Lansoprazole

Lansoprazole
Clinical data
Pronunciation /lænˈsprəzl/ lan-SOH-prə-zohl
Trade names Prevacid, others
AHFS/Drugs.com Monograph
MedlinePlus a695020
License data
Pregnancy
category
  • AU: B3
  • US: B (No risk in non-human studies)
    Routes of
    administration
    by mouth, IV
    Drug class proton pump inhibitor
    ATC code
    Legal status
    Legal status
    • UK: POM (Prescription only)
    • US: OTC
    Pharmacokinetic data
    Bioavailability 80% or more
    Protein binding 97%
    Metabolism Hepatic (CYP3A4- and CYP2C19-mediated)
    Elimination half-life 1–1.5 hours
    Excretion Renal and fecal
    Identifiers
    CAS Number
    PubChem CID
    IUPHAR/BPS
    DrugBank
    ChemSpider
    UNII
    KEGG
    ChEBI
    ChEMBL
    ECHA InfoCard 100.173.220 Edit this at Wikidata
    Chemical and physical data
    Formula C16H14F3N3O2S
    Molar mass 369.363 g/mol
    3D model (JSmol)
    Chirality Racemic mixture
      (verify)

    Lansoprazole, sold under the brand name Prevacid among others, is a medication which inhibits the stomach's production of acid. There is no evidence that its effectiveness is different from that of other PPIs.[1] Lansoprazole, given through a nasogastric tube, effectively controls pH inside the stomach and is an alternative to intravenous pantoprazole in people who are unable to swallow solid-dose formulations.[2]

    Lansoprazole is a proton-pump inhibitor (PPI) in the same pharmacologic class as omeprazole. Lansoprazole has been marketed for many years and is one of several PPIs available.[3] It is a racemic 1:1 mixture of the enantiomers dexlansoprazole (Dexilant, formerly named Kapidex) and levolansoprazole.[4] Dexlansoprazole is an enantiomerically pure active ingredient of a commercial drug as a result of the enantiomeric shift. Lansoprazole's plasma elimination half-life (1.5 h) is not proportional to the duration of the drug's effects to the person (i.e. gastric acid suppression).[5] The effects of the medication last for over 24 hours after it has been used for a day or more.[6]

    It is manufactured by a number of companies worldwide under several brand names. In the United States, it was first approved by the Food and Drug Administration (FDA) in 1995.[7] Prevacid patent protection expired on November 10, 2009.[8][9]

    Medical uses

    Lansoprazole is used for treatment of:

    There is no good evidence that it works better than other PPIs.[1]

    Side effects

    Side effects of PPIs in general[10] and lansoprazole in particular[11] may include:

    PPIs may be associated with a greater risk of hip fractures and Clostridium difficile-associated diarrhea.[6]:22

    Interactions

    Lansoprazole interacts with several other drugs, either due to its own nature or as a PPI.[15]

    Lansoprazole possibly interacts with, among other drugs:

    History

    Lansoprazole was originally synthesized at Takeda and was given the development name AG 1749.[17] Takeda patented it in 1984 and the drug launched in 1991.[18]

    Society and culture

    Prevacid 30 mg

    Patents

    The lansoprazole molecule is off-patent and so generic drugs are available under many brand names in many countries;[19] there are patents covering some formulations in effect as of 2015.[20]

    Availability

    Since 2009, lansoprazole has been available over the counter (OTC) in the U.S. in a marketed by Novartis as Prevacid 24HR.[21][6][22] In Australia, it is marketed by Pfizer as Zoton.

