Lansoprazole pharmacokinetics

Saito M, Yasui-Furukori N, Uno T, Takahata T, Sugawara K, Munakata A, Tateishi T Effects of clarithromycin on lansoprazole pharmacokinetics between CYP2CI9 genotypes BrJ Clin Pharmacol (2005) 59, 302-9... 

Karol MD, Machinist JM, Cavanaugh JM (1997) Lansoprazole pharmacokinetics in subjects with various degrees of kidney function. Clin Pharmacol Ther 61 450-458... 

Katsuki H, Nakamura C, Arimori K, Fujiyama S, Nakano M (1997) Genetic polymorphism of CYP2C19 and lansoprazole pharmacokinetics in Japanese subjects. Eur J Clin Pharmacol 52 391-396... 

Andersson T. Pharmacokinetics, metabolism and interactions of acid pump inhibitors. Focus on omeprazole, lansoprazole and pantoprazole. Clin Pharmacokinet 1996 31(l) 9-28. 

Pharmacokinetics Omeprazole and lansoprazole are enteric-coated to protect them from premature activation by gastric acid. After absorption in the duodenum, they are transported to the acid parietal cell canaliculus, where they are converted to active species. Metabolites of these agents are excreted in urine and feces. 

Co-administration of either lansoprazole or pantoprazole in healthy subjects did not affect the steady-state pharmacokinetics of theophylline in therapeutic doses (74). 

Pan WJ, Goldwater DR, Zhang Y, Pilmer BL, Hunt RH. Lack of a pharmacokinetic interaction between lansoprazole or pantoprazole and theophylline. Aliment Pharmacol Ther 2000 14(3) 345-52. 

Regarding proton pump inhibitors, the effect of CYP2C19 PM status is not limited to pharmacokinetic alterations. The difference in the pharmacokinetics has been shown to influence the outcome of H. Pylori eradication therapy. Furuta et al. showed that in patients with confirmed H. Pylori infection treated with omeprazole or lansoprazole plus clarithromycin and amoxicillin, CYP2C19 PMs had an eradication rate of 97.8% compared with a rate of 72.7% (P < 0.001) for CYP2C19 EMs (51). 

Baldi R Lansoprazole oro-dispersible tablet pharmacokinetics and therapeutic use in acid-related disorders. Drugs 2005 65(10) 1419-1426. 

Andersson T, Holmberg J, Rohss K, Walan A. Pharmacokinetics and effect on caffeine metaboUsm of the proton pump inhibitors, omeprazole, lansoprazole, and pantoprazole. Br J Clin Pharmacol 1998 45 369-375. 

In six healthy Japanese subjects given 30 mg of racemate, marked stereoselectivity was found in the pharmacokinetics of lansoprazole (Table 1)... 

Katsuki, H. Yagi, H. Arimori, K. Nakamura, C. Nakano, M. Katafuchi, S. Fujioka, Y. Fujiyama, S. Determination of R(+)- and S(—)-lansoprazole using chiral stationary-phase liquid chromatography and their enantioselec-tive pharmacokinetics in humans. Pharm. Res. 1996, 13, 611-615. 

A study in 30 healthy subjects given 0.6 g/kg of alcohol before and after taking lansoprazole 30 mg daily for 3 days found that the pharmacokinetics of alcohol were not significantly changed, and blood-alcohol levels were not raised, by lansoprazole. ... 

Giire C, Coutelle C, David P, Fleury B, Thomas G, Palmobo S, Dally S, Couzigou P. Lack of effect of lansoprazole on the pharmacokinetics of ethanol in male volunteers. Gastroenterology (1994)106, A504. 

The findings from these studies suggest that neither lansoprazole nor omeprazole cause any clinically important changes in the pharmacokinetics of paracetamol. No special precautions appear to be needed on concurrent... 

In pharmacological studies, omeprazole caused a minor increase in k-warfarin levels, with no or a minor increase in anticoagulant effect. Conversely, lansoprazole, pantoprazole and rabeprazole did not alter warfarin pharmacokinetics or anticoagulant effect Omeprazole does not appear to alter the effects of aeenoeoumarol and pantoprazole does not appear to later the effects of phenpro-coumon. Nevertheless, a number of isolated reports describe increased anticoagulant effects when PPIs are given with coumarins. 

A study in 24 healthy subjects stabilised on warfarin found that lansoprazole 60 mg daily for 9 days had no effect on the pharmacokinetics of either S- orR-warfarin, and did not alter the effect of warfarin on prothrombin times. ... 

Omeprazole markedly raised the levels of a single dose of carbamazepine, but had no significant effect on carbamazepine taken long-term. Some anecdotal reports surest that carbamazepine serum levels may possibly be reduced by lansoprazole. Pantoprazole did not affect the pharmacokinetics of carbamazepine in one study. 

