Lansoprazole

What Does Lansoprazole Do?

Lansoprazole reduces the amount of acid produced in the stomach. It is used to treat various conditions involving excessive stomach acid, including reflux (gastroesophageal reflux disease, GERD), where it helps reduce the amount of acid in your stomach, thus reducing the amount of acid that can travel upward too.  

Lansoprazole may also help the healing of gastric and duodenal ulcers, and reduces the risk of new ulcers forming. It is used to treat erosive oesophagitis, helping to heal inflammation and ulcers in the oesophagus. Lansoprazole is used to treat hypersecretory conditions where the stomach produces too much acid, such as Zollinger-Ellison syndrome. It is also used in combination with antibiotics to treat Helicobacter pylori stomach infections. 

Over-the-counter lansoprazole is used to treat frequent heartburn, while prescription lansoprazole is also used to prevent stomach ulcers that can be caused by long term anti-inflammatory drug use. By decreasing stomach acid production, lansoprazole allows the oesophagus, stomach, and duodenum to heal.

How Does Lansoprazole Work?

The mechanism of action involves inhibiting the proton pump in gastric parietal cells, significantly reducing gastric acid secretion. Its key action halts the hydrogen-potassium ATPase enzyme system, or 'proton pump', located on the gastric parietal cells. This action leads to a considerable, prolonged downregulation of gastric acid secretion. The theory is: less acid, less stomach and gut irritation/inflammation. 

Drug Type and Category of Lansoprazole

Lansoprazole is a proton pump inhibitor (PPI). 

What dosage of Lansoprazole should you be taking?

NHS Recommendations ¹

The usual dose to treat:

• indigestion is 15mg to 30mg a day
• acid reflux is 15mg to 30mg a day
• stomach ulcers is 15mg to 30mg a day
• Zollinger-Ellison syndrome is 60mg a day – this can increase to 120mg a day depending on how well it works for you
• Doses are usually lower for children, older people and people with liver problems.

What are the side-effects of Lansoprazole?

The most common side effects of lansoprazole include:

• Diarrhoea, stomach pain, nausea
• Constipation, headache
• Dizziness
• Rash, itching
• Swelling of the face, lips, tongue, or throat
• Difficulty breathing or swallowing
• In men, difficulty achieving or maintaining an erection

Less common side effects:

• Increased or decreased appetite, joint pain, vomiting
• Insomnia, hallucinations, confusion
• Anaemia, inflammation of the tongue, candidiasis, pancreatitis, change in taste
• Inflammation of the liver, skin reactions, hair loss
• Kidney problems, breast swelling in males

Rare side effects:

• Reduction in white blood cells, colitis, severe skin reactions, severe allergic reactions
• Irregular heartbeat, muscle spasms, seizures, severe diarrhea
• New or worsening joint pain, sun-sensitive rash

Lansoprazole may increase the risk of bone fractures, especially with long-term use, high doses and in older adults. It can also lead to low magnesium levels in the blood with long-term use.

Drug Interactions

Major Interactions:

• Erlotinib, nelfinavir, rilpivirine - Severe interactions, so best to avoid combination

Serious Interactions:

• Atazanavir, dapsone, dasatinib, delavirdine, digoxin, idelalisib, indinavir, itraconazole, ketoconazole, mesalamine, nilotinib, nisoldipine, pazopanib, phenytoin, ponatinib, sofosbuvir/velpatasvir - Combination may require dosage adjustment or close monitoring

Moderate Interactions:

• Lansoprazole has moderate interactions with at least 48 different drugs

Mild Interactions:

• Lansoprazole has mild interactions with at least 54 different drugs

Other Key Interactions:

• Lansoprazole may decrease the absorption of certain drugs that require stomach acid, such as ampicillin, atazanavir, erlotinib, itraconazole, ketoconazole, and others.
• Dexlansoprazole and Lansoprazole are very similar, so they should not be used together.

