Lansoprazole (Oral)

Being a proton pump inhibitor, lansoprazole works to reduce stomach acid and is sometimes used in conjunction with antibiotics to treat ulcers.

Overview

Lansoprazole is a drug which is effective at reducing stomach acid and is taken via an oral route. It comes in several forms, including a delayed-release disintegrating tablet, a packet, a delayed-release capsule, and a powder for suspension. It can be purchased over-the-counter, and it is also available as a prescription drug, depending on its intended usage.

Because of its highly beneficial properties of reducing stomach acid, it is used for several different medical conditions:

  • Gastric ulcers
  • Duodenal ulcers
  • Gastric ulcers triggered by NSAIDs usage
  • Gastroesophageal reflux disease
  • Erosive esophagitis
  • Ulcers caused by infectious H. pylori bacteria
  • Heartburn
  • Swallowing problems
  • Persistent coughing

By decreasing the amount of acid produced by the stomach, lansoprazole can bring relief to patients suffering from any of the conditions above. It also helps to mend any damage which may have been done to the esophagus or stomach, and it is thought to have a role in the prevention of esophageal cancer.

The over-the-counter version of this medication is most often used to treat heartburn, although its effects are not noticed immediately. More often, it achieves full effectiveness within four days of ingestion, so any person taking lansoprazole should not expect quick relief from a temporary condition. It is more appropriate for people who experience heartburn on a regular basis, e.g. up to four or more times every week, since the condition is then an ongoing one.

Condition Treated

  • Excess stomach acid
  • Stomach ulcers
  • Zollinger-Ellison Syndrome

Type Of Medicine

  • Proton pump inhibitor

Side Effects

In addition to the highly beneficial medical advantages provided by lansoprazole, it may also induce some unwanted side effects in patients, some of which will be quite mild, and some which may be more severe. Some patients may experience no side effects at all, while others get several of them, and they are relatively more severe. Since every person's body chemistry is a little different, there can be a wide range of patient reactions to any medication, including lansoprazole.

The first side effect to be aware of is the possibility of an allergic reaction, and if you suspect you are having an allergic reaction to this drug, you should seek medical attention immediately, since the symptoms have the potential to become life-threatening. Here are the symptoms to look for in an allergic reaction:

  • Dizziness or lightheadedness, as though you may be about to faint
  • Extreme itchiness, occurring at various sites all around the body
  • Tightness in the chest, often accompanied by difficulty with your breathing
  • Severe puffiness or swelling in the area of the eyelids, or around the tongue, lips, and possibly even the throat (which can be extremely dangerous)
  • The appearance of rashes and/or hives on skin surfaces.

There is a grouping of side effects which are considered to be more severe than other side effects you might experience, and it is possible that these may also require some kind of medical attention. That will depend on how severe your own experience is, and how uncomfortable it causes you to feel. If any of the side effects on the following list should cause you extreme discomfort, contact your doctor at the earliest opportunity, because he/she may want to consider alternative treatment options or to reduce your dosage of lansoprazole.

  • Diarrhea
  • Skin rashes or itching
  • Stomach pains or cramping
  • Abdominal pains or cramping
  • Nausea and or vomiting
  • Pain in the joints
  • Decreased appetite
  • Increased appetite
  • Cold or flu symptoms
  • Bleeding from the rectum
  • Muscle pains
  • Persistent coughing
  • Depression
  • Constipation
  • Unexplained bleeding or bruising
  • Back or leg pains
  • Bleeding gums
  • Mood changes
  • Muscle spasms and twitching
  • Nosebleeds
  • Difficulty with urination or painful urination
  • Pains which originate in the stomach, abdomen, or side, and radiate toward the back
  • Loosening of the skin, along with peeling and/or blistering
  • Feeling of fullness or bloatedness
  • Changes in mental attitude
  • Chest pains
  • Chills and fevers
  • Clay-colored stools
  • Hoarseness
  • Pinpoint red spots which show up on the skin
  • Swelling on the eyelids, tongue, lips, or throat
  • Urine which is dark-colored or bloody
  • Difficulty with swallowing
  • Drowsiness at many times of the day
  • Fast or irregular heartbeat
  • Hives
  • General swelling around the body
  • Red or irritated eyes
  • Seizures or convulsions
  • Sore throat
  • Red lesions on the skin, sometimes having a purple center
  • White spots, sores, or ulcers appearing on the lips or inside the mouth
  • Indigestion
  • Uncharacteristic fatigue or weakness which persists
  • Swollen glands
  • Swelling of the hands, legs, ankles, or feet
  • Tightness of the chest
  • Trembling or shaking
  • Yellowish tinge to the skin or around the eyes.

