Abdominal pain lansoprazole

Sucralfate 1 g tds in combination with amoxicillin 500 mg tds and clarithromycin 400 mg bd for 2 weeks was as effective as a combination of lansoprazole 30 mg bd plus amoxicillin 500 mg tds and clarithromycin 400 mg bd for 2 weeks for H. pylori eradication in a randomized, multicenter trial in 150 patients (9). There was no significant difference in adverse effects between the two groups. Diarrhea, abdominal pain, glossitis, and taste disturbance were the adverse effects commonly reported. 

Lansoprazole is a proton pump inhibitor. Its safety profile has been reviewed based on premarketing chnical studies, and has to be regarded with the reservations appropriate to this type of material. In 4749 patients the most frequent adverse effects were headache (4.7%), diarrhea (3.2%), abdominal pain (2.2%), pharyngitis (1.8%), and nausea (1.4%) some patients had upper respiratory complaints or suffered anxiety or depression, or myalgia (1). The adverse reaction profile appears to be closely similar to that of omeprazole. 

Lansoprazole 15 and 30 mg/day were more effective than placebo, but not misoprostol 200 micrograms qds, for the prevention of NSAID-induced gastric ulcers in a multicenter, double-blind, placebo-controUed trial in 537 patients without Helicobacter pylori infection who were long-term users of NSAIDs (2). However, adverse effects were significantly more frequent (31% versus less than 20%) and treatment adherence significantly less (71% versus more than 90%) in patients taking misoprostol. The most commonly reported adverse effects in aU groups were diarrhea, abdominal pain, and nausea. 

The clinical and fiscal impact of replacing omeprazole with lansoprazole as the only proton pump inhibitor has been assessed by reviewing the medical records of 3833 patients requiring long-term proton pump inhibitor therapy (2224 were started on lansoprazole and 1479 were converted from omeprazole to lansoprazole) (13). There were considerable pharmaceutical savings. The true lansoprazole failure rate (requiring conversion to omeprazole) was 5.3%. Withdrawal of lansoprazole was due to poor symptom control (in 69%) and/or adverse effects (in 22%). The most common adverse effects were diarrhea (10%), abdominal pain (5%), and urticaria (1%). 

Omeprazole 40 mg/day for 6 weeks and lansoprazole 30 mg bd have been compared for sjmptom control in a randomized study in 96 patients with gastro-esophageal reflux disease who had earher failed to respond to lansoprazole 30 mg/day (14). The two drugs were equally effective in symptom control. There were no significant differences in adverse events between the two groups. The most frequent adverse events reported were diarrhea, abdominal pain/discomfort, bloating/gas, vomiting, and headache. 

Lansoprazole 30 mg/day, lansoprazole 15 mg/day, and ranitidine 150 mg/day have been compared in a randomized, double-bhnd, multicenter trial in the prevention of relapse of duodenal ulcer and symptom control over 12 months in 359 patients (25). Both doses of lansoprazole were superior to ranitidine. There was no significant difference between the two lansoprazole groups, although there was a trend in favor of lansoprazole 30 mg/day. There were no differences in adverse effects profiles in the three groups. The adverse effects included diarrhea, abdominal pain, viral infections, headache, and vomiting. 

Lansoprazole 15 or 30 mg/day and ranitidine 150 mg bd for 8 weeks have been compared in the treatment of non-erosive gastro-esophageal reflux disease in two double-bhnd, multicenter trials in 901 patients (27). Overall symptom control was significantly better with either dose of lansoprazole than with ranitidine or placebo. There was no significant difference in reported adverse events between the treatment groups. The more commonly reported were abdominal pain and diarrhea. 

The adverse effects profile of the proton pump inhibitors during short-term administration (under 12 weeks) is similar to that reported with short-term use of histamine receptor antagonists. The type and frequency of adverse effects reported with lansoprazole, omeprazole, pantoprazole, and rabeprazole are comparable. The most common adverse effects include headache, diarrhea, nausea, abdominal pain, constipation, dizziness, and skin rashes. 

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