Natural Alternatives to Lansoprazole

Here are some natural alternatives to lansoprazole for treating acid reflux and GERD:

Digestive Enzymes

Digestive enzymes help break down food faster, preventing acid buildup. You can take a supplement with meals if you don't produce enough naturally. ²

Probiotics

Probiotics are "friendly bacteria" that aid digestion. You can get them from supplements or probiotic-rich foods like yogurt, kefir, sauerkraut, and kimchi. ²

Chamomile Tea

Chamomile has anti-inflammatory properties that can soothe the esophagus and reduce swelling from acid reflux. It also has a calming effect that can help relieve stress, a major trigger for GERD. ⁴

Ginger

Ginger is an effective anti-nausea herb that can prevent acid reflux by reducing stomach contractions. Eat it raw, brew it into tea, or add it to recipes like stir-fries, but don't exceed 4 grams per day as too much can worsen symptoms. ⁴

Stress Management

Stress can increase stomach acid and slow digestion, worsening reflux. Try relaxation techniques like meditation, yoga, deep breathing, or hypnotherapy to manage stress. ⁴

Lifestyle Changes

Avoid dietary triggers, eat smaller meals, lose weight if overweight, quit smoking, and don't lie down after eating. Elevate the head of your bed 6-8 inches to prevent nighttime reflux. ⁵

Always consult your doctor before making major changes to your medication regimen. Some natural remedies may interact with medications or have side effects with long-term use. ⁶

Interesting facts about Lansoprazole

Lansoprazole was originally synthesised by Takeda Pharmaceutical in 1984 and given the development name AG 1749. It was patented that year and launched in 1991. ⁷

Patent protection of the lansoprazole molecule expired on November 10, 2009, and generic formulations became available under many brand names in many countries.

Interestingly, Lansoprazole may interfere with certain lab tests, potentially causing false results.

It can increase serum chromogranin A (CgA) levels. Elevated CgA can interfere with diagnostic tests for neuroendocrine tumors. To avoid this, lansoprazole should be stopped at least 14 days before assessing CgA levels, and the same commercial lab should be used for serial tests as reference ranges may vary.

Lansoprazole may also cause false positive urine screening tests for tetrahydrocannabinol (THC). If a PPI-induced false positive is suspected, the positive result should be confirmed using an alternative testing method. Lansoprazole can cause a hyper-response in gastrin secretion to the secretin stimulation test, falsely suggesting the presence of a gastrinoma, thus it should be stopped at least 28 days prior to performing this test. For tests related to Helicobacter pylori, lansoprazole and other proton pump inhibitors should be avoided for 1-2 weeks prior, as they can suppress H. pylori and lead to false negative results.

Lansoprazole is currently the fourth most prescribed drug in the UK, as of 2024. 

Controversies about Lansoprazole

The issue with long-term use of proton pump inhibitors (PPIs) like Lansoprazole is multifaceted. Some therapists believe that the root cause of digestive problems may not be excessive stomach acid, but rather too little. In such cases, further reducing stomach acid through PPIs may not provide a lasting solution. 

Additionally, lowering hydrochloric acid levels can interfere with the breakdown of food, leading to reduced mineral absorption. Reducing minerals directly affects the bones, and potential complications like osteoporosis are known to occur with prolonged PPI use. Another issue is that patients are often prescribed PPIs like lansoprazole for extended periods, sometimes lasting months or even years, and patients are often put on repeat prescription. Addressing lifestyle and diet, as well as education, may be more effective long term. 

While there are ongoing debates about the potential links between long-term PPI use and cardiovascular disease, dementia, kidney disease, and gastric cancer, these associations remain largely unproven, and further research is necessary to establish clear causal relationships.

Disclaimer:

This article is generated for informational purposes only. It was created in June 2024. Medications and medical guidance can change over time. Therefore, it is essential to consult with your general practitioner or healthcare provider before making any decisions regarding medications or treatment plans. Your GP can provide personalised advice based on your specific health needs and conditions.

References

1. https://www.nhs.uk/medicines/lansoprazole/
2. https://www.pushdoctor.co.uk/nutrition-advice/5-natural-alternatives-to-antacids
3. https://www.naturalgrocers.com/health-hotline-article/soothe-burn-healthy-alternatives-acid-blocking-drugs
4. https://www.naturomedica.com/blog/news/heart-health/top-5-natural-alternatives-to-treat-acid-reflux
5. https://badgut.org/information-centre/a-z-digestive-topics/natural-counter-heartburn-treatments/
6. https://www.drugs.com/tips/lansoprazole-patient-tips
7. https://en.wikipedia.org/wiki/Lansoprazole