Lancerol

Lancerol is an inhibitor of the "proton pump", used to eliminate GERD, as well as ulcer pathologies.

Indications of the lancerol

Indicated when:

• ulcer of the duodenal ulcer or gastric ulcer (benign forms), also in the treatment of these diseases resulting from the intake of NSAIDs;
• treatment of GERD;
• treatment of gastrinoma,
• for the destruction of the pathogenic bacterium Helicobacter pylori (combining the drug with antibiotics).

Release form

Issued in capsules, the first blister contains 10 pieces. Inside one pack - 1 blister plate.

Pharmacodynamics

Lansoprazole oppresses the processes of action of the H ⁺ K ⁺ -ATPase proton pump inside the gastric mucosa lining cells. This allows the drug to suppress the final stage of acid formation inside the gastric juice. This effect reduces its acidity and reduces the amount of acid it contains. As a result, the negative effect of juice on the gastric mucosa becomes much weaker.

The strength of inhibition depends on the duration of the course of therapy, as well as the size of the dose. Even the use of a single dose of drugs (in the amount of 30 mg) by 70-90% reduces the secretion of gastric juice. The effect of the drug begins 1-2 hours later, and then continues throughout the day.

Pharmacokinetics

Absorption of the component occurs inside the intestine. After taking a healthy person 30 mg of the drug peak plasma level reaches 0.75-1.15 mg / l after 1-2 hours. The level of bioavailability, as well as peak plasma parameters do not change in accordance with the frequency of drug use, the change in values in this case depends on the individual characteristics of the person.

Synthesis of the active substance with the plasma protein is 98%.

Excretion of lansoprazole is carried out with urine, as well as bile (solely in the form of decay products - such as lansoprazolesulfone with hydroxylansoprazole). During the day, 21% of the drug is excreted (with urine). The half-life is 1.5 hours. This indicator increases in people with severe disorders of hepatic activity, as well as in elderly patients (over 69 years of age). In disorders of renal activity, the absorption rates of drugs do not change almost.

Dosing and administration

It is used orally. The standard dosage of drugs is 30 mg once a day (before meals, for 30-40 minutes). Capsules are washed down with water (150-200 ml) and do not chew. If it is impossible to perform such manipulation, it is permitted to open the capsule, and then dissolve the substance contained in it in apple juice (enough 1 tablespoon of the beverage). A similar procedure is required for drug administration using a nasogastric tube.

The timing of the therapy and the size of dosages are prescribed by the doctor, taking into account the patient's particulars, the course of the pathology, as well as the clinical picture of the disease.

For a day it is allowed to consume not more than 60 mg of medicine, and people with disorders in the work of the liver - not more than 30 mg. For people with gastrinoma, the size of the doses may increase.

If you need 2 daily doses, you need to divide the intake 2 times - in the morning before breakfast and in the evening before dinner.

If you miss the time for taking a dose of drugs, try to take the capsule as quickly as possible. But if before the use of the subsequent dose there is not enough time, the previous missed capsule is prohibited.

During the treatment of duodenal ulcers: the active phase should be treated with a single dose of 30 mg of medication in a period of 0.5-1 months. When eliminating ulcers that have arisen because of the use of NSAIDs, the dosage is similar, but the course of treatment is continued for 1-2 months.

When treating a benign form of gastric ulcer: the active phase is treated with 30 mg of LS (once a day) in the period of 2 months. To get rid of ulcers, provoked by the use of NSAIDs, you should use a similar dosage of the drug for 1-2 months.

During treatment of GERD: severe and moderate stages of the illness are treated during the first month (taking 30 mg of the drug once per day). If the result after 4 weeks of admission is not available, the duration of therapy should be doubled. With prolonged prevention of recurrence of pathology, you should also drink 30 mg once a day. Confirmed information that supportive treatment for 1 year is effective and safe for health.

