Laprazol (Lansoprazole)

Lansoprazole acts on the gastric proton pump to lower acid secretion, making it useful for several acid‑related disorders.

• Gastro‑oesophageal reflux disease (GERD): alleviates heartburn and esophageal irritation.
• Peptic ulcer disease: promotes ulcer healing and prevents recurrence.
• Erosive esophagitis: reduces mucosal damage and supports recovery.
• NSAID‑induced ulcer prophylaxis: lowers risk of ulcer formation in patients on non‑steroidal anti‑inflammatory drugs.
• Helicobacter pylori eradication (in combination therapy): enhances bacterial clearance when used with antibiotics.

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

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

Common Side Effects

• Headache: mild to moderate pain often resolves without intervention.
• Diarrhea: loose stools that may be transient.
• Abdominal pain: discomfort or cramping in the stomach area.
• Nausea: feeling of queasiness, sometimes accompanied by vomiting.
• Flatulence: increased intestinal gas.

Serious or Rare Side Effects

• Clostridioides difficile infection: severe colitis presenting with watery diarrhea.
• Severe allergic reaction (anaphylaxis): rash, swelling, difficulty breathing.
• Stevens‑Johnson syndrome or toxic epidermal necrolysis: extensive skin blistering.
• Hepatic enzyme elevation: signs of liver injury such as jaundice.
• Hypomagnesemia: low magnesium levels causing muscle cramps or arrhythmias.

Before initiating therapy, consider the following safety measures.

• Assess renal function: adjust use in patients with severe impairment.
• Monitor hepatic status: use cautiously in liver disease.
• Check magnesium levels: prolonged therapy may deplete magnesium.
• Avoid abrupt discontinuation: taper to prevent rebound acid hypersecretion.
• Pregnancy and lactation: prescribe only if benefit outweighs potential risk.
• Store at room temperature: keep in the original container, protect from moisture and heat.

Lansoprazole can affect the absorption or metabolism of several co‑administered drugs.

Major Interactions (Avoid)

• Atazanavir: reduced antiviral efficacy due to decreased gastric acidity.
• Nelfinavir: diminished plasma concentrations compromising HIV therapy.
• Rilpivirine: lower exposure leading to suboptimal viral suppression.

Moderate Interactions (Monitor Closely)

• Clopidogrel: reduced activation may lessen antiplatelet effect.
• Warfarin: possible increase in INR, requiring closer monitoring.
• Digoxin: elevated serum levels may occur, watch for toxicity.
• Methotrexate: increased exposure can enhance adverse effects.
• Oral contraceptives: decreased effectiveness, consider alternative contraception.