There is another class of side effect which is considered to be less severe in nature and does not generally require medical attention, although your own case may be different. In any case, even if these milder symptoms are the only side effects you experience, you should mention them to your doctor at your next appointment.

  • Dizziness or disorientation
  • Mild headaches
  • Burning, blistering, peeling, or discoloration of the skin
  • Mild nausea
  • Acid or sour stomach
  • Profuse sweating
  • Vomiting
  • Stomach discomfort'pins and needles' feeling
  • Feeling flushed or warm
  • Redness of the skin, especially around the neck and face
  • Changes in taste or smell
  • Bad or unpleasant aftertaste in your mouth after ingestion
  • Uncharacteristic belching
  • Diarrhea
  • Decrease in volume of urine, often with dribbling
  • Decrease in frequency of urination
  • Difficulty with speaking, sometimes observed as slurring of words.

Dosage

It's important to note that this medicine should be taken right before a meal, and should always be taken for the full length of the prescribed time, even if you should begin to feel better much sooner than that. If this medicine is being taken for the treatment of an ulcer associated with H. pylori infection, it must be taken with amoxicillin, clarithromycin, or whatever antibiotic is being used, at the very same time each day.

When ingesting the capsule form of this oral medicine, you should swallow the capsule whole without breaking, chewing, or crushing it. If you are unable to swallow a capsule of this size, it can be opened and sprinkled on top of yogurt, cottage cheese, pudding, or applesauce. You can also mix the contents of the capsule with 2 ounces of orange juice, tomato juice or apple juice, and as soon as you have mixed the two together, you should drink the entire liquid immediately. You should then follow up with another cup of the same juice right afterward, to make sure that you have received all the medicine that was in the cup.

When taking this medicine with a nasogastric tube, the capsule should be opened and then mixed with 40 mL of apple juice, but no other kinds of liquid. The mixture can then be poured into the nasogastric tube, and afterward the tube should be flushed with more apple juice to make sure all medicine has been rinsed clear of the tube and into the stomach.

When using the disintegrating tablet, make sure to wash your hands and dry them completely before you actually touch the tablet. Avoid crushing, breaking, chewing, or cutting the tablet, and when you place it on the tongue, allow it to dissolve into particles which can be swallowed right away.

When using the orally disintegrating tablet in tandem with an oral syringe, be sure to wash your hands and dry them completely before touching the tablet. Do not crush chew, break, or cut the tablet. If using the 15 mg tablet, place it in an oral syringe with 4 mL of water, and if using the 30 mg tablet, place it in an oral syringe with 10 mL of water. The syringe should then be gently shaken until the tablet dissolves and is well mixed together. The mixture should be ingested within 15 minutes, after which the syringe should be refilled with between 2 mL and 5 mL of water, and gently shaken before ingesting this also, to flush out all medicine.

When using the orally disintegrating tablet in accompaniment with a nasogastric tube, be sure hands are well washed and dried before handling the tablet, and do not crush, break, cut or chew the tablet. The tablet which is 15 mg should be placed in a syringe along with 4 mL of water, and the tablet which is 30 mL should be put in a syringe with 10 mL of water, and in both cases the syringe needs to be gently shaken until dissolution occurs. Then the mixture can be put into the nasogastric tube within 15 minutes, and after administration, the tube should be refilled with 5 mL of water, shaken gently, and flushed through the tube to rinse all medicine from the tube and into the stomach.

