Lansoprazole
PREVACID
Pronunciation: lan-SOE-pra-zoel (PREV-a-sid)
“Lanso Prevents acid”
What it isProton pump inhibitor; GERD, ulcer disease and H. pylori regimens.
Why this oneAvailable as an orally disintegrating tablet, which suits swallowing difficulty and nasogastric administration.
What limits itCYP2C19-dependent, with the same long-term class costs: B12, magnesium, fracture and enteric infection.
FDA-approved for
- GERD/ulcers (1995)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Duodenal ulcer, short-term | Adults | 15 mg QD ×4 wk | 15 mg QD | 15 mg QD |
| Duodenal ulcer, maintenance of healed | Adults | 15 mg QD | 15 mg QD | 15 mg QD |
| H. pylori — triple therapy (+amoxicillin+clarithromycin) | Adults | 30 mg BID ×10-14 days | 30 mg BID | 30 mg BID |
| H. pylori — dual therapy (+amoxicillin) | Adults | 30 mg TID ×14 days | 30 mg TID | 30 mg TID |
| Benign gastric ulcer | Adults | 30 mg QD up to 8 wk | 30 mg QD | 30 mg QD |
| NSAID-associated gastric ulcer — healing | Adults | 30 mg QD ×8 wk | 30 mg QD | 30 mg QD |
| NSAID gastric ulcer — risk reduction | Adults | 15 mg QD up to 12 wk | 15 mg QD | 15 mg QD |
| Symptomatic GERD | Adults | 15 mg QD up to 8 wk | 15 mg QD | 15 mg QD |
| Erosive esophagitis — short-term | Adults | 30 mg QD up to 8 wk | 30 mg QD | 30 mg QD |
| Erosive esophagitis — maintenance | Adults | 15 mg QD | 15 mg QD | 15 mg QD |
| Pathological hypersecretory (Zollinger-Ellison) | Adults | 60 mg QD | Titrate to response | Per response |
Renal Undefined
Hepatic Consider dose reduction in severe hepatic impairment
Instructions
- Swallow capsules whole
- See PI for alternative administration options (open capsule / sprinkle)
Available strengths
- DR cap 15, 30 mg
- ODT 15, 30 mg
Contraindications
- Concomitant rilpivirine-containing products
Cautions
- Symptomatic response does not preclude gastric malignancy
- Acute tubulointerstitial nephritis
- C. difficile-associated diarrhea
- Bone fracture (long-term/high-dose)
- Severe cutaneous adverse reactions
- Cutaneous and systemic lupus erythematosus
- Vitamin B12 deficiency (long-term)
- Hypomagnesemia
- Fundic gland polyps
- Interaction with methotrexate
Adverse reactions
- Diarrhea
- Abdominal pain
- Nausea
- Constipation
Pregnancy Observational data do not indicate increased risk; animal data show effects on fetal bone growth
Lactation No human milk data; present in rat milk
Cost
Generic entry2009
NO BOXED WARNINGS
Principal riskLong-term use: B12 deficiency, hypomagnesemia, fracture
Classes and tags
Clinical profile
Legacy pregnancy categoryB
Defining liabilityLong-term infection, magnesium/B12 and bone risks; selected agents have clinically important CYP interactions.
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