Lansoprazol Krka (Lansoprazole)

Lansoprazole is indicated for several acid‑related gastrointestinal disorders.

• Gastro‑oesophageal reflux disease (GERD): provides symptomatic relief by decreasing esophageal acid exposure.
• Peptic ulcer disease: promotes ulcer healing by suppressing gastric acid production.
• Helicobacter pylori eradication regimens: enhances antibiotic efficacy by creating a less acidic gastric environment.
• Zollinger‑Ellison syndrome: controls excessive gastric acid secretion associated with gastrin‑producing tumors.

• Lansoprazole selectively and irreversibly inhibits the H+/K+ ATPase enzyme (the gastric proton pump) located on the secretory surface of parietal cells. By blocking this final step of acid production, it markedly reduces basal and stimulated gastric acid secretion, leading to increased gastric pH and allowing mucosal healing in acid‑related disorders.

Lansoprazole is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Headache: mild to moderate intensity.
• Diarrhea: usually transient.
• Nausea or abdominal discomfort.
• Flatulence or bloating.
• Constipation: occasional.
• Dry mouth.

Serious or Rare Side Effects

• Severe allergic reactions: rash, itching, swelling, or difficulty breathing.
• Clostridioides difficile infection: persistent diarrhea with possible fever.
• Low magnesium levels (hypomagnesemia): muscle cramps, irregular heartbeat.
• Bone fractures: increased risk with long‑term use.
• Liver enzyme abnormalities: elevated transaminases.
• Acute interstitial nephritis: kidney inflammation presenting with reduced urine output.

Before initiating therapy, consider the following safety measures.

• Assess renal and hepatic function: adjust use if severe impairment is present.
• Review concomitant medications: avoid drugs that require gastric acidity for absorption.
• Monitor long‑term users: watch for bone density loss and magnesium deficiency.
• Pregnancy and lactation: use only if clearly needed after risk‑benefit evaluation.
• Elderly patients: start at the lowest effective dose and monitor for adverse effects.
• Store at ambient temperature: keep below 25 °C, in the original container, protected from moisture and direct sunlight.

Lansoprazole may alter the pharmacokinetics of several co‑administered drugs.

Major Interactions (Avoid)

• Antiretroviral protease inhibitors (e.g., atazanavir, nelfinavir): reduced absorption and efficacy.
• Antifungal agents (e.g., ketoconazole, itraconazole): markedly decreased bioavailability.
• Clopidogrel: diminished antiplatelet effect leading to increased cardiovascular risk.

Moderate Interactions (Monitor Closely)

• Warfarin: potential increase in INR; monitor coagulation parameters.
• Methotrexate (high dose): possible accumulation; check serum levels.
• Digoxin: slight increase in serum concentration; observe for toxicity signs.
• Diazepam: enhanced sedation; adjust dose if necessary.
• Iron salts: reduced iron absorption; consider timing separation.