Severe hypomagnesaemia due to lansoprazole
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A 71-year-old woman, who had been taking lansoprazole for 18 months for dyspepsia, presented with vomiting, thought to be due to gallstones, and was found to have severe hypomagnesaemia. She was treated with intravenous and then oral magnesium, and discharged, but was soon readmitted with symptoms due to hypomagnesaemia, and again treated with magnesium supplementation. No other recognised cause for hypomagnesaemia was found. Because of recent reports of hypomagnesaemia due to other proton pump inhibitors, lansoprazole was changed to ranitidine. Her symptoms resolved and the serum magnesium returned to normal. Oral magnesium supplementation was stopped with no return of symptoms or hypomagnesaemia. Such an association must be borne in mind with suggestive symptoms in patients on long term proton pump inhibitors; their cessation or change to H(2) receptor antagonists is likely to correct the situation rapidly.Keywords:
Lansoprazole
SUMMARY Background: Lansoprazole is a new proton pump inhibitor which powerfully decreases acid secretion. Methods : We compared the efficacy and short‐term safety of lansoprazole against ranitidine in the healing of gastric ulcer. This was a parallel group, comparative multicentre, prospectively randomized, double‐blind study which included 250 patients with gastric ulcer, 219 of whom had follow‐up endoscopic data. Results: Both lansoprazole 30 mg and 60 mg daily produced significantly more rapid healing of gastric ulcer than ranitidine 300 mg nightly with healing rates after 4 weeks of 78% (P < 0.05), 84% (P < 0.01) and 61%, respectively. After 8 weeks, the corresponding healing rates were 99%, 97% and 91% (P = 0.08). Symptom relief was similar for all treatment groups, but fewer antacids were used by patients receiving lansoprazole. Sixty‐nine patients experienced 91 adverse events; the incidence, pattern and severity was similar across all three treatment groups. Conclusions: Lansoprazole 30 mg and 60 mg once daily had similar efficacy. Both were superior to ranitidine 300 mg nocte in healing gastric ulcer. The short‐term safety profile of lansoprazole was similar to ranitidine. These data indicate that lansoprazole should be used at a dose of 30 mg once daily for the treatment of gastric ulcers.
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Lansoprazole, a new proton pump inhibitor, selectively inhibits the H+/K(+)-ATPase. Its inhibitory effect on basal and gastrin stimulated gastric acid secretion is equal to omeprazole and stronger than that of H2-receptor antagonists. Healing rates concerning gastric and duodenal ulcers and refluxesophagitis are significantly higher compared to H2-receptor antagonists and at least comparable to omeprazole. Regarding pilot studies in H. pylori eradication therapy, lansoprazole in combination with various antibiotics is expected to show good eradication rates. Considering its excellent safety and interaction profile lansoprazole is effective and safe in treating acid related disorders.
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This randomized, double-blind study was designed to determine whether the proton pump inhibitor lansoprazole could prevent relapse among patients with healed erosive reflux esophagitis that had been resistant to healing with at least 3 months of H2-receptor antagonist therapy.By the end of the year, 13% of placebo patients remained healed compared with 67% of lansoprazole 15 mg and 55% of lansoprazole 30 mg patients (p < 0.001 for time to first relapse). All placebo patients were symptomatic by the end of the study whereas only one-third of the lansoprazole patients was symptomatic at the end of the 12-month study period. The two lansoprazole doses were comparably effective in maintaining healing and in symptom control and were well tolerated. Fasting serum gastrin values increased significantly to about 1.5-2 times the baseline values over the first 2 months of lansoprazole treatment; no further increase was noted.Erosive relapse can be prevented in most patients for up to 1 yr with lansoprazole 15 mg or 30 mg once daily.