Destruction of the pathogenic bacterium Helicobacter pylori: a 2-times daily dose of 30 mg (before breakfast and before dinner) is required. The drug should be drunk in combination with selected antibiotics according to a pre-selected scheme (1-2 weeks).

Treatment of gastrinoma: dosage is prescribed individually, taking into account the prevention of excess basal acid release (10 mmol / h). Often the size of the initial dose is 60 mg per day (once before breakfast). In the case of drugs in the amount of more than 120 mg, it is required to drink a part of the dose before breakfast, and the second dose - before dinner. The course lasts until the symptoms of the disease completely disappear.

[1]

Use of the lancerol during pregnancy

The intake of Lancerol capsules by pregnant women is forbidden.

If you need to drink a medicine during the lactation period, you should stop breastfeeding for this period.

Contraindications

Among the main contraindications of drugs:

• severe intolerance to lansoprazole or other elements contained in capsules;
• Combination of the drug with the substance atazanavir;
• presence of malignant tumors in the digestive tract;
• the child's age of the patient.

Side effects of the lancerol

In the treatment with Lanzerol, there are usually side effects such as nausea, abdominal pain and diarrhea (most often). In some cases, there were headaches. Other negative reactions:

• CAS organs: shock state, decrease / increase in blood pressure, myocardial infarction, angina pectoris development, palpitations, cerebrovascular changes, and vasodilation;
• organs of the digestive tract: the development of vomiting, constipation, anorexia, cholelithiasis, cardiopathy, hepatotoxicity, as well as hepatitis with jaundice. In addition, thirst, dryness of the oral mucosa, candidiasis of mucous membranes inside the gastrointestinal tract, eructation with dysphagia and dyspepsia occur. It is also possible the appearance of colitis, esophagitis, esophageal form of ulcer / stenosis, bloating, gastroenteritis, gastric polyps, bleeding in the gastrointestinal tract. There is a change in color of feces, deterioration / increase in appetite, a disorder of taste buds, vomiting with blood, salivation increases, melena develops, glossitis with stomatitis, ulcerative colitis, pancreatitis and tenesmus, and bleeding from the anus;
• organs of the endocrine system: the development of hypo- or hyperglycemia, goitre, as well as diabetes mellitus;
• lymph and hematopoiesis: development of neutrophilic, leuko-, thrombocyto- or pancytopenia, hemolysis, anemia (also hemolytic or aplastic forms of the disease), eosinophilia with agranulocytosis, and thrombocytopenic / thrombotic purpura;
• connective tissues, as well as organs of ODA: the development of myalgia or arthralgia / arthritis, pain in the skeleton and muscles;
• organs of the National Assembly: development of apathy, amnesia, depression, increased excitement, vertigo. In addition, the appearance of fainting or dizziness, hallucinations, feelings of fear, nervousness, hostility and drowsiness. The emergence of tremors, hemiplegia, paresthesias, insomnia, confusion, and in addition, a disorder of mental processes and a decrease in libido;
• organs of the respiratory system: the appearance of the common cold, hiccoughs, coughs, dyspnoea, the development of pharyngitis, asthma, infectious processes in the lower, upper parts of the respiratory system (pneumonia or bronchitis), bleeding in the lungs or from the nose;
• subcutaneous layer and skin: the development of erythema polyforma, Quincke's edema, Lyell's syndrome or Stevens-Johnson syndrome, facial hyperemia, and besides itching with acne and polymorphic erythema. There is also a rash with purpura, alopecia starts, photosensitization, urticaria, and in addition increased sweating and petechiae;
• sensory organs: the appearance of pain in the eyes, deterioration of visual clarity, as well as visual field defects. In addition, noises in the ears, the development of otitis media or deafness. Speech disturbances can develop and taste perception may change;
• organs of the urogenital system: development of tubulointerstitial nephritis capable of developing into kidney failure, delay of urination, formation of concrements inside the kidneys, the appearance of hematuria, glucosuria or albuminuria. Perhaps the development of impotence, an increase (gynecomastia) or tenderness of the mammary glands, a disorder of the menstrual cycle;
• combined lansoprazole with amoxicillin, as well as clarithromycin: most often with triple treatment with the use of the above drugs in the period of 2 weeks develop headaches, diarrhea, as well as eating disorders. In the case of using lansoprazole with amoxicillin, only headaches and diarrhea often appear. These reactions are short-lived and pass on their own, without the abolition of therapy;
• changes in the testimony: an increase in the level of alkaline phosphatase and ALT with AST, and in addition globulins with creatinine and γ-GTP, as well as a breakdown in the balance of albumins with globulins. In addition, there is a decrease / increase in leukocyte counts, eosinophilia and bilirubinemia with hyperlipidemia, the number of erythrocytes varies, platelets, electrolytes or cholesterol values increase / decrease, gastrin, urea and potassium, as well as lipoproteins (low density) and glucocorticoids increase. Also, the level of hemoglobin decreases, and the analysis for latent blood gives a positive result. Inside the urine - there is the appearance of salts, and in addition hematuria, albuminuria or glucosuria. There is information on the increase in the final stage of therapy of hepatic enzymes (more than three times the maximum permissible limit of the norm), but jaundice did not develop;
• other: the emergence of anaphylaxis, asthenia, anaphylactoid manifestations, candidiasis, swelling, chest pain, bad odor from the mouth. In addition, there is increased fatigue, a fever, the development of infections, a sense of weakness and an influenza-like syndrome.

