LANSOPRAZOLE
( Prevacid® SoluTab™; Prevacid®)


DOSING IN  ADULTS

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
Duodenal ulcer:  Short-term treatment: 15 mg once daily for 4 weeks; maintenance therapy: 15 mg once daily
Peptic ulcer disease: Eradication of Helicobacter pylori: 30 mg once daily or 60 mg/day in 2 divided doses; requires combination therapy with antibiotics
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
NSAID-associated gastric ulcer (to reduce risk): 15 mg once daily for up to 12 weeks; controlled studies did not extend past 12 weeks


DOSING IN  RENAL IMPAIRMENT  

No adjustment is necessary.


DOSING IN  HEPATIC IMPAIRMENT  

May require a dose reduction.


DOSAGE FORMS 

Capsule, delayed release:
   Prevacid®: 15 mg, 30 mg
Granules, for oral suspension, delayed release:
   Prevacid®: 15 mg/packet (30s) [strawberry flavor], 30 mg/packet (30s) [strawberry flavor] [DSC]
Tablet, orally disintegrating:
  Prevacid® SoluTab™: 15 mg [contains phenylalanine 2.5 mg; strawberry flavor]; 30 mg [contains phenylalanine 5.1 mg; strawberry flavor]


ADMINISTRATION

Best if taken before breakfast. The intact granules should not be chewed or crushed.  Capsules may be opened and the intact granules sprinkled on 1 tablespoon of applesauce, 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.
Delayed release oral suspension granules should be mixed with 2 tablespoonfuls (30 mL) of water; no other liquid should be used. Stir well and drink immediately


ADVERSE REACTIONS SIGNIFICANT

Headache
Diarrhea
Abdominal pain
Nausea


CONTRAINDICATIONS — Hypersensitivity to lansoprazole, substituted benzimidazoles (ie, esomeprazole, omeprazole, pantoprazole, rabeprazole), or any component of the formulation


DRUG INTERACTIONS 

Antiretrovirals: Proton pump inhibitors may decrease the absorption of atazanavir and Indinavir. Concurrent use is not recommended.
Antifungal agents (imidazoles): Proton pump inhibitors may decrease the absorption of itraconazole and ketoconazole.
CYP2C19 inducers: May decrease the levels/effects of lansoprazole. Example inducers include aminoglutethimide, carbamazepine, fosphenytoin, phenytoin, and rifampin.
CYP2C19 substrates: Lansoprazole may increase the levels/effects of CYP2C19 substrates. Example substrates include citalopram, diazepam, methsuximide, phenytoin, propranolol, and sertraline.
CYP3A4 inducers: CYP3A4 inducers may decrease the levels/effects of lansoprazole. Example inducers include aminoglutethimide, carbamazepine, nafcillin, nevirapine, phenobarbital, phenytoin, and rifamycins.
HMG-CoA reductase inhibitors: Proton pump inhibitors may increase the serum concentration of HMG-CoA reductase inhibitors.
Iron salts (oral): Lansoprazole may decrease the absorption of oral iron salts.
Methotrexate: Proton pump inhibitors may decrease the excretion of methotrexate.


PREGNANCY RISK FACTOR  B


LACTATION — Excretion in breast milk unknown/not recommended.