Lanso-D
Generic Name
Lansoprazole 30 mg + Domperidone 30 mg (SR)
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| lanso d 60 mg capsule | ৳ 18.00 | ৳ 180.00 |
Description
Overview of the medicine
Lanso-D 60 mg capsule is a combination medicine containing Lansoprazole (a proton pump inhibitor) and Domperidone (a prokinetic agent). It is used to treat conditions associated with excessive stomach acid production, gastroesophageal reflux disease (GERD), and dyspepsia, providing relief from symptoms like heartburn, acid regurgitation, and nausea.
Uses & Indications
Dosage
Adults
One Lanso-D 60 mg capsule once daily, preferably 15-30 minutes before breakfast. The dosage and duration of treatment should be determined by a physician based on the patient's condition.
Elderly
No specific dose adjustment is generally required, but caution is advised due to potential age-related decrease in renal or hepatic function.
Renal_impairment
No dose adjustment needed for Lansoprazole in mild to moderate renal impairment. Domperidone may require dose adjustment in severe renal impairment (e.g., dose reduction by 50% for eGFR < 30 mL/min).
How to Take
Take the capsule orally with water, preferably before a meal (e.g., breakfast). Do not chew or crush the capsule.
Mechanism of Action
Lansoprazole selectively inhibits the gastric H+/K+-ATPase enzyme system (proton pump) at the secretory surface of the parietal cells, thereby blocking the final step of acid production. Domperidone acts as a peripheral dopamine D2 receptor antagonist, increasing gastrointestinal motility and tone of the lower esophageal sphincter, and exerting anti-emetic effects by blocking dopamine receptors in the chemoreceptor trigger zone (CTZ).
Pharmacokinetics
Onset
Acid suppression effect of Lansoprazole starts within 1-2 hours. Prokinetic effect of Domperidone starts within 30-60 minutes.
Excretion
Lansoprazole metabolites are primarily excreted in feces (two-thirds) and urine (one-third). Domperidone is excreted mainly in feces (66%) and urine (33%).
Half life
Lansoprazole: approximately 1.5-2 hours. Domperidone: approximately 7-9 hours.
Absorption
Lansoprazole is rapidly absorbed after oral administration, with bioavailability around 80-90%. Domperidone is also rapidly absorbed, but undergoes extensive first-pass metabolism, resulting in low oral bioavailability (around 15%).
Metabolism
Lansoprazole is extensively metabolized in the liver, primarily by CYP2C19 and CYP3A4 enzymes. Domperidone is extensively metabolized in the liver by CYP3A4.
Side Effects
Contraindications
- Hypersensitivity to Lansoprazole, Domperidone, or any component of the formulation.
- Patients with moderate to severe hepatic impairment.
- Patients with known prolongation of cardiac QTc intervals, significant electrolyte disturbances, or underlying cardiac diseases (e.g., congestive heart failure).
- Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, clarithromycin).
- Patients with prolactin-releasing pituitary tumor (prolactinoma).
- Patients with gastrointestinal hemorrhage, mechanical obstruction, or perforation.
Drug Interactions
Warfarin
Increased INR/prothrombin time; monitor closely.
Tacrolimus
Increased plasma concentrations of tacrolimus.
Clopidogrel
Reduced antiplatelet effect of clopidogrel; consider alternative PPIs or antiplatelet therapy.
Methotrexate
Possible increased and prolonged exposure to methotrexate; consider temporary PPI withdrawal.
Anticholinergics
May antagonize the prokinetic effect of Domperidone.
Ketoconazole, Itraconazole, Digoxin, Iron Salts
Lansoprazole reduces gastric acidity, potentially affecting the absorption of pH-dependent drugs.
Strong CYP3A4 inhibitors (e.g., Ketoconazole, Erythromycin, Clarithromycin)
Increased plasma levels of Domperidone, increasing the risk of QTc prolongation. Concomitant use is contraindicated.
QTc-prolonging drugs (e.g., certain antiarrhythmics, antipsychotics, antidepressants)
Increased risk of QTc prolongation and cardiac arrhythmias. Concomitant use is contraindicated.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include drowsiness, disorientation, and extrapyramidal reactions (Domperidone), or gastrointestinal disturbances (Lansoprazole). Treatment is symptomatic and supportive. There is no specific antidote.
