Lansoprazole adverse effects

ALMOTRIPTAN, ELETRIPTAN, ZOLMITRIPTAN H2-RECEPT0R BLOCKERS -CIMETIDINE t efficacy and adverse effects of zolmitriptan, e.g. flushing, sensations of tingling, heat, heaviness, pressure or tightness of any part of body including the throat and chest, dizziness Inhibition of metabolism via CYP1A2 Consider alternative acid suppression, e.g. H2 antagonist or proton pump inhibitors (not omeprazole or lansoprazole), or monitor more closely and l maximum dose of zolmitriptan to 5 mg/24 hours... 

PRAMIPEXOLE, ROPINIROLE H2-RECEPTOR BLOCKER-CIMETIDINE T efficacy and adverse effects of pramipexole 1 renal excretion of pramipexole by inhibition of cation transport system. Inhibition of CYP1A2-mediated metabolism of ropinirole Monitor closely i dose of pramipexole may be required. Adjust dose of ropinirole as necessaiy or use alternative acid suppression, e.g. H2 antagonist proton pump inhibitor (not omeprazole or lansoprazole)... 

BZDs PROTON PUMP INHIBITORS -OMEPRAZOLE/ ESOMEPRAZOLE T efficacy and adverse effects, e.g. prolonged sedation Inhibition of metabolism via CYP4S0 (some show competitive inhibition via CYP2C19) Monitor for t side-effects, and 1 dose as necessaiy. Likely to delay recovery after procedures for which BZDs have been used. Consider alternative proton pump inhibitor, e.g. lansoprazole or pantoprazole... 

VECURONIUM PROTON PUMP INHIBITORS -LANSOPRAZOLE Possible t efficacy and adverse effects of vecuronium Unclear Altered duration of action. May need t recovery time... 

CIMETIDINE FAMOTIDINE NIZATIDINE, RANITIDINE BRONCHODILATORS -THEOPHYLLINE t efficacy and adverse effects, including seizures. There is conflicting information associated with ranitidine, famotidine and nizatidine Inhibition of metabolism via CYP1A2, cimetidine being the best known inhibitor Use alternative acid suppression, e.g. a proton pump inhibitor (not omeprazole or lansoprazole) or monitor closely considerable patient variation. Check levels on day 3 and then at 1 week. A 30-50% i dose of theophylline may be required. For doses <400 mg/day, the interaction may not be clinically significant... 

In a similar study in 221 patients with peptic ulcer disease associated with H. pylori, rabeprazole has been compared with omeprazole and lansoprazole (combining them with amoxicillin plus clarithromycin for 1 week) (6). Rabeprazole was as effective as omeprazole and lansoprazole in eradicating H. pylori (84-88% each). There were no differences in reported adverse events. Common adverse effects were soft stools, glossitis, taste disturbances, and skin rashes. 

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. 

An unblinded questionnaire survey has been carried out to determine patients perceptions of differences in the efficacy, adverse effects, and value of omeprazole versus lansoprazole for gastro-esophageal reflux disease maintenance therapy (5). The patients had been taking omeprazole for at least 2 months and then switched to lansoprazole for a minimum of 2 months. There was no significant difference between median symptom scores with the two drugs, but 64% of patients preferred omeprazole to lansoprazole. The most commonly reported adverse effects with both drugs were flatulence, headache, and diarrhea. Significantly more patients reported adverse effects with lansoprazole than with omeprazole. 

The results of a therapeutic interchange program, in which 78 patients with acid peptic disease requiring proton pump inhibitor therapy (both newly diagnosed patients and those previously stabilized on omeprazole) were treated with lansoprazole, have been retrospectively analysed (12). Although the switch was associated with considerable pharmaceutical savings, there was an overall lansoprazole-associated failure rate of 28%. Reported lack of efficacy required withdrawal of lansoprazole in 15%, while adverse effects required withdrawal of lansoprazole in 13% of patients (versus none with omeprazole). The main adverse effect was diarrhea. 

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 multiple unit pellet system (MUPS) 20 mg/day and pantoprazole 40 mg/day for 8 weeks were more effective than lansoprazole 30 mg/day in relieving heartburn in a randomized, double-bhnd trial in 461 patients with sjmptomatic reflux esophagitis (15). Patient satisfaction and adverse effects were similar in the three groups. The most common adverse effects were diarrhea, headache, and nausea. 

Lansoprazole 30 mg/day and omeprazole 20 mg/day for 8 weeks have been compared in the rehef of heartburn in a multicenter, randomized, double-blind trial in 3510 patients with erosive esophagitis (22). Symptom control was significantly more effective and faster with lansoprazole than omeprazole. Both drugs were weh tolerated. The most common adverse effect was diarrhea. 

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. 

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. 

Lima JJ, Lang JE, Mougey EB et al (2013) Association of CYP2C19 polymorphisms and lansoprazole respiratory adverse effects in children. J Pediatr 163(3) 686-691... 

A patient with a recurrence of a gastrointestinal stromal tumour was given imatinib 400 mg daily without adverse effect. However, after 2 months, lansoprazole 15 mg daily was also given for dyspepsia and the patient developed bilateral eyelid oedema with hyperaemic conjunctivae and labial oedema. Both drugs were stopped, but on reintroduction the symptoms re-... 

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