It seems that in practice no clinically relevant interaction is likely to occur between omeprazole and carbamazepine. For lansoprazole, information seems to be limited to this handful of reports from which no broad general conclusions can be drawn, but they do suggest that this interaction should be considered if lansoprazole is added to established treatment with carbamazepine. Pantoprazole appears not to afifeet the pharmacokinetics of carbamazepine. 

Karol MD, Mukherji D, Cavanaugh JH. Lack of effect of concomitant multi-dose lansoprazole on single-dose phenytoin pharmacokinetics in subjects, Gastroenterology (1994) 106, A103. 

Karol MD, Locke CS, Cavanai h JH. Lack of a pharmacokinetic interaction between lansoprazole and intravenously administered phenytoin. JC/mP/jarwaco/ (1999) 39, 1283-9. 

Cavanaugh JH, Park YK, Awni WM, Mukherjee DX, Karol MD, Granneman GR. Effect of lansoprazole on antipyrine and ICG pharmacokinetics. Gastroenterology (1991) 100, A40. 

Naproxen had no significant effect on the AUC, half-life, or clearance of methotrexate and its major metabolite 7-hydroxymethotrexate in 18 patients with rheumatoid arthritis given intravenous methotrexate 15 mg weekly. Other studies have found that naproxen did not affect the pharmacokinetics of methotrexate. In a study in 27 patients with rheumatoid arthritis who had taken oral methotrexate 7.5 to 15 mg weekly for at least 3 months, the concurrent use of naproxen 600 mg twice daily with lansoprazole did not affect the pharmacokinetics of methotrexate or 7-hydroxymethotrexate. Another study in patients with rheumatoid arthritis with normal renal function found that no toxicity was caused when naproxen 500 mg twice daily was given with methotrexate 15 mg given orally or intravenously, nor was the methotrexate clearance altered. ... 

Lansoprazole 60 mg daily for 10 days was found to have no effeet on the pharmacokinetics of a single 100-microgram/kg intravenous dose of diazepam. ... 

A double-blind crossover study in 18 healthy subjects found that lansoprazole 60 mg daily for 7 days did not significantly affect the pharmacokinetics of a single 80-mg dose of propranolol. ... 

Karol MD, Locke CS, Cavanaugh JH. Lack of interaction between lansoprazole and propranolol, a pharmacokinetic and safety assessment. J CUn Pharmacol (2000) 40,301-8. 

Maalox does not appear to alter the pharmacokinetics of omeprazole, pantoprazole or rabeprazole. Antacids may cause a slight reduction in the bioavailability of lansoprazole. This is probably not clinically relevant but can be accommodated by separating their administration by one hour. There is no interaction between sodium alginate and omeprazole. 

The small changes in lansoprazole and omeprazole pharmacokinetics are not clinically relevant, so it appears that they may be taken with grapefruit juice. See also Proton pump inhibitors + Food or Drinks , p.970, for the... 

A study of roxithromycin 300 mg twice daily with omeprazole 20 mg twice daily or with lansoprazole 30 mg twice daily, for 6 days found that neither PPI significantly affected the pharmacokinetics of roxithromycin. ... 

The pharmacokinetic interactions between clarithromycin and omeprazole, esomeprazole and lansoprazole are established. However, none of the changes reported represents an adverse interaction, but they may help to explain why concurrent use is valuable in the eradication of Helicobacter pylori. Erythromycin is likely to interact similarly, whereas roxithromycin does not. Pantoprazole is not affected by macrolides. 

Mainz D, Bomer K, Koeppe P, Kotwas J, Lode H. Pharmacokinetics of lansoprazole, amoxicillin and clarithromycin after simultaneous and single administration JAntimicrob Chemoti-er(2002) 50.699-706. 

Esomeprazole, lansoprazole and omeprazole do not alter the pharmacokinetics of amoxicillin, and omeprazole does not alter bacampicillin bioavailability. Isolated reports describe glossitis, stomatitis and/or black tongue in a small number of patients when treated with lansoprazole and antibacterials, which included amoxicillin, clarithromycin and metronidazole. 

A study in 12 healthy subjects found no significant changes in the pharmacokinetics of amoxicillin 1 g twice daily when it was given with lansoprazole 30 mg twice daily and clarithromycin 500 mg twice daily for 4 days. Other randomised, crossover studies in a total of 36 healthy subjects also found no changes in the bioavailability or half-life of amoxicillin 1 g twice daily when it was given with clarithromycin 500 mg twice daily and either esomeprazole 20 mg twice daily or 40 mg once daily for 7 days. ... 

The pharmacokinetics of amoxicillin do not appear to be affected by concurrent use of esomeprazole, lansoprazole and omeprazole, and omeprazole was not affected by amoxicillin. 

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