Dexlansoprazole

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 NameManufacturerStrength/Dosage FormPrice (USD)
DexilantTakeda30 mg Capsule$3.00
KapidexTakeda60 mg Capsule$3.50

15 FAQs with Answers

  1. What is Dexlansoprazole used for? – Primarily to treat GERD and maintain healed erosive esophagitis.
  2. Can Dexlansoprazole cause side effects? – Common side effects include diarrhea and abdominal pain.
  3. How should Dexlansoprazole be taken? – Swallow capsules whole, once daily, with or without food.
  4. What are the serious side effects of Dexlansoprazole? – Includes osteoporosis-related fractures and hypomagnesemia.
  5. Is Dexlansoprazole safe during pregnancy? – Category B, use only if clearly needed.
  6. Can Dexlansoprazole be taken with alcohol? – Alcohol may exacerbate GERD symptoms; best avoided.
  7. What does Dexlansoprazole interact with? – Reduces the effectiveness of clopidogrel and some HIV medications.
  8. What should I avoid while taking Dexlansoprazole? – Avoid taking with medications that require acidic pH for absorption.
  9. What are signs of a Dexlansoprazole overdose? – Symptoms may include confusion, flushed skin, and increased heart rate.
  10. Is Dexlansoprazole addictive? – No, but it should be used as directed by a healthcare professional.
  11. Should I stop taking Dexlansoprazole suddenly? – Consult with a healthcare provider before discontinuing to avoid rebound acid secretion.
  12. What are the rare but serious side effects of Dexlansoprazole? – Can include serious intestinal infections and severe magnesium deficiency.
  13. What other medications interact with Dexlansoprazole? – Can interact significantly with drugs that depend on stomach pH for absorption.
  14. Who should not take Dexlansoprazole? – Individuals with known hypersensitivity to PPIs or who are taking clopidogrel.
  15. How does Dexlansoprazole work to treat GERD? – It inhibits the stomach’s acid pumps to decrease the production of acid.