Pregnancy & Lactation
Lanso-D should be used during pregnancy only if clearly needed and the potential benefits outweigh the potential risks. Domperidone is excreted in breast milk; therefore, use is not recommended during breastfeeding unless the potential benefit to the mother outweighs the potential risk to the infant.
Side Effects
Contraindications
- Hypersensitivity to Lansoprazole, Domperidone, or any component of the formulation.
- Patients with moderate to severe hepatic impairment.
- Patients with known prolongation of cardiac QTc intervals, significant electrolyte disturbances, or underlying cardiac diseases (e.g., congestive heart failure).
- Concomitant use with strong CYP3A4 inhibitors (e.g., ketoconazole, erythromycin, clarithromycin).
- Patients with prolactin-releasing pituitary tumor (prolactinoma).
- Patients with gastrointestinal hemorrhage, mechanical obstruction, or perforation.
Drug Interactions
Warfarin
Increased INR/prothrombin time; monitor closely.
Tacrolimus
Increased plasma concentrations of tacrolimus.
Clopidogrel
Reduced antiplatelet effect of clopidogrel; consider alternative PPIs or antiplatelet therapy.
Methotrexate
Possible increased and prolonged exposure to methotrexate; consider temporary PPI withdrawal.
Anticholinergics
May antagonize the prokinetic effect of Domperidone.
Ketoconazole, Itraconazole, Digoxin, Iron Salts
Lansoprazole reduces gastric acidity, potentially affecting the absorption of pH-dependent drugs.
Strong CYP3A4 inhibitors (e.g., Ketoconazole, Erythromycin, Clarithromycin)
Increased plasma levels of Domperidone, increasing the risk of QTc prolongation. Concomitant use is contraindicated.
QTc-prolonging drugs (e.g., certain antiarrhythmics, antipsychotics, antidepressants)
Increased risk of QTc prolongation and cardiac arrhythmias. Concomitant use is contraindicated.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose may include drowsiness, disorientation, and extrapyramidal reactions (Domperidone), or gastrointestinal disturbances (Lansoprazole). Treatment is symptomatic and supportive. There is no specific antidote.
Pregnancy & Lactation
Lanso-D should be used during pregnancy only if clearly needed and the potential benefits outweigh the potential risks. Domperidone is excreted in breast milk; therefore, use is not recommended during breastfeeding unless the potential benefit to the mother outweighs the potential risk to the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 months
Availability
Pharmacies nationwide
Approval Status
Approved (Bangladesh)
Patent Status
Generic available
Clinical Trials
Clinical trials have demonstrated the efficacy and safety of Lansoprazole and Domperidone in their respective indications, as well as the benefits of their combination in treating gastroesophageal reflux disease and dyspepsia.
Lab Monitoring
- Regular monitoring of serum magnesium levels, especially in patients on long-term PPI therapy.
- Liver function tests in patients with hepatic impairment.
Doctor Notes
- Emphasize the cardiac risk associated with Domperidone, particularly in high-risk patients (elderly, pre-existing cardiac conditions, concomitant QTc-prolonging drugs or CYP3A4 inhibitors).
- Prescribe the lowest effective dose for the shortest duration necessary.
- Caution in patients with hepatic impairment (contraindicated in moderate to severe) and severe renal impairment (dose adjustment for Domperidone).
- Advise patients to report any cardiac symptoms or unusual side effects immediately.
Patient Guidelines
- Take the capsule whole with water; do not chew, crush, or open it.
- Take this medicine preferably before a meal.
- Inform your doctor about all other medications you are taking, especially strong CYP3A4 inhibitors or QTc-prolonging drugs.
- Report any chest pain, palpitations, or fainting immediately to your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. 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 visual disturbances. If you experience these symptoms, avoid driving or operating heavy machinery.
Lifestyle Advice
- Avoid foods that trigger heartburn or indigestion, such as fatty, spicy, or acidic foods.
- Eat smaller, more frequent meals.
- Avoid lying down immediately after eating and elevate the head of your bed.
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