Dexlansoprazole

Introduction

Dexlansoprazole is a proton pump inhibitor (PPI) used to treat various conditions related to excessive stomach acid. It is a more potent derivative of lansoprazole and is employed to reduce gastric acid secretion in the treatment of gastroesophageal reflux disease (GERD), erosive esophagitis, and other acid-related disorders.

Uses

Dexlansoprazole is primarily used to:

Treat GERD: Relieves symptoms of gastroesophageal reflux disease, including heartburn and acid regurgitation.
Manage Erosive Esophagitis: Treats inflammation and damage to the esophagus caused by acid reflux.
Heal Peptic Ulcers: Promotes healing of ulcers in the stomach and duodenum by reducing gastric acid production.

It is also used in combination with antibiotics for the eradication of Helicobacter pylori to prevent ulcers.

Brand Name	Dexlansoprazole
Type
Weight
Generic	Dexlansoprazole
Manufacturer
Available in	English বাংলা

Mechanism of Action

Dexlansoprazole works by irreversibly inhibiting the hydrogen-potassium ATPase enzyme system in the gastric parietal cells. This action blocks the final step of gastric acid production, thereby reducing the amount of acid secreted into the stomach. The result is decreased acidity in the stomach and esophagus, leading to symptom relief and healing of acid-related damage.

How Long Does It Take to Work?

Dexlansoprazole typically starts to work within 1 to 2 hours of administration, with peak effects usually observed within 1 to 2 days. Full therapeutic effects, such as complete symptom relief, may take up to 2 to 4 weeks of consistent use.

Absorption

Dexlansoprazole is well absorbed from the gastrointestinal tract after oral administration. It has a bioavailability of approximately 15% due to first-pass metabolism. The drug is absorbed and reaches peak plasma concentrations about 1 to 2 hours after ingestion.

Route of Elimination

Dexlansoprazole is metabolized primarily in the liver via the cytochrome P450 enzyme system (CYP2C19 and CYP3A4). The drug is excreted predominantly in the urine, with a smaller fraction eliminated in the feces. The elimination half-life of dexlansoprazole is approximately 1 to 2 hours.

Dosage

Dexlansoprazole dosing recommendations-

Maintenance of Healed erosive esophagitis and relief of heartburn: 30 mg Once daily
Symptomatic Non-Erosive GERD: 30 mg Once daily for 4 weeks
Healing of erosive esophagitis: 60 mg Once daily for up to 8 weeks

Dexlansoprazole MUPS dosing recommendations-

Maintenance of healed erosive esophagitis and relief of heartburn: One 30 mg tablet once daily for 6 months in adults and 16 weeks in patients 12 to 17 years of age
Symptomatic Non-Erosive GERD: One 30 mg tablet once daily for 4 weeks

The typical dosage for dexlansoprazole is:

GERD: 30 mg once daily for up to 4 weeks. Some patients may require up to 60 mg daily based on the severity of symptoms.
Erosive Esophagitis: 60 mg once daily for up to 8 weeks.
Peptic Ulcer Disease: 30 mg to 60 mg once daily, depending on the specific treatment regimen.

Dosage adjustments may be necessary based on individual patient response and the specific condition being treated.

Administration

Dexlansoprazole is administered orally, typically in the form of extended-release capsules. The capsules should be swallowed whole and not crushed or chewed. It can be taken with or without food, but it is usually recommended to be taken at the same time each day for consistent results.

Side Effects

Common side effects include:

Headache
Nausea
Diarrhea
Abdominal pain
Dizziness

Serious side effects are less common but may include severe allergic reactions, liver problems, or kidney issues. Seek medical attention if any severe reactions occur.

Toxicity

In cases of overdose, symptoms may include severe nausea, vomiting, or diarrhea. There is no specific antidote for dexlansoprazole overdose; treatment typically involves supportive care and symptom management. If overdose is suspected, contact a healthcare provider or poison control center immediately.

Precautions

Precautions include:

Use with caution in patients with liver impairment, as dose adjustments may be necessary.
Monitor for potential interactions with other medications metabolized by CYP2C19 or CYP3A4.
Long-term use may increase the risk of gastrointestinal infections, bone fractures, and vitamin B12 deficiency.

Regular monitoring and consultation with a healthcare provider are advised for patients on long-term therapy.

Interaction

Dexlansoprazole may interact with other medications, including:

Anticoagulants such as warfarin: May increase the risk of bleeding.
Other PPIs or H2-receptor antagonists: May reduce the effectiveness of dexlansoprazole.
Medications metabolized by CYP2C19 or CYP3A4: May require dose adjustments.

Inform your healthcare provider of all medications being taken to manage potential interactions.

Disease Interaction

Patients with:

Liver disease: May require dose adjustments or close monitoring.
Kidney disease: Should be monitored for potential accumulation or adverse effects.
Osteoporosis: Prolonged use may increase the risk of bone fractures.

Regular monitoring and consultation with a healthcare provider are advised for patients with these conditions.

Drug Interaction

Drug interactions may occur with:

Antifungal agents such as ketoconazole: May increase the blood levels of these drugs.
Antiretrovirals such as atazanavir: May decrease the effectiveness of these drugs.

Always inform your healthcare provider of all medications and supplements being used to manage potential interactions.

Food Interactions

There are no specific food interactions with dexlansoprazole. However, it is generally recommended to take the medication with a full glass of water and avoid taking it with food that may increase stomach acidity or cause gastrointestinal discomfort.

Pregnancy Use

Dexlansoprazole is classified as a Category B drug for pregnancy. This means that animal studies have not shown any risk to the fetus, but there are no well-controlled studies in pregnant women. Use during pregnancy should be considered only if the potential benefits outweigh the risks. Consult a healthcare provider before use.

Lactation Use

Dexlansoprazole is excreted in breast milk in small amounts. The potential risk to a nursing infant is considered low, but consult with a healthcare provider before using this medication while breastfeeding to ensure it is safe for both mother and infant.

Acute Overdose

Symptoms of acute overdose may include severe nausea, vomiting, and diarrhea. In the event of an overdose, seek immediate medical attention. Treatment typically involves supportive care and monitoring.

Contraindication

Dexlansoprazole is contraindicated in patients with:

Known hypersensitivity to dexlansoprazole or other PPIs.
Severe liver impairment without close monitoring and dose adjustments.

Avoid use in these conditions to prevent serious adverse effects.

Use Direction

Use dexlansoprazole exactly as prescribed by a healthcare provider. Follow the dosing instructions on the label or provided by the healthcare provider. Do not exceed the recommended dose and consult with a healthcare provider for any necessary adjustments based on individual needs and responses.

Storage Conditions

Store dexlansoprazole at room temperature, away from moisture and heat. Keep the medication in its original container with the lid tightly closed. Store out of reach of children and follow any additional storage instructions provided on the label.

Volume of Distribution

The volume of distribution for dexlansoprazole is approximately 1.2 to 1.8 L/kg. This reflects its distribution into the body's tissues and fluids.

Half Life

The half-life of dexlansoprazole is approximately 1 to 2 hours. This short half-life is typical for PPIs, and the effects of the drug last longer due to its mechanism of action.

Clearance

Dexlansoprazole is primarily cleared from the body through hepatic metabolism and renal excretion. The clearance rate may be reduced in patients with liver or kidney impairment, necessitating dose adjustments and careful monitoring.

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