Prevacid (lansoprazole) is a proton pump inhibitor (PPI) designed for the medical management of gastric acid-related disorders. By selectively inhibiting the H+/K+ ATPase enzyme system at the secretory surface of the gastric parietal cell, it effectively suppresses both basal and stimulated acid secretion. This mechanism provides sustained relief from symptoms and promotes healing of acid-induced damage to the esophageal mucosa. Clinicians prescribe Prevacid for its established efficacy in treating conditions such as gastroesophageal reflux disease (GERD), erosive esophagitis, and pathological hypersecretory conditions including Zollinger-Ellison syndrome. Its delayed-release formulation ensures targeted delivery and optimized bioavailability.

Features

• Active ingredient: Lansoprazole 15 mg or 30 mg delayed-release capsules
• Pharmacologic class: Proton pump inhibitor (PPI)
• Administration: Oral route, with or without food
• Formulation: Enteric-coated granules to protect against gastric acid degradation
• FDA-approved indications include GERD maintenance, Helicobacter pylori eradication (in combination), and risk reduction of NSAID-associated gastric ulcers
• Available as orally disintegrating tablets for patients with swallowing difficulties

Benefits

• Provides 24-hour acid control with once-daily dosing for most indications
• Promotes healing of erosive esophagitis and prevents relapse in maintenance therapy
• Effectively reduces heartburn frequency and severity in GERD patients
• Enables combination therapy for H. pylori eradication with antibiotics
• Demonstrates favorable safety profile in both short-term and maintenance treatment
• Offers flexible administration options including sprinkling capsules on soft foods

Common use

Prevacid is primarily indicated for the short-term treatment (4-8 weeks) of active duodenal ulcers and maintenance of healed duodenal ulcers. It is extensively used for the treatment of erosive esophagitis diagnosed by endoscopy, with healing typically occurring within 4-8 weeks of therapy. For GERD patients, it provides symptomatic relief of heartburn and acid regurgitation. Additionally, it is employed in combination with amoxicillin and clarithromycin for H. pylori eradication to reduce the risk of duodenal ulcer recurrence. In patients requiring continuous NSAID therapy who are at high risk for developing gastric ulcers, Prevacid is indicated for reduction of this risk.

Dosage and direction

The recommended adult dosage for healing of erosive esophagitis is 30 mg once daily for up to 8 weeks. For maintenance healing of erosive esophagitis, 15 mg once daily is recommended. For symptomatic GERD, the dose is 15 mg once daily for up to 8 weeks. For H. pylori eradication, the triple therapy regimen consists of Prevacid 30 mg twice daily plus amoxicillin 1 g twice daily and clarithromycin 500 mg twice daily for 10-14 days. For risk reduction of NSAID-associated gastric ulcers, the dose is 15 mg once daily for up to 12 weeks. Capsules should be swallowed whole; alternatively, contents may be sprinkled on one tablespoon of applesauce, Ensure pudding, cottage cheese, yogurt, or strained pears and swallowed immediately without chewing.

Precautions

Patients should be advised that Prevacid may increase the risk of bone fractures with long-term use and multiple daily doses. Hypomagnesemia may occur with prolonged treatment, requiring monitoring particularly in patients taking digoxin or drugs that may cause hypomagnesemia. Avoid concomitant use with atazanavir and nelfinavir due to significant reduction in antiviral drug levels. Use with caution in patients with hepatic impairment, as lansoprazole is extensively metabolized in the liver. Long-term therapy may lead to vitamin B12 deficiency due to decreased gastric acid secretion. Periodic monitoring of magnesium levels is recommended for patients expected to be on prolonged therapy or taking PPIs with medications such as diuretics.

Contraindications

Prevacid is contraindicated in patients with known hypersensitivity to any component of the formulation or substituted benzimidazoles. Concomitant use with rilpivirine-containing products is contraindicated due to potential for antiviral therapeutic failure and development of resistance. Should not be used in patients taking atazanavir due to significantly reduced atazanavir exposure. Avoid use in patients with a history of acute interstitial nephritis with prior PPI use. Not recommended for patients with suspected gastrointestinal malignancy without proper diagnostic evaluation, as symptom relief may delay diagnosis.

Possible side effect

Common adverse reactions (≥1%) include diarrhea (3.8%), abdominal pain (2.1%), nausea (1.5%), and headache (1.3%). Less frequent side effects may include constipation, dizziness, and rash. Serious adverse reactions include acute interstitial nephritis, Clostridium difficile-associated diarrhea, bone fracture, hypomagnesemia, vitamin B12 deficiency, and fundic gland polyps. Cutaneous and systemic lupus erythematosus have been reported with PPI use. Long-term use may be associated with increased risk of chronic kidney disease progression. Patients may experience symptoms of acid hypersecretion after discontinuation of therapy.

Drug interaction

Prevacid may decrease the absorption of drugs requiring gastric acid for absorption, including ketoconazole, itraconazole, iron salts, erlotinib, dabigatran etexilate, and mycophenolate mofetil. Concomitant use with methotrexate may increase methotrexate levels. May increase exposure to tacrolimus. Coadministration with warfarin may increase INR and prothrombin time. CYP2C19 and CYP3A4 inducers (rifampin, St. John’s wort) may decrease lansoprazole levels. May alter the pharmacokinetics of saquinavir. Monitoring of international normalized ratio (INR) is recommended when warfarin is coadministered with lansoprazole.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed dose. Patients should maintain their regular dosing schedule and not take extra medicine. For patients taking twice-daily dosing for H. pylori eradication, if a dose is missed, the next dose should be taken at the regular time according to the prescribed schedule. Consistency in dosing is important for optimal acid suppression and therapeutic effect.

Overdose

Lansoprazole is not removed by hemodialysis. Doses up to 500 mg daily have been administered without dose-limiting toxicity. Reported symptoms of overdose may include confusion, drowsiness, blurred vision, tachycardia, nausea, vomiting, diaphoresis, flushing, headache, and dry mouth. Specific recommendations include symptomatic and supportive care. Gastric lavage may be considered if performed soon after ingestion. Monitor for arrhythmias and hypotension if large overdoses occur. There is no specific antidote for lansoprazole overdose. Contact a poison control center for current recommendations.

Storage

Store at room temperature between 20°C to 25°C (68°F to 77°F) with excursions permitted between 15°C to 30°C (59°F to 86°F). Keep container tightly closed and protect from moisture. Dispense in original container with desiccant capsule included. Do not store after removal from blister package beyond the specified time. Keep out of reach of children and pets. Do not use if the seal under the cap is broken or missing. Protect from light and excessive humidity. Do not freeze the medication.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting or changing any medication regimen. The prescribing physician should be consulted for specific dosing recommendations based on individual patient characteristics. This product is available by prescription only. Patients should disclose all medical conditions and current medications to their healthcare provider. Not all possible uses, precautions, side effects, or interactions are listed here.

Reviews

Clinical studies demonstrate Prevacid 30 mg daily provides complete heartburn relief in 80% of GERD patients by week 8 of treatment. In endoscopic healing trials, 92% of patients with erosive esophagitis achieved healing after 8 weeks of therapy. Maintenance therapy with 15 mg daily maintained healing in 67-79% of patients at 12 months. Combination therapy for H. pylori eradication achieves success rates of 85-90% in clinical settings. Patients report significant improvement in quality of life measures related to GERD symptoms. The delayed-release formulation is generally well-tolerated with a favorable benefit-risk profile for indicated uses.