Lansoprazole

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Lansoprazole, sold under the brand name Prevacid among others, is a medication which reduces stomach acid.<ref name=AHFS2019/> It is a proton pump inhibitor (PPI), used to treat peptic ulcer disease, gastroesophageal reflux disease, and Zollinger–Ellison syndrome.<ref name=BNF76/> Its effectiveness is similar to that of other PPIs.<ref name=TI2016>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> It is taken by mouth.<ref name=AHFS2019/> Onset is over a few hours and effects last up to a couple of days.<ref name=AHFS2019/>

Common side effects include constipation, abdominal pain, and nausea.<ref name=AHFS2019/><ref name="Lansoprazole label" /> Serious side effects may include osteoporosis, low blood magnesium, Clostridioides difficile infection, and pneumonia.<ref name=AHFS2019/><ref name="Lansoprazole label" /> Use in pregnancy and breastfeeding is of unclear safety.<ref name=Preg2019>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> It works by blocking H⁺/K⁺-ATPase in the parietal cells of the stomach.<ref name=AHFS2019>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Lansoprazole was patented in 1984 and came into medical use in 1992.<ref>Template:Cite book</ref> It is available as a generic medication.<ref name=BNF76>Template:Cite book</ref> In 2022, it was the 224th most commonly prescribed medication in the United States, with more than 1Template:Nbspmillion prescriptions.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Medical uses

Lansoprazole is used for treatment of:<ref name="Lansoprazole label">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

• Ulcers of the stomach and duodenum, and NSAID-induced ulcers
• Helicobacter pylori infection, alongside antibiotics (adjunctive treatment), treatment to kill H. pylori causing ulcers or other problems involves using two other drugs besides lansoprazole known as "triple therapy", and involves taking twice daily for 10 or 14 days lansoprazole, amoxicillin, and clarithromycin
• Gastroesophageal reflux disease
• Zollinger–Ellison syndrome<ref>Template:Cite journal</ref>

There is no good evidence that it works better than other PPIs.<ref name=TI2016/>

Side effects

Side effects of PPIs in general<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> and lansoprazole in particular<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> may include:<ref name="Lansoprazole label" />

• Common: diarrhea, abdominal pain<ref>{{#invoke:citation/CS1|citation

|CitationClass=web }}</ref>

• Infrequent: dry mouth, insomnia, drowsiness, blurred vision, rash, pruritus
• Rarely and very rarely: taste disturbance, liver dysfunction, peripheral oedema, hypersensitivity reactions (including bronchospasm, urinary, angioedema, anaphylaxis), photosensitivity, fever, sweating, depression, interstitial nephritis, blood disorders (including leukopenia, leukocytosis, pancytopenia, thrombocytopenia), arthralgia, myalgia, skin reactions<ref>Template:Cite journal</ref> including (erythroderma,<ref name="bolognia">Template:Cite book.</ref> Stevens–Johnson syndrome, toxic epidermal necrolysis, bullous eruption)

PPIs may be associated with a greater risk of hip fractures and Clostridioides difficile-associated diarrhea.<ref name="Lansoprazole label" />Template:Rp

Interactions

Lansoprazole interacts with several other drugs, either due to its nature or as a PPI.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

• PPIs reduce absorption of antifungals (itraconazole and ketoconazole) <ref>Template:Cite journal</ref> and possibly increase digoxin in plasma
• Increases plasma concentrations of cilostazol (risk of toxicity)

Lansoprazole possibly interacts with, among other drugs:

• sucralfate
• ampicillin
• bisacodyl
• clopidogrel
• delavirdine
• fluvoxamine
• iron salts
• voriconazole
• aminophylline and theophylline
• astemizole

Chemistry

It is a racemic 1:1 mixture of the enantiomers dexlansoprazole and levolansoprazole.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Dexlansoprazole is an enantiomerically pure active ingredient of a commercial drug as a result of the enantiomeric shift. Lansoprazole's plasma elimination half-life (1.5 h) is not proportional to the duration of the drug's effects to the person (i.e., gastric acid suppression).<ref name="RxList">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

History

{{#invoke:Labelled list hatnote|labelledList|Main article|Main articles|Main page|Main pages}} Lansoprazole was originally synthesized at Takeda and was given the development name AG 1749.<ref>Template:Cite book</ref> Takeda patented it in 1984 and the drug was launched in 1991.<ref>Template:Cite book</ref> In the United States, it was approved for medical use in 1995.<ref name="Mosby's">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Society and culture

File:Prevacid30mg.png

Prevacid 30 mg

Patents

Patent protection of the lansoprazole molecule expired on 10 November 2009,<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref name="Teva">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> and generic formulations became available under many brand names in many countries.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Some formulations may not be available in generic form.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Availability

Since 2009, lansoprazole has been available over the counter (OTC) in the U.S. as Prevacid 24HR<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> and as Lansoprazole 24HR.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> In Australia, it is marketed by Pfizer as Zoton.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Research

In vitro experiments have shown that lansoprazole binds to the pathogenic form of tau protein.<ref name=Lancetrev2015/> Template:As of laboratory studies were underway on analogs of lansoprazole to explore their use as potential PET imaging agents for diagnosing tauopathies including Alzheimer's disease.<ref name=Lancetrev2015>Template:Cite journal</ref>

References

1. REDIRECT Template:Drugs for peptic ulcer and GORD