Dexlansoprazole
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Generic Name of Dexlansoprazole - Learn More
Dexlansoprazole
Dexlansoprazole Precaution - What You Need to Know
Dexlansoprazole, a proton pump inhibitor (PPI), is generally well-tolerated but requires caution in certain populations. It should be used with caution in patients with a history of gastrointestinal (GI) disorders, such as gastroesophageal reflux disease (GERD) or peptic ulcers, as prolonged use may lead to complications like Clostridium difficile-associated diarrhea or GI infections. Chronic use of PPIs, including dexlansoprazole, can increase the risk of bone fractures, particularly in the elderly, due to reduced calcium absorption. As such, bone health should be monitored in long-term users. Dexlansoprazole may cause low magnesium levels (hypomagnesemia), which can lead to serious issues like muscle spasms, arrhythmias, or seizures, especially when used for extended periods. It is crucial to monitor magnesium levels in patients on long-term therapy. Patients with severe liver impairment should be given a reduced dose, as dexlansoprazole is metabolized by the liver. In pregnant women, dexlansoprazole should only be used if the benefits outweigh the risks, as its safety in pregnancy has not been fully established. It is also excreted in breast milk, so caution is advised when administering it to breastfeeding women. The potential for drug interactions is another consideration, as dexlansoprazole can alter the absorption of drugs dependent on gastric pH, such as iron supplements, ketoconazole, and digoxin. Monitoring for any adverse effects, particularly in high-risk individuals, is essential.
Dexlansoprazole Indication - Uses and Benefits
Dexlansoprazole is primarily indicated for the treatment of GERD, especially for healing erosive esophagitis and for maintaining the healing of erosive esophagitis associated with GERD. It is also used for the treatment of heartburn associated with symptomatic GERD. Dexlansoprazole works by inhibiting the proton pumps in the stomach lining, thus reducing gastric acid secretion, which helps alleviate the symptoms of GERD and promotes healing of the esophagus. It can also be used in the treatment of Zollinger-Ellison syndrome, a condition characterized by excessive stomach acid production. Off-label uses of dexlansoprazole may include the treatment of H. pylori eradication as part of combination therapy with antibiotics, though other PPIs are more commonly prescribed for this purpose. Additionally, dexlansoprazole has been studied for use in patients with NSAID-induced ulcers or for preventing gastric ulcers in patients at risk due to long-term NSAID therapy, although this is not an FDA-approved indication. Given its ability to reduce gastric acid production, dexlansoprazole can be effective in managing conditions associated with excessive stomach acid, though its use should be guided by clinical need.
Dexlansoprazole Contraindications - Important Warnings
Dexlansoprazole is contraindicated in individuals who are hypersensitive to the drug or any of its components. It should also be avoided in patients with a known allergy to other PPIs, as there is a potential for cross-sensitivity. In patients with severe liver impairment, the drug should be used with caution, and the dose may need to be adjusted. The drug should not be used in combination with certain medications, such as the HIV drug atazanavir, as PPIs can reduce the absorption and effectiveness of such medications. Additionally, dexlansoprazole should be avoided in patients with vitamin B12 deficiency when long-term use is anticipated, as it can reduce the absorption of vitamin B12 from food. Although dexlansoprazole is generally safe during pregnancy, it should only be used if clearly needed, as the drug has not been fully evaluated for fetal safety. The use of dexlansoprazole is generally not recommended for pediatric patients under the age of 12, as safety and efficacy have not been established in this age group.
Dexlansoprazole Side Effects - What to Expect
The most common side effects of dexlansoprazole are generally mild and may include headache, diarrhea, abdominal pain, flatulence, and nausea. These are typically transient and may resolve with continued use. However, long-term use of PPIs, including dexlansoprazole, has been associated with an increased risk of more serious side effects. These include bone fractures, especially in individuals with osteoporosis or those taking other medications that affect bone health. Other potential serious side effects include kidney problems, including acute interstitial nephritis, and low magnesium levels (hypomagnesemia), which can lead to symptoms like muscle spasms, arrhythmias, or seizures. In some cases, prolonged PPI use can lead to vitamin B12 deficiency, which may result in neurological symptoms and anemia. Rarely, dexlansoprazole may cause allergic reactions, including rash, itching, and difficulty breathing. If signs of a severe allergic reaction, such as swelling of the face or throat, occur, patients should seek immediate medical attention. Additionally, some individuals may experience gastrointestinal infections like C. difficile-associated diarrhea, as PPIs can alter the balance of gut microbiota. To mitigate the risk of side effects, dexlansoprazole should be taken at the lowest effective dose for the shortest duration necessary.
