Lansoprazole, Dexlansoprazole (Dosage)

Lansoprazole is a proton pump inhibitor drug that acts by reducing acid production in the gastric juice. It is used for the treatment of pathologies such as duodenal and gastric ulcer, reflux or Helicobacter pylori. It is metabolized by CYP2C19 so the analysis of the presence of certain genetic variants can help to choose the most adjusted therapeutic dose.

Lansoprazole is a drug belonging to the family of so-called PPIs ("proton pump inhibitors") that is used in gastric infections such as those caused by the bacterium Helicobacter pylory.

Its mechanism of action is to inhibit the secretion of acid in the stomach by binding to the proton pump in the gastric parietal cell, inhibiting the transport of H + to the gastric lumen.

When lansoprazole is prescribed, extreme caution should be exercised if there is suspicion that the patient may present malignant gastric tumors and it is recommended to exclude this medication in the event of such tumors.

Ingestion of lansoprazole has certain side effects such as headache, dizziness, nausea, diarrhea, stomach pain, constipation, vomiting, flatulence, dry mouth or throat, increased liver enzymes, urticaria, pruritus, rash, fatigue and benign gastric polyps.

In addition, there exist drug interactions with other medications. Avoid association with ketoconazole and itraconazole.

Lansoprazole reduces plasma concentration of theophylline, caution should be exercised.

Fluvoxamine increased plasma concentration of lansoprazole, dose reduction is recommended. Lansoprazole produces reduced plasma concentration by rifampicin and H. perforatum.

Dosage of antacids and sucralfate is recommended after lansoprazole intake.

BRAND NAMES

  • Estomil ®
  • Lansoprazol ®
  • Lanzol ®
  • Monolitum ®
  • Opiren ®
  • Pro Ulco ®
  • Protoner ®

Genes analyzed

CYP2C19

Bibliography

Chiba K, Shimizu K, Kato M, et al.Prediction of inter-individual variability in the pharmacokinetics of CYP2C19 substrates in humans. Drug Metab Pharmacokinet. 2014;29(5):379-86.

El Rouby N, Lima JJ, Johnson JA.Proton pump inhibitors: from CYP2C19 pharmacogenetics to precision medicine. Expert Opin Drug Metab Toxicol. 2018 Apr;14(4):447-460.

Lima JJ, Thomas CD, Barbarino J, et al.Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2C19 and Proton Pump Inhibitor Dosing. Clin Pharmacol Ther. 2021 Jun;109(6):1417-1423.

Zhao F, Wang J, Yang Y, et al.Effect of CYP2C19 genetic polymorphisms on the efficacy of proton pump inhibitor-based triple therapy for Helicobacter pylori eradication: a meta-analysis. Helicobacter. 2008 Dec;13(6):532-41.

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