitioners, they should inform them they are taking Dexlansoprazole. Similarly, if patients are due to undergo any medical procedures, they will need to contact the relevant personnel and tell them they are taking this medication. This includes and dental treatment or oral surgical procedures.

Dexlansoprazole may alter the results of some medical tests. This should be taken into account when tests are carried out and when the results are analyzed.

Currently, it is not believed that Dexlansoprazole poses a significant harm to an unborn fetus if the medication is taken by a pregnant patient. However, patients should tell their physician if they are pregnant and discuss any potential risks before taking Dexlansoprazole.

If patients become pregnant when taking Dexlansoprazole, they should contact their physician for further advice.

It is not yet known if Dexlansoprazole can pass from a breastfeeding mother to an infant or if the medication would pose a significant risk to the child. Due to this, patients may be advised not to breastfeed if they are being treated with Dexlansoprazole. Patients should tell their doctor if they are breastfeeding before they take Dexlansoprazole and they should seek medical advice before they begin or resume breastfeeding after taking this medication.

Before beginning treatment, patients should discuss any allergies they have with their doctor. This includes allergies to medications, as well as allergies to other substances, such as animals, foods and preservatives.

In some cases, patients may experience an allergic reaction when taking Dexlansoprazole. Although this is not particularly common, it can be life-threatening if anaphylaxis occurs. If patients exhibit any of the following symptoms when taking Dexlansoprazole, they will need emergency medical treatment:

  • Wheezing
  • Difficulty breathing
  • Hoarseness
  • Difficulty swallowing
  • Rash on the skin
  • Swelling of the mouth, lips, throat or face

Storage

When patients are prescribed Dexlansoprazole, they will typically be given their medication to take at home. When storing medicines at home, patients will need to ensure that they are kept in a safe location. Dexlansoprazole must be kept out of reach of children and pets, for example. Using a locked cupboard or lockable medicine box should ensure that your medication cannot be accessed.

Unless instructed otherwise, patients should store Dexlansoprazole at room temperature, in a closed container. If Dexlansoprazole is packaged in blister packs, these should only be opened as and when the patient is ready to take their next dose of medication.

Dexlansoprazole should also be kept away from moisture, heat and direct light. This is particularly important if patients are given oral disintegrating tablets, as any moisture could cause the tablets to start disintegrating.

Patients should not continue to store Dexlansoprazole at home if they are advised to stop taking the medication or if the medicine has exceeded its use-by date. However, medicines should not be disposed of with normal household waste, either.

Patients should contact their doctor's office or pharmacist if they need to dispose of medications. Often, pharmacies will allow patients to take part-used medication to the store so that it can be disposed of safely.

Summary

As a proton pump inhibitor, Dexlansoprazole prevents the stomach from producing too much gastric acid. Without this medication, patients are likely to experience the uncomfortable symptoms associated with excess acid production, such as burning pains and chronic heartburn.

In addition to this, patients may develop ongoing health problems if excess stomach acid is left untreated. It is not uncommon for acid reflux to cause damage to the esophagus and this may result in the patient suffering from various conditions, such as erosive esophagitis.

By taking Dexlansoprazole, however, patients can obtain relief from these symptoms and reduce the risk of further health problems arising. Whilst Dexlansoprazole can be used to treat erosive esophagitis and manage gastroesophageal reflux disease, it can also be used to allow an irritated esophagus to heal before permanent damage occurs.

Available as a disintegrating tablet or a capsule, Dexlansoprazole can be taken by the vast majority of patients. As it can be administered via an oral syringe or feeding tube, Dexlansoprazole can be used to treat patients who have difficulties swallowing and who may not be able to receive alternative medications.