Interactions with other drugs

Lansoprazole, similarly to other inhibitors of the "proton pump," lowers the indices of atazanavir (which is an inhibitor of HIV protease), the absorption of which is associated with the acidity of the stomach. Because of this, Lancerol can affect the effectiveness of atazanavir, and also contribute to the development of HIV-related resistance. Because of this, it is forbidden to combine these medicines.

The drug is able to increase the plasma values of drugs that are metabolized by the CYPZA4 element (such as ibuprofen and prednisolone with warfarin, and in addition antipyrine with phenytoin and indomethacin, propranolol with clarithromycin, and terfenadine with diazepam).

Drugs that depress 2C19 (eg, fluvoxamine) can greatly increase (approximately fourfold) the plasma level of lansoprazole, so if combined with them, the dose of the latter should be adjusted.

Inductors of elements 2S19, as well as CYPZA4 (among such herbs of St. John's wort with rifampicin) are able to greatly reduce the plasma values of lansoprazole, so when combined with them, the dose of Lancerol should be adjusted.

Lansoprazole is able to suppress the secretory function of the stomach for a long time, which can affect the level of bioavailability of drugs, for absorption of which acidity values are important (among them digoxin with ketoconazole, iron salts with itraconazole, as well as ampicillin esters).

Antacids and sucralfate are able to reduce the bioavailability of the drug, and therefore need to use it at least 1 hour after using the above drugs.

Combination of the drug with theophylline (elements CYP1A2, as well as CYPZA) causes a moderate increase (not more than 10%) of the purification coefficient of this substance, but the likelihood that such an interaction will have a medicinal value is very low. It should be noted that individuals need to adjust the dosage of theophylline at the initial stage of the combination therapy and after the completion of the use of Lancerol in order to maintain the drug-effective values of theophylline.

Lansoprazole has no effect on the prothrombin time, as well as the pharmacokinetic properties of warfarin.

Increasing the values of PTV and MNO can cause bleeding, and in the future even provoke a fatal outcome.

Combined reception with digoxin promotes an increase in the plasma values of this substance.

Combined use with tacrolimus increases its plasma level (especially for those who underwent organ transplantation).

[2], [3]

Storage conditions

To contain medicines is necessary in a place inaccessible to small children, in conditions suitable for medicines. The temperature value is a maximum of 25 ° C.

[4]

Shelf life

Lancerol is allowed to be used in the period of 2 years from the date of manufacture of the medicinal product.