Lansoprazole

About Lansoprazole

Lansoprazole switches off the acid pumps in the stomach lining. It treats reflux and erosive esophagitis in adults and children from one year old, heals stomach and duodenal ulcers, lowers the risk of ulcers from NSAIDs, controls Zollinger-Ellison syndrome and, with antibiotics, helps clear H. pylori. Adults usually take 15 mg once a day for reflux and 30 mg for erosive esophagitis.

Diarrhea, stomach pain, nausea and constipation are the most common side effects. Long-term use is linked to low magnesium and vitamin B12 and to fractures; C. difficile diarrhea, kidney inflammation, lupus and severe skin reactions are less common. It must not be taken with the HIV drug rilpivirine, and the SoluTab contains phenylalanine, which matters in phenylketonuria.

Over the counter, 15 mg is sold as Prevacid 24HR and as store-brand capsules and dissolving tablets for frequent heartburn, taken each morning for 14 days, no more than one course every four months without a doctor’s advice. If you are prescribed 15 mg once a day, the over-the-counter product is the same medicine and strength without a dispensing fee; whether it can replace your prescription is your prescriber’s decision.

No FDA-approved lansoprazole oral suspension is on the US market now: Prevacid’s suspension packets are discontinued. For people who cannot swallow a capsule, the label allows it to be opened onto soft food or into juice, and the SoluTab to be dissolved in water for an oral syringe. Prevpac, the brand H. pylori pack, is discontinued too.

Taking Lansoprazole

How to take it

Usually once a day before a meal, or two or three times a day with antibiotics for H. pylori. Swallow capsules whole, or sprinkle the granules on a tablespoon of applesauce or stir them into about 60 mL of apple, orange or tomato juice and swallow at once. Let the SoluTab dissolve on the tongue. Take it at least 30 minutes before sucralfate.

If you miss a dose

Take it as soon as you remember, unless the next dose is nearly due; then skip the missed one. Do not take a double dose.

Storage

At room temperature, tightly closed, away from heat and moisture (not in the bathroom), out of reach of children.

Interactions to know about

It must not be taken with rilpivirine; nelfinavir, St. John’s wort and rifampin are avoided. It can raise digoxin, tacrolimus and high-dose methotrexate levels and the INR on warfarin, theophylline may need adjusting, and it can reduce iron absorption. Antacids can be taken with it.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Lansoprazole differs from pharmacy to pharmacy

Generic capsules have many makers, so a fill is priced mostly on each pharmacy’s dispensing fee and markup. The dissolving tablets have fewer makers and their quotes vary more, and a prescription naming Prevacid or SoluTab without allowing substitution is priced as a brand.

Over-the-counter 15 mg products carry no dispensing fee; there is no 30 mg over-the-counter product.

Ways to pay less for Lansoprazole without insurance

• If you take 15 mg once a day, ask your prescriber whether the over-the-counter product would do, and for how long.
• Ask for the prescription to allow generic substitution.
• If the SoluTab was chosen only for easier swallowing, ask whether an opened capsule on applesauce would do.
• For H. pylori, ask the pharmacy to quote lansoprazole and the antibiotics as separate generics.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Lansoprazole

1. 1.Is over-the-counter 15 mg the same as my prescription?
2. 2.How long before a meal should I take it?
3. 3.Can I open the capsule if swallowing is hard?
4. 4.Does it interact with my blood thinner, methotrexate or HIV medicines?
5. 5.How long should I stay on it?

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