Dexlansoprazole Pregnancy Category ID - Safety Information
2
Dexlansoprazole Mode of Action - How It Works
Dexlansoprazole works by inhibiting the proton pumps (H+/K+ ATPase enzymes) located in the parietal cells of the stomach lining. These proton pumps are responsible for the final step of gastric acid production. By inhibiting these pumps, dexlansoprazole reduces the secretion of hydrochloric acid into the stomach. This leads to a decrease in gastric acidity, which helps alleviate symptoms of acid reflux, promotes healing of ulcers or erosive esophagitis, and reduces inflammation in the gastrointestinal tract. As a result, dexlansoprazole is highly effective in the treatment of conditions like GERD, where acid reflux leads to heartburn and esophageal damage. Dexlansoprazole has a unique pharmacokinetic profile compared to other PPIs in that it is a dual delayed-release formulation, allowing for more sustained acid suppression over a 24-hour period with fewer dosing adjustments. This ensures that patients experience consistent symptom relief throughout the day, even with a single dose.
Dexlansoprazole Drug Interactions - What to Avoid
Dexlansoprazole can interact with several drugs, particularly those that require an acidic environment for absorption. Drugs such as ketoconazole, atazanavir, and digoxin may have reduced effectiveness when taken with dexlansoprazole due to changes in stomach pH. In some cases, the absorption of calcium and magnesium supplements may be reduced. Additionally, dexlansoprazole can increase the serum concentrations of certain drugs, such as warfarin and methotrexate, potentially increasing the risk of adverse effects. Therefore, careful monitoring of drug levels and dose adjustments may be necessary in these cases. Concurrent use of dexlansoprazole with other PPIs, H2 antagonists, or antacids should be avoided, as it may reduce its effectiveness. There is also a potential for interaction with clopidogrel, as dexlansoprazole may inhibit the enzyme CYP2C19, which is involved in clopidogrel’s activation. This can reduce the efficacy of clopidogrel and may increase the risk of adverse cardiovascular events. Patients should also avoid taking dexlansoprazole with alcohol, as it may exacerbate gastrointestinal symptoms and lead to increased acid reflux.
Dexlansoprazole Adult Dose - Recommended Dosage
For the treatment of GERD and erosive esophagitis, the recommended adult dose of dexlansoprazole is 30 mg once daily for up to 8 weeks. If necessary, treatment may be extended for an additional 8 weeks, depending on the patient's clinical response. For maintenance of healing in erosive esophagitis or to reduce GERD symptoms, a dose of 30 mg once daily is often sufficient. In patients with Zollinger-Ellison syndrome, the starting dose is typically 60 mg daily, which can be increased based on the patient's needs. Dexlansoprazole should be taken on an empty stomach, at least 30 minutes before a meal, to maximize its effectiveness. It can be taken as a whole tablet or by opening the capsule and sprinkling the contents on applesauce or other soft food for patients who have difficulty swallowing pills. The maximum recommended daily dose is 60 mg, and doses above this amount should be avoided unless specifically prescribed by a healthcare provider.
Dexlansoprazole Child Dose - Dosage for Children
Dexlansoprazole is not recommended for use in children under the age of 12, as safety and efficacy have not been established for this age group. In pediatric patients aged 12 years and older, the usual dose for GERD is 30 mg once daily, similar to the adult dosing. However, this should only be used when clinically indicated and under the guidance of a healthcare professional. For the treatment of erosive esophagitis or symptomatic GERD, the appropriate dosage should be determined based on the patient's response and condition. Careful monitoring is important, particularly for long-term use, to detect any potential adverse effects. Regular follow-up visits may be required to assess the effectiveness of treatment and to ensure safety in pediatric populations.
Dexlansoprazole Renal Dose - Dosage for Kidney Conditions
In patients with mild to moderate renal impairment (creatinine clearance ≥30 mL/min), no dose adjustment is necessary for dexlansoprazole. However, in patients with severe renal impairment (creatinine clearance <30 mL/min), caution should be used when prescribing dexlansoprazole. Although specific dose adjustments for severe renal impairment have not been clearly defined, healthcare providers should carefully assess renal function and monitor the patient for potential adverse effects during treatment. The drug should be used at the lowest effective dose in patients with renal dysfunction. Regular monitoring of kidney function is recommended in those receiving long-term therapy with dexlansoprazole, especially in those with underlying kidney disease or risk factors for renal complications.