    Research

    In vitro experiments have shown that lansoprazole binds to the pathogenic form of tau protein.[23] As of 2015 laboratory studies were underway on analogs of lansoprazole to explore their use as potential PET imaging agents for diagnosing tauopathies including Alzheimer's disease.[23] Lansoprazole is also a prodrug that targets the cytochrome bc1 complex of Mycobacterium tuberculosis once converted to lansoprazole sulfide in mycobacterial host cells.[24]

    References

    1. 1 2 "[99] Comparative effectiveness of proton pump inhibitors | Therapeutics Initiative". 28 June 2016. Retrieved 14 July 2016.
    2. Freston, James; Chiu, Yi-Lin; Pan, Wei-Jian; Lukasik, Nancy; Taubel, Jorg (2001). "Effects on 24-hour intragastric pH: a comparison of lansoprazole administered nasogastrically in apple juice and pantoprazole administered intravenously". The American Journal of Gastroenterology. 96 (7): 2058–2065. doi:10.1111/j.1572-0241.2001.03939.x. ISSN 0002-9270. PMID 11467632.
    3. http://www.patient.co.uk/showdoc/30002943/
    4. "Pharmacy Benefit Update". Retrieved 2 July 2014.
    5. "Prevacid Pharmacology, Pharmacokinetics, Studies, Metabolism". RxList.com. 2007. Retrieved April 14, 2007.
    6. 1 2 3 4 "Prevacid 24HR Label" (PDF). May 2010. Retrieved November 15, 2014.
    7. Mosby's Drug Consult: Lansoprazole
    8. Prevacid drug patents
    9. Teva to release Prevacid version when patent expires
    10. British National Formulary (Free registration required) 1.3.5 Proton pump inhibitors
    11. British National Formulary (Free registration required) Lansoprazole
    12. "Prevacid (Lansoprazole) Drug Information: Side Effects and Drug Interactions - Prescribing Information at RxList". RxList. Retrieved 2016-02-09.
    13. K C Singhal & S Z Rahman, Lansoprazole Induced Adverse Effects on the Skin, Indian Medical Gazette, July 2001, Vol. CXXXV. N0. 7: 223-225
    14. Sterry W, Assaf C (2007). "Erythroderma". In Bolognia JL. Dermatology. St. Louis: Mosby. p. 154. ISBN 1-4160-2999-0. .
    15. British National Formulary (Free registration required) Lansoprazole interactions
    16. Piscitelli, S. C.; Goss, T. F.; Wilton, J. H.; d'Andrea, D. T.; Goldstein, H; Schentag, J. J. (1991). "Effects of ranitidine and sucralfate on ketoconazole bioavailability". Antimicrobial Agents and Chemotherapy. 35 (9): 1765–1771. doi:10.1128/aac.35.9.1765. PMC 245265. PMID 1952845.
    17. Fischer, Janos; Ganellin, C. Robin (2006). Analogue-based Drug Discovery. John Wiley & Sons. p. 102. ISBN 9783527607495.
    18. Chorghade, Mukund S. (2006). Drug Discovery and Development, Volume 1: Drug Discovery. John Wiley & Sons. p. 201. ISBN 9780471780090.
    19. drugs.com International availability of lansoprazole Page accessed February 3, 2015
    20. drugs.com Generic lansoprazole Page accessed February 3, 2015
    21. "Novartis launches Prevacid 24HR over-the-counter for full 24-hour frequent heartburn treatment" (PDF) (Press release). November 12, 2009. Retrieved November 13, 2009.
    22. "Novartis launches Prevacid 24HR over-the-counter for full 24-hour frequent heartburn treatment" (Press release). November 12, 2009. Retrieved November 13, 2009.
    23. 1 2 Villemagne, VL; Fodero-Tavoletti, MT; Masters, CL; Rowe, CC (January 2015). "Tau imaging: early progress and future directions". The Lancet. Neurology. 14 (1): 114–24. doi:10.1016/s1474-4422(14)70252-2. PMID 25496902.
    24. Rybniker, Jan; et al. (July 2015). "Lansoprazole is an antituberculous prodrug targeting cytochrome bc1". Nature Communications. 6: 7659. doi:10.1038/ncomms8659. PMC 4510652. PMID 26158909.
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