Lansoprazole
Reflux esophagitis
Esophagitis
Tolterodine
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瞄准：为了比较 lansoprazole 的二不同一日量，给 12 个星期并且到估计角色胃肠(官方补给) 是的调查为选择病人的标准。方法：从 45 ，病人们为 unexplained 提交了长期的坚持的咳嗽， 36 有至少一官方补给的调查(内视镜检查法，食道的 pH-metry 和质子的4星期的试用抽的 24-h 禁止者( PPI )治疗)积极并且随机被分配收到 30 mg lansoprazole o.d 或 30 mg 为 12 个星期的 lansoprazole b.i.d 。症状在 PPI 测试(访问 2 ) 以后并且在 12 星期的 lansoprazole 治疗经期(访问 3 ) 以后在基线(访问 1 ) 被评估。结果：35 个病人完成了学习协议。报导的 21 个病人(60.0%) 没有二个治疗组之间的差别从他们的咳嗽完成地势(58.8% 和 61.1% 没在 30 mg lansoprazole 和 60 个 mg lansoprazole 组有咳嗽，分别地) 。在治疗的结束从他们的咳嗽有完全的地势的超过 80% 病人显示出积极回答到 PPI 测试。结论：12 星期甚至在标准一日量的 lansoprazole 治疗，在有长期的坚持的咳嗽的病人是有效的。对起始的 PPI 测试的积极回答似乎是为选择对治疗作出回应的病人的最好的标准。
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Two studies were performed on healthy adult males using 24-h intragastric pH monitoring to investigate the acid secretion inhibitory effects of the proton pump inhibitor lansoprazole in its injectable form (lansoprazole injection). In the first study (study 1), eight subjects received 30 mg once daily and 30 mg twice daily of lansoprazole injection by the crossover method. In the second study (study 2), 12 subjects received 15 and 30 mg twice daily of lansoprazole injection and 20 mg twice daily of a histamine H2-receptor antagonist using the crossover method. The results of study 1 showed that 30 mg once daily of lansoprazole injection was not able to achieve sufficient suppression of acid secretion, and the results of study 2 suggested that the effectiveness of the three treatment regimens studied in suppressing gastric acid secretion can be ranked as follows: lansoprazole 30 mg twice daily > lansoprazole 15 mg twice daily > H2-receptor antagonist 20 mg twice daily.
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Lansoprazole is an acid proton-pump inhibiting drug that is used for the treatment of duodenal or gastric ulcers, H. pylori infection, gastroesophageal reflux disease or Zollinger-Ellison syndrome. Although lansoprazole is well known for its gastrointestinal and dermatologic adverse effects, mild pulmonary symptoms are also known to develop from taking this drug. There have been no reports about lansoprazole-induced interstitial lung disease. We report here a case of lansoprazole-induced interstitial lung disease that developed in a 66-year-old man.
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To c o m p a r e t w o d i f f e r e n t d a i l y d o s e s o f lansoprazole given for 12 weeks and to assess the role of gastrointestinal (GI) investigations as criteria for selecting patients. METHODS:Out of 45 patients referred for unexplained chronic persistent cough, 36 had at least one of the GI investigations (endoscopy, 24-h esophageal pHmetry and a 4-week trial of proton pump inhibitor (PPI) therapy) positive and were randomly assigned to receive either 30 mg lansoprazole o.d. or 30 mg lansoprazole b.i.d. for 12 weeks.Symptoms were evaluated at baseline (visit 1) after the PPI test (visit 2) and after the 12-week lansoprazole treatment period (visit 3). RESULTS:Thirty-five patients completed the study protocol.Twenty-one patients (60.0%) reported complete relief from their cough with no difference between the two treatment groups (58.8% and 61.1% had no cough in 30 mg lansoprazole and 60 mg lansoprazole groups, respectively).More than 80% of the patients who had complete relief from their cough at the end of the treatment showed a positive response to the PPI test. CONCLUSION:Twelve weeks of lansoprazole treatment even at a standard daily dose, is effective in patients with chronic persistent cough.A positive response to an initial PPI test seems to be the best criterion for selecting patients who respond to therapy.
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Lansoprazole, a proton pump inhibitor, has been reported to inhibit ethanol-induced injury in rats. However, the mechanism of the protective effect is not known. This study was carried out to investigate the role of prostaglandin (PG) in the protective effect of lansoprazole. Male Wistar rats were given either 30 mg/kg of lansoprazole or vehicle alone intragastrically 30 min before administration of ethanol. They were killed to measure the gross mucosal lesions in the stomach as the ulcer index. In another experiment, 5 mg/kg of indomethacin was injected 30 min before administration of lansoprazole. The effects of 16,16-dimethyl PGE2 (dmPGE2) on ethanol-induced injury over time were compared with lansoprazole. PGE2 synthesis in gastric mucosa after administration of lansoprazole was measured by radioimmunoassay. Lansoprazole reduced gastric mucosal injury by lansoprazole. DmPGE2 significantly reduced gastric mucosal injury from 5 min after exposure to ethanol. Lansoprazole did not affect PGE2 synthesis in the gastric mucosa. These results suggest that PG may not be involved in the protective effect of lansoprazole.
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