Drug interaction, lansoprazole

While generally not of major concern, omeprazole may inhibit the metabolism of warfarin, diazepam, and phenytoin lansoprazole may decrease theophylline concentrations. Drug interactions with omeprazole are of particular concern in patients who are considered slow metabolizers, as are approximately 3% of the Caucasian population. Unfortunately, it is unclear which patients have the polymorphic gene variation that makes them slow metabolizers.17 The metabolism of esomeprazole may also be altered in patients with this polymorphic gene variation. Patients on potentially interacting drugs should be monitored for development of drug-related problems. 

Omeprazole (Prilosec) was the original PPI this drug is now joined by esomeprazole (Nexium), lansoprazole (Prevacid), pantoprazole (Protonix), and rabeprazole (AcipHex) (see Table 27-2). All of these drugs are similar, with selection often depending on cost, availability, and the drug interaction potential of each agent.15 Likewise, nonprescription forms of certain PPIs are now available, and these forms offer a convenient,... 

P450, or inducing specific isoforms of this enzyme system. However, drug interactions involving these isoenzymes and omeprazole or lansoprazole are uncommon and generally appear to be clinically unimportant. Pantoprazole seems to have a lower drug interaction potential than either omeprazole or lansoprazole. 

Dilger K, Zheng Z, Klotz U. Lack of drug interaction between omeprazole, lansoprazole, pantoprazole and dieqphylline. BrJ Clin Pharmacol (1999) 48, 438-44. 

FracaroH TS, Miranda LQ, Sodre JL, Chaves M, Gripp A. Toxic epidermal necrolysis induced by lansoprazole. An Bras Dermatol 2013 88 117-20. Zhao W, Fakhoury M, Maisin A, Baudouin V, Storme T, Deschenes G, et al. Pharmacogenetic determinant of the drug interaction between tacrolimus and omeprazole. Ther DrugMonit 2012 34 739-A1. 

Information on possible drug interactions with lansoprazole is incomplete [59]. Some pertinent drugs have been studied only at standard dosage (prednisone [60]), not at all (carbamazepine), or data were published only in descriptive terms (warfarin [61]). However, compounds representative of most CYP isoforms have been studied with negative results [20, 60], with the notable exception of 2D6 (not investigated). 

Steinijans VW, Huber R, Hartmann M, Zech K, Bliesath H, Wurst W, Radtke HW (1996) Lansoprazole of pantoprazole drug interactions in man an updated review. Int J Clin Pharmacol Ther 34 (Suppl 1) S31-S50... 

Deravirdine (Rescnptor) [Antiretroviral/NNRTI] Uses HIV Infxn Action Nonnucleoside RT inhibitor Dose 400 mg PO tid Caution [C, ] CDC recommends HIV-infected mothers not to breast-feed (transmission risk) w/ renal/hepatic impair Contra Use w/ drugs dependent on CYP3A for clearance (Table VI-8) Disp Tabs SE Fat redistribution, immune reconstitution synd, HA, fatigue, rash, T transaminases, N/V/D Interactions T Effects W/ fluoxetine T effects OF benzodiazepines, cisapride, clarithromycin, dapsone, ergotamine, indinavir, lovastatin, midazolam, nifedipine, quinidine, ritonavir, simvastatin, terfena-dine, triazolam, warfarin effects W/ antacids, barbiturates, carbamazepine, cimetidine, famotidine, lansoprazole, nizatidine, phenobarbital, phenytoin, ranitidine, rifabutin, rifampin effects OF didanosine EMS Use of benzodiazepines and CCBs should be avoided may cause a widespread rash located on upper body and arms OD May cause an extension of nl SEs symptomatic and supportive Deferasirox (Exjade) [Iron Chelator] Uses Chronic iron overload d/t transfusion in pts >2 y Action Oral iron chelator Dose Initial 20 mg/kg... 

Granneman GR, Karol MD, Locke CS, Cavanau JH. Pharmacokinetic interaction between lansoprazole and theophylline. Ther Drug Monit (1995) 17, 460-4. 

---