First - Lansoprazole

Generic name: Lansoprazole
Drug class: Proton pump inhibitors

Usage of First - Lansoprazole

Lansoprazole is used to treat certain conditions where there is too much acid in the stomach. It is used to treat duodenal and gastric ulcers, gastric ulcers caused by NSAID use, erosive esophagitis, and gastroesophageal reflux disease (GERD). GERD is a condition wherein the acid in the stomach washes back up into the esophagus. Sometimes lansoprazole is used in combination with antibiotics (eg, amoxicillin, clarithromycin) to treat ulcers associated with an infection caused by H. pylori bacteria.

Lansoprazole is also used to treat Zollinger-Ellison syndrome (ZES), which is a condition where the stomach produces too much acid.

Lansoprazole is a proton pump inhibitor (PPI). It works by decreasing the amount of acid produced by the stomach.

This medicine is available both over-the-counter (OTC) and with your doctor's prescription.

First - Lansoprazole side effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  • Diarrhea
  • itching, skin rash

    • Less common

  • Increased or decreased appetite
  • joint pain
  • nausea
  • stomach pain
  • vomiting

    • Rare

  • Anxiety
  • blurred vision
  • chest pain or discomfort
  • colds
  • constipation
  • dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • fast, pounding, or irregular heartbeat or pulse
  • increased cough
  • lightheadedness, dizziness or fainting
  • mental depression
  • muscle pain
  • nervousness
  • pain or discomfort in the arms, jaw, back, or neck
  • pounding in the ears
  • rectal bleeding
  • slow or irregular heartbeat
  • sweating
  • unusual bleeding or bruising

    • Incidence not known

  • Back or leg pains
  • bleeding gums
  • blistering, peeling, or loosening of the skin
  • bloating
  • bloody, black, or tarry stools
  • change in mental status
  • chest tightness
  • chills
  • clay colored stools
  • confusion
  • cough
  • dark or bloody urine
  • difficulty with swallowing
  • drowsiness
  • fast heartbeat
  • fever
  • general body swelling
  • hives
  • hoarseness
  • indigestion
  • loss of appetite
  • lower back or side pain
  • mood or mental changes
  • muscle cramps in the hands, arms, feet, legs, or face
  • muscle spasms (tetany) or twitching seizures
  • nosebleeds
  • numbness and tingling around the mouth, fingertips, or feet
  • painful or difficult urination
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • pale skin
  • pinpoint red spots on the skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • seizures
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stomach tenderness
  • swelling of the feet or lower legs
  • swollen or painful glands
  • trembling
  • trouble breathing
  • unusual tiredness or weakness
  • yellow eyes or skin

    • Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    More common

  • Dizziness
  • headache

    • Less common

  • Bleeding, blistering, burning, coldness, or discoloration of the skin
  • mild nausea

    • Rare

  • Bad, unusual, or unpleasant (after) taste
  • bad breath
  • belching
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • change in taste
  • difficulty in moving
  • double vision
  • feeling of heat or warmth
  • flushing or redness of the skin, especially on the face and neck
  • lack or loss of strength
  • loss or thinning of the hair
  • mild diarrhea
  • mild headache
  • mild vomiting
  • persistent non-healing sore
  • reddish patch or irritated area
  • shiny bump
  • stomach discomfort or upset
  • swollen joints
  • white, yellow or waxy scar-like area

    • Incidence not known

  • Decrease in passing urine (dribbling)
  • decrease in the frequency of urination
  • decrease in urine volume
  • difficulty with speaking

    • Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

    Before taking First - Lansoprazole

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of lansoprazole to treat GERD and erosive esophagitis in children 1 to 17 years of age. Safety and efficacy have not been established in children younger than 1 year of age. This medicine may increase the risk for heart problems (eg, heart valve thickening) in children younger than 1 year of age.

    Geriatric

    Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of lansoprazole in the elderly. However, elderly patients are more sensitive to the effects of this medicine than younger adults.

    Breast Feeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Interactions with Medicines

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Rilpivirine

    • Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acalabrutinib
  • Amphetamine
  • Atazanavir
  • Atezolizumab
  • Belumosudil
  • Benzphetamine
  • Bosutinib
  • Capecitabine
  • Cefuroxime Axetil
  • Cilostazol
  • Citalopram
  • Clopidogrel
  • Dabrafenib
  • Dacomitinib
  • Dasatinib
  • Delavirdine
  • Dextroamphetamine
  • Erlotinib
  • Eslicarbazepine Acetate
  • Fedratinib
  • Fluconazole
  • Gefitinib
  • Infigratinib
  • Ketoconazole
  • Ledipasvir
  • Levoketoconazole
  • Lisdexamfetamine
  • Mavacamten
  • Methamphetamine
  • Methotrexate
  • Methylphenidate
  • Mycophenolate Mofetil
  • Nelfinavir
  • Neratinib
  • Nilotinib
  • Octreotide
  • Palbociclib
  • Pazopanib
  • Pexidartinib
  • Phenobarbital
  • Pirtobrutinib
  • Primidone
  • Saquinavir
  • Secretin Human
  • Selpercatinib
  • Sotorasib
  • Sparsentan
  • Sunitinib
  • Tocilizumab
  • Velpatasvir
  • Vismodegib
  • Voriconazole

    • Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acenocoumarol
  • Dicumarol
  • Levothyroxine
  • Phenprocoumon
  • Tacrolimus
  • Warfarin

    • Interactions with Food/Tobacco/Alcohol

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Cranberry

    • Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Diarrhea or
  • Hypomagnesemia (low magnesium in the blood), history of or
  • Osteoporosis (bone problem) or
  • Seizures, history of or
  • Systemic lupus erythematosus (SLE)—Use with caution. May make these conditions worse.
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.
  • Phenylketonuria (PKU)—The orally disintegrating tablet contains phenylalanine, which can make this condition worse.

    • Relate drugs

    How to use First - Lansoprazole

    Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. If you are using this medicine without a prescription, follow the instructions on the medicine label.

    This medicine comes with a Medication Guide and patient instructions. Read and follow these instructions carefully. Ask your doctor if you have any questions.

    Take this medicine before a meal and for the full time of treatment, even if you begin to feel better after a few days.

    If you are taking this medicine to treat an ulcer that is associated with an H. pylori infection, take it together with the antibiotics (eg, amoxicillin, clarithromycin) at the same time of day.

    To use the delayed-release capsule:

  • Swallow the capsule whole. Do not break, crush, or chew it.
  • If the capsule cannot be swallowed, open it and sprinkle the contents on one tablespoonful of applesauce, Ensure® pudding, cottage cheese, yogurt, or strained pears. Swallow the mixture right away. Do not chew or crush the granules.
  • The contents of the capsule can also be mixed with 2 ounces (1/4 cup or 60 mL) of apple juice, orange juice, or tomato juice. After mixing, drink and swallow the mixture right away. Do not chew or crush the granules. Refill the cup 2 more times with juice and drink the liquid to make sure all of the medicine is taken.

    • To use the capsule with a nasogastric (NG) tube:

  • Open the capsule and mix the contents with 40 mL of apple juice. Do not use any other liquids.
  • Inject or pour the mixture into the nasogastric tube.
  • Flush the tube with more apple juice to rinse all of the medicine from the tube into the stomach.

    • To use the delayed-release orally disintegrating tablet:

  • Make sure your hands are dry before you handle the tablet.
  • Do not crush, chew, break, or cut the tablet.
  • Place the tablet on the tongue, with or without water, and allow it to dissolve into particles. Swallow the particles right away.

    • To use the orally disintegrating tablet with an oral syringe:

  • Make sure your hands are dry before you handle the tablet.
  • Do not crush, break, or cut the tablet.
  • For the 15 mg tablet: Place it in the oral syringe and add 4 mL of water.
  • For the 30 mg tablet: Place it in the oral syringe and add 10 mL of water.
  • Shake the syringe gently until the tablet dissolves and is mixed well.
  • Give the mixture within 15 minutes.
  • Refill the syringe with 2 mL (15 mg tablet) or 5 mL (30 mg tablet) of water and shake it gently. Give the mixture to make sure all of the medicine is taken.

    • To use the orally disintegrating tablet with a nasogastric (NG) tube:

  • Make sure your hands are dry before you handle the tablet.
  • Do not crush, break, or cut the tablet.
  • For the 15 mg tablet: Place it in the syringe and add 4 mL of water.
  • For the 30 mg tablet: Place it in the syringe and add 10 mL of water.
  • Shake the syringe gently until the tablet dissolves and is mixed well.
  • Inject or pour the mixture into the nasogastric tube within 15 minutes.
  • Refill the syringe with 5 mL of water and shake it gently. Flush the tube with the water to rinse all of the medicine from the tube into the stomach.

