Lancid, 15 mg capsules 30 pcs

Lancid is a specific proton pump inhibitor (H+-K+-ATPase); it is metabolized in the parietal cells of the stomach to active sulfonamide derivatives, which inactivate the H+-K+-ATPase. Blocks the final stage of hydrochloric acid secretion, reducing basal and stimulated secretion, regardless of the nature of the stimulant. Having high lipophilicity it easily penetrates into the parietal cells of the stomach, concentrates in them and exerts cytoprotective effect, increasing the oxygenation of the gastric mucosa and increasing the secretion of hydrocarbonate.

The rate and degree of inhibition of basal and stimulated hydrochloric acid secretion are dose-dependent: pH begins to increase 1-2 h and 2-3 h after taking 15 and 30 mg, respectively; inhibition of hydrochloric acid production at a dose of 30 mg is 80-97%. There is no effect on gastrointestinal motility. Inhibitory effect increases during the first 4 days of use. After discontinuation of the dose acidity remains below 50% of the basal level for 39 hours, “ricochet” increase in secretion is not observed. Secretory activity normalizes 3-4 days after discontinuation of the drug.

In patients with Zollinger-Ellison syndrome the action is longer. Promotes the formation of specific IgA to Helicobacter pylori in the gastric mucosa, inhibiting their growth, increases the anti-Helicobacter activity of other drugs. Increases the concentration of pepsinogen in blood serum and inhibits the production of pepsin. Inhibition of secretion is accompanied by an increase in the number of nitrosobacteria and an increase in the concentration of nitrates in the gastric secretion. It is effective in treatment of gastric and duodenal ulcers resistant to histamine H2-receptor blockers. It provides faster healing of duodenal ulcers (85% of duodenal ulcers heal in 4 weeks of treatment at the dose of 30 mg/day).

After the first dose of lansoprazole at a dose of 30 mg, the pH of gastric juice increases in 1-2 hours. When taking the drug several times a day (30 mg) an increase in gastric juice pH is noted in the first hour after intake. The duration of action is more than 24 hours. No risk of increased gastric acidity after discontinuation of lansoprazole has been observed. The recovery of hydrochloric acid secretion to normal levels occurs gradually over a period of 2 to 4 days after several doses of the drug.

Pharmacokinetics:

Absorption
Absorption of lansoprazole begins as soon as the drug leaves the stomach. The absorption rate is high and Cmax in plasma is reached after 1.7 h, which is combined with a high bioavailability of more than 80%. Food intake reduces absorption and bioavailability (by 50%), but the inhibitory effect on gastric secretion remains the same, regardless of food intake. Such parameters of lansoprazole pharmacokinetics as Cmax and AUC are approximately proportional. If the drug is taken 30 min after a meal, both pharmacokinetics are reduced by 50%. Food has no pronounced effect if the drug is taken before meals.

Distribution
Binding to plasma proteins is 97.7-99.4%. Lansoprazole penetrates well into the tissues, including the lining cells of the stomach. Vd – 0.5 l/kg.

Metabolism
Lansoprazole is metabolized in the liver. Two metabolites (sulfinyl hydroxylate and sulfone derivative), which are inactive, are found in significant amounts in plasma. In the acidic environment of the parietal tubules lansoprazole is transformed into 2 active substances that are not detectable in the systemic blood flow.

Elimination
T1/2 of lansoprazole is less than 2 hours, which does not affect the duration of suppression of gastric secretion. It is excreted as lansoprazole sulfone and hydroxylansoprazole with bile (2/3), with urine – 14-23%.

Pharmacokinetics in special clinical cases

In liver cirrhosis, absorption may be delayed.

Renal insufficiency does not significantly affect the rate and amount of excretion. In patients with impaired renal function the protein binding may be reduced by 1-1.5%.

