Nursing2024 Drug Handbook

846 lansoprazole

500 mg PO clarithromycin, all given b.i.d. for 10 to 14 days. ➤ Short-term treatment of symptomatic GERD Adults: 15 mg PO once daily for up to 8 weeks. Children ages 12 to 17: 15 mg PO once daily for up to 8 weeks. Children ages 1 to 11 weighing more than 30 kg: 30 mg PO once daily for up to 12 weeks. Children ages 1 to 11 weighing 30 kg or less: 15 mg PO once daily for up to 12 weeks. ➤ NSAID-related ulcer in patients who continue NSAID use Adults: 30 mg PO daily for 8 weeks. ➤ To reduce risk of NSAID-related ulcer in patients with history of gastric ulcer who need NSAIDs Adults: 15 mg PO daily for up to 12 weeks. ➤ Dyspepsia Adults: 15 or 30 mg once daily for up to 8 weeks. ADMINISTRATION PO • Give before a meal. • Don’t crush or allow patient to chew cap- sules. • For patients who have difficulty swallowing capsules, the capsules can be opened and the intact granules sprinkled on 1 tablespoon of applesauce, Ensure pudding, cottage cheese, yogurt, or strained pears and swallowed im- mediately. Or, capsule contents may be emp- tied into a small volume (60 mL) of apple, orange, or tomato juice and swallowed. • Contents of capsule can be mixed with 40 mL of apple juice in a syringe and given within 3 to 5 minutes via an NG or nasojeju- nal tube. Flush with additional apple juice to give entire dose and maintain patency of the tube. • Place ODT on patient’s tongue and allow it to disintegrate with or without water until the particles can be swallowed. • To give ODTs using an oral syringe, dis- solve a 15-mg tablet in 4 mL water or a 30-mg tablet in 10 mL water and give within 15 min- utes. Refill syringe with about 2 mL (15-mg tablet) or 5 mL (30-mg tablet) of water, shake gently, and give any remaining contents. • To give ODTs through an 8 French or larger NG tube, dissolve a 15-mg tablet in 4 mL wa- ter or a 30-mg tablet in 10 mL water and give

within 15 minutes. Refill syringe with about 5 mL of water, shake gently, and flush the NG tube. • ODTs contain 2.5 mg phenylalanine/ 15-mg tablet and 5.1 mg phenylalanine/ 30-mg tablet. ACTION Reduces acid secretion in gastric parietal cells through inhibition of (H + , K + )-ATPase en- zyme system, inhibiting the final step in gas- tric acid production. Route Onset Peak Duration PO 1–3 hr 1.7 hr 24 hr Half-life: Less than 2 hours. ADVERSE REACTIONS CNS: headache, dizziness. GI: abdominal pain, constipation, diarrhea, nausea. GU: hematuria. INTERACTIONS Drug-drug. Amoxicillin, clarithromycin: May increase risk of adverse effects. Moni- tor patient. Atazanavir, nelfinavir: May reduce antiviral GI absorption and activity. Don’t use together. Cefuroxime: May reduce cefuroxime absorp- tion. Avoid combination. Clopidogrel: May decrease clopidogrel serum concentration. Monitor therapy or consider H 2 receptor antagonist (e.g., famotidine). Digoxin: May increase digoxin level. Monitor digoxin concentration; digoxin dosage adjust- ment may be needed. Erlotinib, iron salts, ketoconazole, mycophe- nolate mofetil: May inhibit absorption of these drugs. Monitor patient closely. Methotrexate: May increase methotrexate serum level. Monitor methotrexate concen- tration and adjust dosage as needed. Rilpivirine: May decrease rilpivirine concen- tration. Use together is contraindicated. Strong CYP2C19 or CYP3A inducers (riton- avir): May decrease lansoprazole level. Mon- itor therapy. Strong CYP2C19 or CYP3A4 inhibitors (voriconazole): May increase lansoprazole level. Use cautiously together. Sucralfate: May cause delayed lansoprazole absorption. Give lansoprazole at least 30 min- utes before sucralfate. Tacrolimus: May increase tacrolimus level, especially in patients with a transplant who

Reactions in bold italics are life-threatening . Interactions may have a rapid onset or a delayed onset .