    • Dosing

    The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

    The amount of medicine that you take Depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (capsules or orally disintegrating tablets):
  • To treat duodenal ulcers:
  • Adults—15 milligrams (mg) once a day before a meal. Your doctor may adjust your dose as needed.
  • Children—Use and dose must be determined by your doctor.
  • To treat duodenal ulcers with H. pylori infection:
  • Adults—30 milligrams (mg) before meals 2 or 3 times a day. The dose is usually taken together with amoxicillin or clarithromycin plus amoxicillin. Your doctor may adjust your dose as needed.
  • Children—Use and dose must be determined by your doctor.
  • To treat erosive esophagitis:
  • Adults—30 milligrams (mg) once a day before a meal. Your doctor may adjust your dose as needed.
  • Children 12 years of age and older—30 mg once a day before a meal. Your doctor may adjust your dose as needed.
  • Children 1 to 11 years of age and weighing over 30 kg—30 mg once a day before a meal. Your doctor may adjust your dose as needed.
  • Children 1 to 11 years of age and weighing 30 kg or less—15 mg once a day before a meal. Your doctor may adjust your dose as needed.
  • Children younger than 1 year of age—Use and dose must be determined by your doctor.
  • To treat benign gastric ulcers:
  • Adults—30 milligrams (mg) once a day before a meal. Your doctor may adjust your dose as needed.
  • Children—Use and dose must be determined by your doctor.
  • To treat gastric ulcers caused by NSAID use:
  • Adults—15 to 30 milligrams (mg) once a day before a meal. Your doctor may adjust your dose as needed.
  • Children—Use and dose must be determined by your doctor.
  • To treat gastroesophageal reflux disease (GERD):
  • Adults and children 12 years of age and older—15 milligrams (mg) once a day before a meal. Your doctor may adjust your dose as needed.
  • Children 1 to 11 years of age and weighing 30 kg or more—30 mg once a day before a meal. Your doctor may adjust your dose as needed.
  • Children 1 to 11 years of age and weighing 30 kg or less—15 mg once a day before a meal. Your doctor may adjust your dose as needed.
  • Children younger than 1 year of age—Use and dose must be determined by your doctor.
  • To treat Zollinger-Ellison syndrome (ZES):
  • Adults—60 milligrams (mg) once a day before a meal. Your doctor may adjust your dose as needed.
  • Children—Use and dose must be determined by your doctor.

    • Missed Dose

    If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

    Storage

    Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

    Keep out of the reach of children.

    Do not keep outdated medicine or medicine no longer needed.

    Ask your healthcare professional how you should dispose of any medicine you do not use.

    Warnings

    It is important that your doctor check the progress of you or your child at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it. Blood, urine, and other laboratory tests may be needed to check for unwanted effects. If your or your child's condition does not improve, or if it becomes worse, discuss this with your doctor.

    Do not take this medicine if you are also using products that contain rilpivirine (Complera®, Edurant®). Using these medicines together may cause unwanted side effects.

    Lansoprazole may cause a serious type of allergic reaction when used in patients with conditions treated with antibiotics. Call your doctor right away if you or your child has itching, trouble breathing or swallowing, or any swelling of your hands, face, or mouth.

    Check with your doctor right away if you have a change in frequency of urination or amount of urine, blood in the urine, fever, joint pain, loss of appetite, skin rash, swelling of the body or feet and ankles, unusual tiredness or weakness, or unusual weight gain. These could be symptoms of a serious kidney problem called acute tubulointerstitial nephritis.

    Taking this medicine for a long time may make it harder for your body to absorb vitamin B12. Tell your doctor if you have concerns about vitamin B12 deficiency.

    Serious stomach conditions may occur while taking this medicine alone or together with antibiotics. Check with your doctor immediately if you or your child has stomach cramps, bloated feeling, watery and severe diarrhea which may also be bloody sometimes, fever, nausea or vomiting, or unusual tiredness or weakness.

    Lansoprazole may increase your risk of having fractures of the hip, wrist, and spine. This is more likely if you have osteoporosis, if you are 50 years of age and older, if you receive high doses of this medicine, or if you use it for one year or more. Call your doctor right away if you have severe bone pain or are unable to walk or sit normally.

    This medicine may cause serious skin reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, acute generalized exanthematous pustulosis, and drug reaction with eosinophilia and systemic symptoms (DRESS). Check with your doctor right away if you have black, tarry stools, blistering, peeling, or loosening of the skin, chest pain, chills, cough, diarrhea, itching, joint or muscle pain, painful or difficult urination, red irritated eyes, red skin lesions, often with a purple center, sore throat, sores, ulcers, or white spots in the mouth or on the lips, swollen glands, unusual bleeding or bruising, or unusual tiredness or weakness.

    Cutaneous or systemic lupus erythematosus may occur or get worse in patients receiving a PPI. Call your doctor right away if you have joint pain or a skin rash on your cheeks or arms that gets worse when exposed to the sun.

    This medicine may cause hypomagnesemia (low magnesium in the blood). This is more likely to occur if you are taking this medicine for more than one year, or if you are taking this medicine together with digoxin (Lanoxin®) or certain diuretics or "water pills". Check with your doctor right away if you have convulsions (seizures), fast, racing, or uneven heartbeat, muscle spasms (tetany), tremors, or unusual tiredness or weakness.

    This medicine may increase your risk for fundic gland polyps (abnormal tissue growth in the upper part of your stomach). This is more likely if you are receiving this medicine for more than 1 year. Talk to your doctor if you have concerns.

    Do not stop taking this medicine without first checking with your doctor, or unless told to do so by your doctor.

    Before you have any medical tests, tell the medical doctor in charge that you or your child are taking this medicine. The results of some tests may be affected by this medicine.

    Do not take other medicines unless they have been discussed with your doctor. This includes prescription (eg, atazanavir, nelfinavir, Reyataz®, Viracept®) or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

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