Introduction
- Generic Name: Dexlansoprazole
- Brand Names: Dexilant, Kapidex
- Pharmacological Class: Proton pump inhibitor (PPI)
- Mechanism of Action: Reduces stomach acid production by selectively inhibiting the H+/K+ ATPase enzyme system at the gastric parietal cell surface.
Indications
- Primary Use: Treatment of gastroesophageal reflux disease (GERD) and associated symptoms like heartburn.
- Other Uses: Management of erosive esophagitis and maintenance of healed erosive esophagitis.
Dosage
- Adults: 30 mg or 60 mg once daily for up to 8 weeks for acute management and up to 6 months for maintenance.
- Elderly: No adjustment necessary under normal renal and hepatic function.
- Children: Safety and efficacy have not been established in patients under 18 years of age.
Administration
- Method: Oral intake.
- Precautions: Swallow capsules whole; do not chew or crush. Can be taken with or without food.
Forms Available
- Delayed-Release Capsules: 30 mg, 60 mg
Side Effects
- Common: Diarrhea, abdominal pain, nausea, upper respiratory infection.
- Less Common: Flatulence, dizziness, dry mouth.
- Rare but Serious: Clostridium difficile-associated diarrhea, osteoporosis-related fractures, hypomagnesemia.
Warnings
- Risk of Long-term Use: Increased risk of osteoporosis-related fractures with long-term and multiple daily dose therapy.
- Contraindications: Hypersensitivity to dexlansoprazole or other proton pump inhibitors.
Precautions
- General: Monitor for signs of gastrointestinal infections and magnesium levels if taking long-term.
- Health Conditions: Caution in patients with severe liver impairment and risk for osteoporosis.
Interactions
- Medications: Can reduce the effectiveness of clopidogrel. Avoid concomitant use with HIV protease inhibitors.
- Food: No significant food interactions; however, absorption may be affected by food intake.
Monitoring Parameters
- Bone Health: Monitor bone density for long-term users.
- Magnesium Levels: Regular monitoring recommended, especially with prolonged use.
Use in Children
- Guidelines: Not recommended for use in individuals under 18 years of age.
Use in Pregnancy
- FDA Category: B. Animal studies have not shown harm, but human studies are lacking. Use only if clearly needed.
Use in Elderly
- Considerations: Generally well-tolerated, but cautious use recommended due to increased risk of bone fractures.
Use in Kidney Disease
- Adjustments: Generally safe, but use cautiously in severe renal impairment.
Use in Liver Disease
- Caution: Dose adjustments may be necessary in severe hepatic conditions; monitor liver enzymes periodically.
Patient Counselling Points
- Medication Use: Importance of taking as prescribed, not exceeding the recommended duration without medical advice.
- Side Effects: Report any severe diarrhea, bone pain, or signs of low magnesium like muscle cramps or tremors.
- Lifestyle: Advise on dietary management of GERD symptoms, such as avoiding trigger foods and eating smaller, more frequent meals.
Table of Brand Names, Manufacturer, and Prices in USD
Brand Name | Manufacturer | Strength/Dosage Form | Price (USD) |
---|
Dexilant | Takeda | 30 mg Capsule | $3.00 |
Kapidex | Takeda | 60 mg Capsule | $3.50 |
15 FAQs with Answers
- What is Dexlansoprazole used for? – Primarily to treat GERD and maintain healed erosive esophagitis.
- Can Dexlansoprazole cause side effects? – Common side effects include diarrhea and abdominal pain.
- How should Dexlansoprazole be taken? – Swallow capsules whole, once daily, with or without food.
- What are the serious side effects of Dexlansoprazole? – Includes osteoporosis-related fractures and hypomagnesemia.
- Is Dexlansoprazole safe during pregnancy? – Category B, use only if clearly needed.
- Can Dexlansoprazole be taken with alcohol? – Alcohol may exacerbate GERD symptoms; best avoided.
- What does Dexlansoprazole interact with? – Reduces the effectiveness of clopidogrel and some HIV medications.
- What should I avoid while taking Dexlansoprazole? – Avoid taking with medications that require acidic pH for absorption.
- What are signs of a Dexlansoprazole overdose? – Symptoms may include confusion, flushed skin, and increased heart rate.
- Is Dexlansoprazole addictive? – No, but it should be used as directed by a healthcare professional.
- Should I stop taking Dexlansoprazole suddenly? – Consult with a healthcare provider before discontinuing to avoid rebound acid secretion.
- What are the rare but serious side effects of Dexlansoprazole? – Can include serious intestinal infections and severe magnesium deficiency.
- What other medications interact with Dexlansoprazole? – Can interact significantly with drugs that depend on stomach pH for absorption.
- Who should not take Dexlansoprazole? – Individuals with known hypersensitivity to PPIs or who are taking clopidogrel.
- How does Dexlansoprazole work to treat GERD? – It inhibits the stomach’s acid pumps to decrease the production of acid.