Dexilant

Dexlansoprazole

Healing of all grades of erosive esophagitis (EE) for up to 8 wk in patients ≥12 yr. Maintain healing of EE & relief of heartburn for up to 6 mth in adults & 16 wk in patients 12-17 yr. Treatment of heartburn associated w/ symptomatic non-erosive GERD for 4 wk in patients ≥12 yr.

Patient ≥12 yr Healing of EE 60 mg once daily up to 8 wk. Maintenance of healed EE & relief of heartburn 30 mg once daily for 6 mth in adult & 16 wk in 12-17 yr. Symptomatic non-erosive GERD 30 mg once daily for 4 wk. Moderate hepatic impairment (Child-Pugh class B) 30 mg once daily up to 8 wk.

May be taken with or without food: Swallow whole. For patients w/ swallowing difficulties, open cap & sprinkle contents in 1 tbsp applesauce. Swallow immediately, do not chew. Alternatively, empty contents in 20 mL water & administer using oral syringe or via a nasogastric tube (≥16 French).

Hypersensitivity. Hypersensitivity reactions including anaphylaxis, anaphylactic shock, angioedema, bronchospasm, acute tubulointerstitial nephritis & urticaria. Concomitant use w/ rilpivirine-containing products.

Gastric malignancy. Discontinue use if acute tubulointerstitial nephritis develops; signs or symptoms of cutaneous or SLE are noted. Clostridium difficile-associated diarrhea. Increased risk for osteoporosis-related fractures of the hip, wrist or spine in patients receiving high-doses & long-term therapy (≥1 yr). Cyanocobalamin (vit B₁₂) deficiency. Monitor Mg levels prior to treatment & periodically for patients on prolonged treatment or medications eg, digoxin or drugs that may cause hypomagnesemia (eg, diuretics). Concomitant use w/ MTX. May cause false +ve results in diagnostic investigations for neuroendocrine tumors; temporarily stop treatment at least 14 days before assessing serum chromogranin A levels & repeat test if initial levels are high. Fundic gland polyps. Not recommended in severe hepatic impairment. Pregnancy & lactation. Not recommended in child <12 yr; risk of heart valve thickening in patients <2 yr. Not recommended for the treatment of symptomatic GERD in ped patients 1 mth-<1 yr.

Diarrhea, abdominal pain, nausea, URTI, vomiting & flatulence.

Decreased exposure of some antiretroviral drugs eg, rilpivirine, atazanavir & nelfinavir. Increased exposure of other antiretroviral drugs eg, saquinavir. Increased INR & prothrombin time w/ warfarin. May elevate & prolong serum conc of MTX &/or its metabolite hydroxymethotrexate, possibly leading to toxicities. Potential for increased exposure of digoxin. Reduced absorption of drugs dependent on gastric pH for absorption (eg, Fe salts, erlotinib, dasatinib, nilotinib, mycophenolate mofetil, ketoconazole/itraconazole). Potentially increased exposure of tacrolimus especially in transplant patients. Falsely suggesting gastrinoma in secretin simulation test due to hyper-response in gastrin secretion. False +ve urine screening tests for tetrahydrocannabinol. Decreased exposure w/ strong CYP2C19 or CYP3A4 inducers. Increased exposure w/ strong CYP2C19 or CYP3A4 inhibitors.

Antacids, Antireflux Agents & Antiulcerants

A02BC06 - dexlansoprazole ; Belongs to the class of proton pump inhibitors. Used in the treatment of peptic ulcer and gastro-oesophageal reflux disease (GERD).

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