Uses
Gastroesophageal Reflux (GERD)
Short-term treatment of symptomatic GERD (e.g., heartburn).
Short-term treatment of erosive esophagitis (endoscopically diagnosed) in patients with GERD.
Maintain healing and decrease recurrence of erosive esophagitis.
IV as short-term (up to 7 days) alternative to oral therapy for the treatment of erosive esophagitis in adults unable to continue taking the drug orally; safety and efficacy of IV lansoprazole not established for initial treatment.
Duodenal Ulcer
Short-term treatment of active duodenal ulcer (endoscopically or radiographically confirmed).
Treatment of Helicobacter pylori infection and duodenal ulcer disease. Used in conjunction with amoxicillin and clarithromycin (triple therapy) or clarithromycin (dual therapy); has been used in other multidrug regimens†.
Maintenance therapy following duodenal ulcer healing.
Gastric Ulcer
Short-term treatment and symptomatic relief of active benign gastric ulcer.
NSAIA-induced Gastric Ulcer
Short-term treatment of NSAIA-induced gastric ulcer in patients continuing NSAIA use.
Risk reduction in patients with history of gastric ulcer who require NSAIA treatment.
Crohn’s Disease-associated Ulcers
Some evidence for use of proton-pump inhibitors (e.g., omeprazole) for gastric acid suppressive therapy as an adjunct in the management of upper GI Crohn’s disease†, including esophageal, gastroduodenal, and jejunoileal disease.
Pathologic GI Hypersecretory Conditions
Long-term treatment of pathologic hypersecretory conditions (e.g., Zollinger-Ellison syndrome with or without multiple endocrine adenoma).
Dosage and Administration
Administration
Oral Administration
Administer orally before a meal.
Antacids may be used concomitantly as needed for pain relief.
Capsules
Swallow capsules intact; do not chew or crush.
Alternatively, open capsule and sprinkle contents on 1 tablespoon of compatible foods (e.g., applesauce, Ensure® pudding, cottage cheese, yogurt, strained pears) or mix with about 60 mL of appropriate juice (e.g., apple juice, orange juice, tomato juice); swallow immediately without chewing. If mixed with juice, rinse glass with ≥120 mL juice and swallow immediately to ensure complete dose ingestion. Do not mix with other foods or liquids.
Granules for Suspension
Mix granules for suspension in 30 mL water, stir well, and swallow immediately. Rinse container with more water and swallow. Do not mix with other liquids. Do not chew or crush.
Orally Disintegrating Tablets
Place orally disintegrating tablets on the tongue and allow to disintegrate (usually in <1 minute) with or without water; swallow particles without chewing.
To administer using an oral syringe, place 15- or 30-mg tablet in oral syringe, draw up about 4 or 10 mL, respectively, of water in the syringe, gently shake syringe to ensure rapid dispersal of particles, and administer within 15 minutes. To ensure complete consumption of dose, draw up an additional 2 mL (15-mg dose) or 5 mL (30-mg dose) of water in syringe, mix gently, and administer remaining contents.
NG Tube
Open capsule and mix contents with about 40 mL apple juice and administer immediately (within 3–5 minutes) through NG tube; flush tube with additional apple juice. Do not mix with other liquids.
Place 15- or 30-mg orally disintegrating tablet in syringe, draw up about 4 or 10 mL, respectively, of water in the syringe, gently shake syringe to ensure rapid dispersal of particles, and administer within 15 minutes through NG tube (8 French or larger). Draw up an additional 5 mL of water in syringe, mix gently, and flush NG tube with syringe contents.
Do not administer granules for suspension through enteral tubes.
IV Administration
For solution compatibility and storage information, see Stability.
Administer by IV infusion over 30 minutes.
Use inline filter provided by manufacturer to remove precipitates that may form when lansoprazole is mixed with IV solutions; follow manufacturer’s instructions for priming the filter and precautions regarding its use.
Separate IV line for lansoprazole administration is not required, but flush the IV line with 5% dextrose, lactated Ringer’s, or 0.9% sodium chloride injection before and after administration.
Do not administer with any other drugs or diluents because of potential incompatibilities.
Reconstitution
Reconstitute vial containing 30 mg of lansoprazole with 5 mL of sterile water for injection to provide a solution containing 6 mg/mL.
Dilution
Dilute reconstituted solution in 50 mL of 5% dextrose, lactated Ringer’s, or 0.9% sodium chloride injection prior to administration.
Dosage
Pediatric Patients
Gastroesophageal Reflux
GERD
Oral
Children 1–11 years of age: Children weighing ≤30 kg: 15 mg once daily for up to 12 weeks. Those weighing >30 kg: 30 mg once daily for up to 12 weeks. Dosage has been increased up to 30 mg twice daily after ≥2 weeks in patients remaining symptomatic.
Children 12–17 years of age: 15 mg daily for up to 8 weeks.
Treatment of Erosive Esophagitis
Oral
Children 1–11 years of age. Children weighing ≤30 kg: 15 mg once daily for up to 12 weeks. Those weighing >30 kg: 30 mg once daily for up to 12 weeks. Dosage has been increased up to 30 mg twice daily after ≥2 weeks in patients remaining symptomatic.
Children 12–17 years of age: 30 mg daily for up to 8 weeks.
Adults
Gastroesophageal Reflux
Chronic, lifelong therapy with proton-pump inhibitor is appropriate for many GERD patients.
GERD
Oral
15 mg once daily for up to 8 weeks.
Treatment of Erosive Esophagitis
Oral
30 mg once daily for up to 8 weeks. May give additional 8 weeks of therapy (up to 16 weeks for a single course) if not healed. If recurs, consider additional 8 weeks of therapy.
IV
30 mg once daily for up to 7 days. Discontinue IV administration as soon as patient can resume oral lansoprazole therapy.
Maintenance of Healing of Erosive Esophagitis
Oral
15 mg once daily. Not studied >1 year.
Duodenal Ulcer
Treatment of Active Duodenal Ulcer
Oral
15 mg once daily for 4 weeks.
Treatment of Helicobacter pylori Infection and Duodenal Ulcer
Oral
Triple therapy: 30 mg every 12 hours for 10 or 14 days in conjunction with amoxicillin and clarithromycin.
Dual therapy: 30 mg every 8 hours for 14 days in conjunction with amoxicillin.
Maintenance of Duodenal Ulcer Healing
Oral
15 mg daily. Safety and efficacy beyond 1 year not established.
Gastric Ulcer
Benign Gastric Ulcer
Oral
30 mg once daily for up to 8 weeks.
NSAIA-induced Gastric Ulcer
Treatment
Oral
30 mg once daily for 8 weeks.
Risk Reduction
Oral
15 mg once daily for up to 12 weeks.
Pathologic GI Hypersecretory Conditions (e.g., Zollinger-Ellison Syndrome)
Oral
60 mg once daily initially. Adjust dosage according to patient response and tolerance; continue therapy as long as necessary. May require dosages of up to 90 mg twice daily. Administer daily dosages >120 mg in divided doses. Patients with Zollinger-Ellison syndrome have been treated for up to 4 years.
Special Populations
Dosage in Hepatic Impairment
Consider dosage reduction in patients with severe hepatic impairment.
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