Indications

– gastric and duodenal ulcer (acute phase);
– erosive ulcerative esophagitis;

Active ingredient

Composition

1 capsule:

– lansoprazole 15 mg

Supplementary substances:

mannitol – 129.7 mg,

lactose monohydrate – 13 mg,

sucrose – 16.6 mg,

povidone – 3.5 mg,

hypromellose phthalate – 18.2 mg,

cetyl alcohol – 2 mg.

Capsule body composition:

gelatin – 24.7626 mg, sodium lauryl sulfate – 0.024 mg, propyl parahydroxybenzoate – 0.24 mg, methyl parahydroxybenzoate – 0.06 mg, titanium dioxide – 0.5557 mg, brilliant blue dye – 0.0034 mg, quinoline yellow dye – 0.0042 mg, water – 4.35 mg.

Capsule cap composition:

gelatin – 16.5084 mg, sodium lauryl sulfate – 0.016 mg, propyl parahydroxybenzoate – 0.04 mg, methyl parahydroxybenzoate – 0.16 mg, titanium dioxide – 0.3705 mg, brilliant blue dye – 0.0022 mg, quinoline yellow dye – 0.0028 mg, water – 2.9 mg.

How to take, the dosage

It is taken orally. Lancid capsules should be swallowed without chewing.

In duodenal ulcer and stress ulcers – 30 mg/day at 1 reception, preferably in the morning, before meals for 2-4 weeks.

In peptic ulcer disease and erosive ulcerative esophagitis – 30 mg/day for 4-8 weeks; if necessary – 60 mg/day.
In reflux esophagitis – 30 mg/day for 4 weeks.

In Zollinger-Ellison syndrome, the dose of Lancid is adjusted individually, until basal acid production is less than 10 mmol/h.

For eradication of Helicobacter pylori, 30 mg twice daily, in combination with antibiotics (clarithromycin and amoxicillin), for at least 7 days.

In nonulcer dyspepsia: 15-30 mg/day for 2-4 weeks.

In liver failure and in elderly patients, treatment begins with half doses of Lancid, gradually increasing to the recommended doses, but not more than 30 mg/day.

Interaction

When used concomitantly, lansoprazole slows the elimination of drugs that are metabolized in the liver by microsomal oxidation (including diazepam, phenytoin, indirect anticoagulants).
Lansoprazole reduces clearance of theophylline by 10%.
Lansoprazole in concomitant use slows pH-dependent absorption of drugs belonging to the group of weak acids and accelerates absorption of drugs belonging to the group of bases.
Lansoprazole is compatible with ibuprofen, indomethacin, diazepam, propranolol, warfarin, oral contraceptives, phenytoin, prednisolone.
Sucralfate decreases bioavailability of lansoprazole by 30%, therefore it is necessary to observe an interval of 30-40 minutes between the intake of drugs.
Antacids should be prescribed 1 hour before or 1-2 hours after taking lansoprazole as they slow down and decrease their absorption.

Special Instructions

Endoscopic control to rule out malignancy is mandatory before and after treatment, because treatment can mask symptoms and delay correct diagnosis.

Contraindications

– malignant tumors of the gastrointestinal tract;
– I trimester of pregnancy;
– lactation period;
– hypersensitivity to the components of the preparation Lancid.
With caution the preparation should be administered in case of hepatic insufficiency, in II-III trimesters of pregnancy, elderly patients and patients under 18 years old.

Side effects

The digestive system: less frequently – increase or decrease of appetite, nausea, abdominal pain; rarely – diarrhea or constipation; in some cases – nonspecific ulcerative colitis, gastrointestinal candidiasis, increased activity of liver transaminases (ALT, AST), GGT, ALT and LDH, hyperbilirubinemia.

Nervous system disorders: headache; rarely – malaise, dizziness, somnolence, depression, anxiety.

Respiratory system disorders: rarely – cough, pharyngitis, rhinitis, upper respiratory tract infection, flu-like syndrome.

Hematopoietic organs: rarely – thrombocytopenia (with hemorrhagic manifestations); anemia in rare cases.

Allergic reactions: skin rash; in some cases – photosensitization, erythema multiforme.

Others: rarely – myalgia, alopecia.

Similarities