  • For treatment of duodenal ulcers 'adults should take 15 mg once daily prior to a meal, and children would have to have a dosage determined by the family doctor
  • For the treatment of duodenal ulcers with H. pylori infection¬†' adults should take 30 mg prior to a meal, either two or three times daily and with amoxicillin or clarithromycin. Again, children should have dosage determined by the family doctor
  • For the treatment of erosive esophagitis' adults should take 30 mg once daily prior to a meal, subject to doctor-recommended adjustments. Children above the age of 12 should take 30 mg once a day before a meal. Children between the ages of one and 11 and weighing over 30 kg should take 30 mg once a day prior to a meal. Children between the ages of 1 and 11, and weighing less than 30 kg, should only take 15 mg once daily prior to a meal. Children less than one-year-old will need to have dosage determined by the family doctor
  • For the treatment of benign gastric ulcers'adults should take 30 mg once daily prior to a meal, subject to doctor-recommended adjustments. Children must have usage and dosage determined by the family doctor
  • For the treatment of gastric ulcers caused by nonsteroidal anti-inflammatory drugs'adults should take between 15 and 30 mg once daily prior to a meal. Children must have usage and dosage of this medicine determined by the family doctor
  • For the treatment of gastroesophageal reflux disease¬†' adults and children above the age of 12 should take 15 mg once daily prior to a meal, subject to doctor-recommended adjustments. Children between the ages of 1 and 11 and weighing over 30 kg, should take 30 mg once daily prior to a meal, subject to doctor-recommended alterations. Children between the ages of 1 and 11 and weighing less than 30 kg, should take 15 mg once daily prior to a meal, subject to doctor-recommended modifications. Children less than one year of age must have their usage and dosage determined by the family doctor
  • For the treatment of Zollinger-Ellison syndrome' adults should take 60 mg once daily prior to a meal, subject to doctor-recommended notifications. Usage and dosage for children must be determined by the family doctor.

If you should forget to take your regularly scheduled dosage of this medicine, you can take it as soon as possible, unless you are drawing near to the time of your next regularly scheduled dosage. In that case, you should skip the missed dosage entirely and just wait for the next one. You should not double up on dosages just for the sake of getting back on schedule or to manage a particularly intense episode of stomach acid symptoms.

Interactions

There are a number of possible interactions with other drugs that may occur when using lansoprazole, and these interactions may take the form of inducing adverse side effects to the patient, or they may cause a decrease in the effectiveness of either of the two drugs in question. In order to avoid such drug interactions, you should prepare a complete list of all the medications you are currently using, including vitamins, herbal supplements, over-the-counter drugs, and other prescription medications, so that your doctor can review this list and make a determination of the potential for interactions.

This list can also be used if you should have to go to a health care clinic where your primary care doctor is not in residence, or if you need to make an unscheduled trip to an emergency room for treatment. Doctors at either of these facilities can review your medication list and make sure to prescribe treatment for you which does not conflict with any of the medications on your list.

The other drugs which are most commonly checked by doctors for potential interaction with lansoprazole are those on the list below:

  • Levothyroxine
  • Montelukast
  • Acetaminophen
  • Amphetamine
  • Dextroamphetamine
  • Amoxicillin
  • Polyethylene glycol 3350
  • Omeprazole
  • Atorvastatin
  • Pregabalin
  • Metoprolol
  • Ranitidine
  • Cetirizine
  • Cholecalciferol
  • Alprazolam
  • Ascorbic acid
  • Cyanocobalamin
  • Rosuvastatin
  • Duloxetine
  • Erythromycin
  • Citalopram
  • Ciprofloxacin
  • Fluoxetine
  • Gabapentin
  • Clopidogrel
  • Albuterol
  • Sertraline
  • Azithromycin
  • Aspirin
  • Calcium
  • Vitamin D.

Warnings

As with virtually all medications, there are certain precautions and warnings which must be taken into account when using lansoprazole, so that the drug may be taken safely without impacting existing medical conditions or triggering new problems. Prior to taking lansoprazole, your doctor will discuss with you the benefits provided by the medication as well as the risks that are associated with taking it, so that you can have a full understanding of whether or not this medicine is right for you.

It will be very important for your doctor to periodically monitor the progress of this medication to see if it is having the desired effects, as well as to check on how well your body is tolerating the medicine. Make sure to keep all appointments and laboratory tests recommended by the doctor, so that your status can be checked regularly.

You should notify your doctor immediately if you experience fevers, joint pains, unusual weight gain, swelling in the feet or ankles, or severe skin rashes, since these could all be symptomatic of acute interstitial nephritis.

When you take this medicine over a prolonged period of time, it may be difficult for your body to absorb vitamin B-12, so you should mention to your doctor if you have any concerns about a deficiency of vitamin B-12 in your diet.

