Lanso-D
Generic Name
Lansoprazole + Domperidone
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| lanso d 30 mg capsule | ৳ 10.00 | ৳ 100.00 |
Description
Overview of the medicine
Lanso-D 30 mg capsule is a combination medication containing Lansoprazole (a proton pump inhibitor) and Domperidone (a prokinetic agent). It is used to treat gastroesophageal reflux disease (GERD), dyspepsia, and other conditions involving excess stomach acid and impaired gut motility.
Uses & Indications
Dosage
Adults
One capsule once daily, typically 15-30 minutes before breakfast, or as directed by the physician.
Elderly
Generally, the same as adults, but caution is advised in patients with underlying cardiac or hepatic impairment. Dose adjustment may be needed based on renal/hepatic function.
Renal_impairment
No dose adjustment is usually required for Lansoprazole in mild-to-moderate renal impairment. For Domperidone, the dose should be reduced to 1-2 times daily in severe renal impairment (CrCl < 30 mL/min).
How to Take
Take orally, preferably 15-30 minutes before a meal (usually breakfast). Swallow the capsule whole with water; do not chew or crush it.
Mechanism of Action
Lansoprazole irreversibly blocks the H+/K+-ATPase pump in gastric parietal cells, thereby reducing gastric acid secretion. Domperidone blocks peripheral dopamine D2 receptors in the chemoreceptor trigger zone and in the gut wall, increasing esophageal peristalsis, lower esophageal sphincter pressure, and accelerating gastric emptying.
Pharmacokinetics
Onset
Lansoprazole: 1-2 hours for acid suppression. Domperidone: 30-60 minutes.
Excretion
Lansoprazole: Primarily biliary/fecal (67%), renal (33%). Domperidone: Primarily fecal (66%), renal (33%).
Half life
Lansoprazole: 1.5-2 hours (plasma, but acid suppression lasts >24 hours). Domperidone: 7-9 hours.
Absorption
Lansoprazole: Rapidly absorbed, high bioavailability (80-90%). Domperidone: Rapidly absorbed, low oral bioavailability (15%) due to extensive first-pass metabolism.
Metabolism
Lansoprazole: Hepatic (CYP2C19, CYP3A4). Domperidone: Hepatic (CYP3A4).
Side Effects
Contraindications
- Hypersensitivity to Lansoprazole, Domperidone, or any components of the formulation
- Patients with gastrointestinal hemorrhage, mechanical obstruction, or perforation
- Patients with a prolactin-releasing pituitary tumor (prolactinoma)
- Moderate to severe hepatic impairment (for Domperidone)
- Concomitant use with QT-prolonging drugs or potent CYP3A4 inhibitors
Drug Interactions
Clopidogrel
Reduced antiplatelet effect of clopidogrel due to CYP2C19 inhibition by lansoprazole.
Atazanavir, Nelfinavir
Reduced absorption and efficacy of these antivirals due to increased gastric pH by lansoprazole.
Ketoconazole, Itraconazole
Reduced absorption due to increased gastric pH by lansoprazole.
QT-prolonging drugs (e.g., Amiodarone, Erythromycin)
Increased risk of cardiac arrhythmias with domperidone.
Strong CYP3A4 inhibitors (e.g., Ketoconazole, Ritonavir)
Increased plasma levels of domperidone, raising the risk of QT prolongation.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include drowsiness, disorientation, extrapyramidal reactions (Domperidone), tachycardia, and gastrointestinal disturbances. Management is symptomatic and supportive. There is no specific antidote. Gastric lavage and activated charcoal may be considered within an hour of ingestion.
Pregnancy & Lactation
Pregnancy: Lansoprazole is Pregnancy Category B. Use only if clearly needed. Domperidone is Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Lactation: Domperidone is excreted in breast milk and can cause adverse effects in the infant; therefore, it is not recommended during breastfeeding unless the expected benefits to the mother outweigh the potential risks to the infant.
Side Effects
Contraindications
- Hypersensitivity to Lansoprazole, Domperidone, or any components of the formulation
- Patients with gastrointestinal hemorrhage, mechanical obstruction, or perforation
- Patients with a prolactin-releasing pituitary tumor (prolactinoma)
- Moderate to severe hepatic impairment (for Domperidone)
- Concomitant use with QT-prolonging drugs or potent CYP3A4 inhibitors
Drug Interactions
Clopidogrel
Reduced antiplatelet effect of clopidogrel due to CYP2C19 inhibition by lansoprazole.
Atazanavir, Nelfinavir
Reduced absorption and efficacy of these antivirals due to increased gastric pH by lansoprazole.
Ketoconazole, Itraconazole
Reduced absorption due to increased gastric pH by lansoprazole.
QT-prolonging drugs (e.g., Amiodarone, Erythromycin)
Increased risk of cardiac arrhythmias with domperidone.
Strong CYP3A4 inhibitors (e.g., Ketoconazole, Ritonavir)
Increased plasma levels of domperidone, raising the risk of QT prolongation.
Storage
Store in a cool, dry place below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include drowsiness, disorientation, extrapyramidal reactions (Domperidone), tachycardia, and gastrointestinal disturbances. Management is symptomatic and supportive. There is no specific antidote. Gastric lavage and activated charcoal may be considered within an hour of ingestion.
Pregnancy & Lactation
Pregnancy: Lansoprazole is Pregnancy Category B. Use only if clearly needed. Domperidone is Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Lactation: Domperidone is excreted in breast milk and can cause adverse effects in the infant; therefore, it is not recommended during breastfeeding unless the expected benefits to the mother outweigh the potential risks to the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, refer to the package for exact expiry date.
Availability
Pharmacies, Hospitals
Approval Status
Approved by regulatory authorities
Patent Status
Generic available
Clinical Trials
Both Lansoprazole and Domperidone have undergone extensive clinical trials individually and in combination to establish their efficacy and safety in treating gastrointestinal disorders.
Lab Monitoring
- Liver function tests (especially in patients with hepatic impairment, particularly for Domperidone)
- Magnesium levels (for patients on long-term PPI therapy, due to risk of hypomagnesemia)
- ECG monitoring (especially in patients with cardiac risk factors or on higher doses of Domperidone)
Doctor Notes
- Exercise caution when prescribing Domperidone, especially in elderly patients, those with a history of cardiac disease, or concurrent use of QT-prolonging drugs.
- Consider baseline ECG and potassium/magnesium levels for high-risk patients on Domperidone.
- For long-term PPI therapy, regularly assess the need for continued treatment and monitor for potential adverse effects like hypomagnesemia.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Do not stop taking the medicine suddenly without consulting your doctor.
- Inform your doctor about all other medications you are taking, including over-the-counter drugs and herbal supplements.
- Report any new or worsening symptoms, especially cardiac symptoms like palpitations or fainting, to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
This medicine may cause dizziness or somnolence. If you experience these effects, avoid driving or operating machinery until you know how the medicine affects you.
Lifestyle Advice
- Avoid trigger foods such as spicy, fatty, or acidic foods.
- Eat smaller, more frequent meals instead of large ones.
- Avoid lying down immediately after meals.
- Elevate the head of your bed to reduce reflux symptoms at night.
- Avoid smoking and excessive alcohol consumption, as these can worsen GERD symptoms.
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