Lansoprazole

CLINICAL USE

Gastric acid suppression

DOSE IN NORMAL RENAL FUNCTION

15–30 mg daily in the morning; duration dependent on indicationZollinger-Ellison syndrome: initially 60 mg daily; adjust according to response (if >120 mg, give in 2 divided doses)

PHARMACOKINETICS

Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :369.4

%Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :97

%Excreted unchanged in urine &nbsp &nbsp : 0 (15–30 as metabolites)

Volume of distribution (L/kg) &nbsp &nbsp &nbsp :25–33 litres

half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :1–2/Unchanged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 &nbsp &nbsp : Dose as in normal renal function

10 to 20 &nbsp &nbsp : Dose as in normal renal function

<10 &nbsp &nbsp &nbsp &nbsp &nbsp : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in normal renal function

HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Not dialysed. Dose as in normal renal function

HDF/high flux &nbsp :Unknown dialysability. Dose as in normal renal function

CAV/VVHD &nbsp &nbsp &nbsp:Unknown dialysability, probably not removed. Dose as in normal renal function.

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Antivirals: concentration of atazanavir possibly reduced

Ciclosporin: theoretical, interaction unlikely – little information availableCilostazol: possibly increased cilostazol concentration – avoid concomitant use

Tacrolimus: may increase tacrolimus concentration

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

–

Comments

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OTHER INFORMATION

Lansoprazole is metabolised substantially by the liver; no dose adjustment is necessary in renal impairment

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