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Lansoprazole

Also indexed as: Prevacid®

Lansoprazole is a “proton pump inhibitor” drug that blocks production of stomach acid. Lansoprazole is used to treat diseases in which stomach acid causes damage, including stomach and duodenal ulcers, esophagitis, and Zollinger-Ellison syndrome.

Interactions with Dietary Supplements

Beta-carotene
Omeprazole, a drug closely related to lansoprazole, taken for seven days led to a near-total loss of stomach acid in healthy people and interfered with the absorption of a single administration of 120 mg of beta-carotene.1 It is unknown whether repeated administration of beta-carotene would overcome this problem or if absorption of carotenoids from food would be impaired. Persons taking omeprazole and related acid-blocking drugs for long periods may want to have carotenoid blood levels checked, eat plenty of fruits and vegetables, and consider supplementing with carotenoids.

Folic acid
Folic acid is needed by the body to utilize vitamin B12. Antacids, including lansoprazole, inhibit folic acid absorption.2 People taking antacids are advised to supplement with folic acid.

Vitamin B12
Omeprazole, a drug closely related to lansoprazole, has interfered with the absorption of vitamin B12 from food (though not supplements) in some,3 4 but not all, studies.5 6 This interaction has not yet been reported with lansoprazole. However, a fall in vitamin B12 status may result from decreased stomach acid caused by acid blocking drugs, including lansoprazole.7

Interactions with Herbs

Cranberry (Vaccinium macrocarpon)
Omeprazole was shown to reduce protein-bound vitamin B12 absorption and cranberry juice was shown to increase protein-bound vitamin B12 absorption in eight people treated with omeprazole (a drug closely related to lansoprazole).8 While this effect has not been studied with lansoprazole, people taking lansoprazole may choose to drink cranberry juice or other acidic liquids with vitamin B12-containing foods. Unlike vitamin B12 found in food, vitamin B12 found in supplements is not bound to peptides (pieces of protein). The absorption of B12 supplements therefore does not require acid and is unlikely to be improved by drinking cranberry juice.

Interactions with Foods and Other Compounds

Food
The initial dose of lansoprazole should be taken 30 minutes before a meal.9 Subsequent doses are equally effective taken with or without food but should be taken at the same time every day.10 Capsules and granule contents should not be chewed or crushed. However, lansoprazole capsules may be opened, the granule contents sprinkled on one tablespoon of applesauce, then immediately swallowed.

Summary of Interactions for Lansoprazole

Depletion or interference Beta-carotene*
Folic acid
Vitamin B12* (dietary, not supplemental B12)
Adverse interaction None known
Side effect reduction/prevention None known
Supportive interaction Cranberry*
Reduced drug absorption/bioavailability None known

For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

References:

1. Tang G, Serfaty-Lacronsniere C, Camilo ME, Russell RM. Gastric acidity influences the blood response to a beta-carotene dose in humans. Am J Clin Nutr 1996;64:622–6.

2. Russell RM, Golner BB, Krasinski SD, et al. Effect of antacid and H2 receptor antagonists on the intestinal absorption of folic acid. J Lab Clin Med 1988;112:458–63.

3. Marcuard SP, Albernaz L, Khazanie PG. Omeprazole therapy causes malabsorption of cyanocobalamin (Vitamin B12). Ann Intern Med 1994;120:211–5.

4. Termanini B, Gibril F, Sutliff VE, et al. Effect of long-term gastric acid suppressive therapy on serum vitamin B12 levels in patients with Zollinger-Ellison syndrome. Am J Med 1998;104:422–30.

5. Koop H, Bachem MG. Serum iron, ferritin, and vitamin B12 during prolonged omeprazole therapy. J Clin Gastroenterol 1992;14:288–92.

6. Schenk BE, Festen HP, Kuipers EJ, et al. Effect of short-and long-term treatment with omeprazole on the absorption and serum levels of cobalamin. Aliment Pharmacol Ther 1996;10:541–5.

7. Saltzman JR, Kemp JA, Golner BB, et al. Effect of hypochlorhydria due to omeprazole treatment or atrophic gastritis on protein-bound vitamin B12 absorption. J Am Coll Nutr 1994;13:584–91.

8. Saltzman JR, Kemp JA, Golner BB, et al. Effect of hypochlorhydria due to omeprazole treatment or atrophic gastritis on protein-bound vitamin B12 absorption. J Am Coll Nutr 1994;13:584–91.

9. Brummer RJ, Geerling BJ, Stockbrugger RW. Initial and chronic gastric acid inhibition by lansoprazole and omeprazole in relation to meal administration. Dig Dis Sci 1997;42:2132–7.

10. Threlkeld DS, ed. Gastrointestinal Drugs, Proton Pump Inhibitors. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Apr 1998, 305r.