Lansoprazole Krka (Lansoprazole)

Lansoprazole is a proton pump inhibitor used to treat disorders characterized by excess gastric acid production.

• Gastro‑oesophageal reflux disease: alleviates heartburn and regurgitation by lowering stomach acidity.
• Peptic ulcer disease: promotes ulcer healing and prevents recurrence through acid suppression.
• Helicobacter pylori eradication: forms part of combination therapy to eradicate H. pylori infection.
• Erosive oesophagitis: heals inflamed oesophageal tissue by reducing acid exposure.

• Lansoprazole selectively and irreversibly inhibits the H+/K+ ATPase enzyme (the gastric proton pump) located on the parietal cell secretory canaliculi. By blocking this final step of acid secretion, it markedly reduces both basal and stimulated gastric acid output, thereby creating a less acidic gastric environment that facilitates healing of acid‑related lesions.

Lansoprazole may cause a range of adverse reactions, most of which are mild and transient.

Common Side Effects

• Headache: mild to moderate pain often resolving without treatment.
• Diarrhoea: loose stools that may occur during the first weeks of therapy.
• Nausea: feeling of queasiness, sometimes accompanied by mild stomach discomfort.
• Abdominal pain: cramping or discomfort in the upper abdomen.
• Flatulence: increased intestinal gas.
• Constipation: reduced bowel movements or hard stools.

Serious or Rare Side Effects

• Severe allergic reaction (anaphylaxis): swelling, rash, difficulty breathing requiring immediate medical attention.
• Clostridioides difficile infection: severe colitis presenting with watery diarrhoea and abdominal pain.
• Low magnesium levels (hypomagnesemia): muscle cramps, irregular heartbeat, especially with prolonged use.
• Liver enzyme elevation: signs of hepatic dysfunction detected on laboratory testing.
• Stevens‑Johnson syndrome: painful skin lesions and mucosal involvement, a medical emergency.
• Interstitial nephritis: kidney inflammation presenting with reduced urine output and flank pain.

Before initiating therapy, consider the following safety measures.

• Renal function assessment: evaluate kidney status, especially in patients with existing impairment.
• Hepatic disease caution: use carefully in individuals with liver dysfunction, monitoring liver enzymes.
• Magnesium monitoring: check serum magnesium during long‑term treatment to prevent deficiency.
• Concomitant drug review: avoid or adjust dosage of medications that may interact adversely.
• Bone health consideration: prolonged use may increase fracture risk; assess calcium and vitamin D status.
• Store at ambient temperature: keep in the original packaging, protect from moisture and direct sunlight.

Lansoprazole can affect the pharmacokinetics of several medicines; awareness of key interactions is essential.

Major Interactions (Avoid)

• Atazanavir: reduced antiviral absorption leading to treatment failure.
• Clopidogrel: decreased activation, potentially lowering antiplatelet effect.
• Warfarin: enhanced anticoagulant effect, increasing bleeding risk.

Moderate Interactions (Monitor Closely)

• Digoxin: increased serum levels may cause toxicity.
• Phenytoin: reduced phenytoin concentrations, risking seizure control.
• Rifampin: accelerated metabolism of lansoprazole, diminishing its efficacy.