If you should notice a persistent watery stool that goes on for a long period of time, or if you experience fevers and stomach pains regularly when taking this medicine, discontinue taking lansoprazole until you've had a chance to discuss the symptoms with your doctor.

This medicine may elevate the risk of bone fractures that occur in the spine, wrist, or hips, and is much more likely if you are above the age of 50 and have osteoporosis. It is also more likely for those patients who have used the drug for longer than a year, or those who have taken unusually high dosages over a period of time.

It is also possible for patients who are using this medication to develop systemic lupus erythematosus, or for patients who already have that medical condition, to have it exacerbated by usage of lansoprazole.

Contact your doctor immediately if you observe skin rashes on your arms or cheeks that worsen under exposure to sunlight, or if you notice persistent joint pains.

It's possible for this medicine to cause hypomagnesemia, especially in cases where you have taken this medication for longer than one year, or if it has been taken in conjunction with digoxin or other diuretics.

Consult with the doctor immediately if you notice a fast or irregular heartbeat, muscle spasms, trembling and shaking, unusual weakness or fatigue, or if you should experience convulsions or seizures.

Do not stop taking this medication on your own, or change the dosage level whatsoever unless you have first consulted with your prescribing doctor.

Before you take any medical tests, make sure that you notify the laboratory technician that you are taking lansoprazole, because it may have an impact on laboratory results.

Women who are pregnant or thinking of becoming pregnant, should seriously consider the advisability of taking lansoprazole, and should discuss this thoroughly with the family doctor. Studies conducted on animal populations have discovered cases of fetal mortality and significantly lower birth weight when this medicine is administered in high doses.

Although there are no controlled studies which have been conducted on human populations, there would appear to be a significant risk involved with taking this medication during pregnancy.

It is also known that lansoprazole is passed through breastmilk to a nursing infant, and given the fact that there has been at least a nominal risk associated with infants who have mothers being administered lansoprazole, use of this medication when breastfeeding is strongly discouraged.

While it's possible that no harm at all will come to an unborn fetus, and that no adverse effects will be delivered to a nursing infant through breastfeeding, it does represent a risk in either case. For this reason, women of childbearing age should have this kind of conversation with the family doctor before agreeing to it a program of treatment which includes lansoprazole.

Lansoprazole which has been prescribed for you personally should not be shared with anyone else, since their body chemistry is likely to be much different, and their reaction to taking the drug will likely be different than your own. By the same token, you should not use lansoprazole which has been prescribed for a friend or relative for the same reason, i.e. your body chemistry will be different than for the prescribed person.

If you suspect that you are overdosing on lansoprazole, you should call 911 or the Poison Control Center immediately and follow all instructions given. The most obvious signs of an overdose are extreme lightheadedness, with the sensation that you are about to pass out, generally accompanied by extreme difficulty with breathing.

Storage

This medication should be stored in a location which is not subject to any extremes of heat, cold, direct light, or moisture. Any of these conditions can degrade the medicine and cause a reduction in its effectiveness. The family bathroom medicine cabinet is a poor choice for storage because it is subject to regular increases in heat and humidity during bathing and showering sessions.

This medication should be kept well out of the reach of pets and small children, and ideally should be kept in a very high location which cannot be reached, even with assistance. You should avoid storing this medicine in a weekly pill reminder because these containers seldom have locking mechanisms which prevent unwanted access.

If you have expired lansoprazole, it should not be ingested, as its effectiveness will be in serious question. Instead, you should discard any expired or unused medication that you have, according to recommendations made by your doctor or pharmacist. Lacking this kind of guidance, you can also consult the FDA website on the safe disposal of medicines. Make sure not to dispose of this medicine by flushing it down the toilet or down the sink, where there is a potential for it to become harmful to others.

Summary

Lansoprazole is a medicine which is available by prescription or over-the-counter and is used for the treatment of stomach acid. It is effective at reducing the amount of acid in the stomach and even has restorative capabilities for stomach or esophageal tissue which has been damaged. It comes in several forms, all of which are meant to be taken orally. In addition to the treatment of stomach acid, lansoprazole is often used to treat some types of ulcers and can be used in conjunction with amoxicillin or erythromycin to achieve the desired results in managing bacteria.