Ogastoro (Lansoprazole)

Lansoprazole acts on the gastric acid secretion pathway and is indicated for several acid‑related disorders.

• Gastro‑oesophageal reflux disease (GERD): provides relief of heartburn and promotes healing of erosive esophagitis.
• Peptic ulcer disease: accelerates ulcer healing and reduces risk of recurrence.
• Helicobacter pylori eradication regimens: used as part of combination therapy to increase eradication rates.
• Zollinger‑Ellison syndrome: controls excessive gastric acid production.
• NSA‑induced gastropathy prophylaxis: lowers risk of ulcer formation in high‑risk patients.

• Lansoprazole selectively and irreversibly binds to the H+/K+‑ATPase enzyme (the gastric proton pump) on the secretory surface of parietal cells, inhibiting the final step of acid secretion. This results in a sustained increase in gastric pH, allowing mucosal healing and symptom relief.

Adverse reactions to lansoprazole are generally mild to moderate, but serious events can occur.

Common Side Effects

• Headache: mild, transient headache reported in clinical trials.
• Diarrhoea: loose stools, usually self‑limiting.
• Nausea: occasional feeling of queasiness.
• Abdominal pain: mild discomfort in the stomach area.
• Flatulence: increased intestinal gas.
• Constipation: reduced bowel movements.

Serious or Rare Side Effects

• Clostridioides difficile infection: severe colitis presenting with watery diarrhoea.
• Acute interstitial nephritis: kidney inflammation with reduced urine output.
• Severe hypersensitivity reactions: rash, angio‑edema, or anaphylaxis.
• Osteoporotic fractures: increased risk of hip, wrist or vertebral fractures with long‑term use.
• Thrombotic thrombocytopenic purpura: rare blood clotting disorder.
• Vitamin B12 deficiency: reduced absorption leading to anaemia over prolonged therapy.

When prescribing lansoprazole, clinicians should consider several safety aspects.

• Assess renal function: adjust use in patients with severe impairment.
• Evaluate hepatic status: use with caution in moderate to severe liver disease.
• Review concomitant medications: potential for altered drug levels.
• Monitor long‑term users: watch for bone density loss and vitamin B12 deficiency.
• Pregnancy and lactation: weigh benefits against potential risks.
• Store below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

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

Major Interactions (Avoid)

• Clopidogrel: reduced antiplatelet effect, increasing cardiovascular risk.
• Atazanavir and other protease inhibitors: decreased absorption, loss of antiviral efficacy.

Moderate Interactions (Monitor Closely)

• Warfarin: possible increase in INR, requiring more frequent monitoring.
• Methotrexate: reduced renal clearance may raise systemic exposure.
• Digoxin: modest rise in serum concentrations.
• Ketoconazole and other azole antifungals: lower absorption, consider alternative agents.