Za Pharmacy
Drugs, Supplies and Delivery
Dexlansoprazole
Dexlansoprazole is a proton pump inhibitor (PPI) and the R-enantiomer of lansoprazole. It is specifically designed to provide prolonged acid suppression with a unique dual delayed-release formulation. Dexlansoprazole is used to treat conditions such as gastroesophageal reflux disease (GERD) and erosive esophagitis. This article synthesizes information from the British National Formulary (BNF), Lippincott Textbook of Pharmacology, and Lange Basic & Clinical Pharmacology to provide a detailed overview of dexlansoprazole, including its mechanism, uses, dosing, side effects, precautions, and drug interactions
Dexlansoprazole is a prodrug that is activated in the acidic environment of the stomach. It irreversibly inhibits the H+/K+-ATPase (proton pump) on the secretory surface of gastric parietal cells. By blocking this enzyme, dexlansoprazole:
- Reduces basal and stimulated gastric acid secretion, including acid secretion induced by food, histamine, and gastrin.
- Increases gastric pH, promoting healing of acid-related damage and providing symptomatic relief (Lippincott, Lange).
Dexlansoprazole’s dual delayed-release formulation allows for two separate releases of the drug, providing prolonged acid suppression over 24 hours (BNF).
- Gastroesophageal Reflux Disease (GERD):
- Provides symptomatic relief and promotes healing of erosive esophagitis (BNF).
- Non-Erosive GERD:
- Used for the management of heartburn and regurgitation in patients without esophageal erosion (Lippincott).
- GERD and Erosive Esophagitis:
- 30–60 mg once daily for up to 8 weeks (BNF).
- Maintenance of Healed Erosive Esophagitis:
- 30 mg once daily (Lippincott).
Administration:
- Can be taken with or without food.
- Capsules should be swallowed whole; do not crush or chew (Lange).
- Common: Headache, nausea, diarrhea, and abdominal pain (Lippincott).
- Serious:
- Hypomagnesemia: Prolonged use may lead to low magnesium levels.
- Increased Risk of Infections: Higher risk of Clostridioides difficile and pneumonia.
- Bone Fractures: Long-term use may increase the risk of osteoporosis-related fractures (BNF).
- Hypomagnesemia: Monitor magnesium levels in patients on long-term therapy (Lippincott).
- Vitamin B12 Deficiency: Prolonged use may reduce vitamin B12 absorption; monitor levels in at-risk patients (Lange).
- Pregnancy: Use only if benefits outweigh risks; limited data available (BNF).
- Liver Impairment: Dose reduction may be necessary in patients with severe hepatic impairment (Lippincott).
- Clopidogrel: Dexlansoprazole may reduce the antiplatelet effects of clopidogrel by inhibiting CYP2C19 (BNF).
- Warfarin: Increased risk of bleeding due to altered metabolism (Lippincott).
- Diazepam and Phenytoin: Dexlansoprazole may increase levels of these drugs by inhibiting CYP2C19 (Lange).
- Methotrexate: Dexlansoprazole may increase methotrexate levels, raising the risk of toxicity (BNF).
Dexlansoprazole is the generic name for this medication. It is marketed under the brand name Dexilant®. Generic versions are also available, making it more accessible for patients.
