Proton Pump Inhibitor (PPI) Pregnancy: There is a limited amount of data from use in pregnant women; animal studies do not indicate direct or indirect harmful effects. As a precautionary measure, it is preferable to avoid the use of lansoprazole during pregnancy. Breast-feeding: it is not known whether lansoprazole is excreted in human breast milk (it is excreted in animal milk); a decision to continue/discontinue breast-feeding or therapy should weigh the respective benefits.

Lansoprazole

Brand names: Zoton FasTab

Lansoprazole is a proton-pump inhibitor used for gastro-oesophageal reflux disease, peptic ulcer disease, as part of Helicobacter pylori eradication, and for gastroprotection.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 30 mg (15 mg for prophylactic / maintenance indications)

Route: Oral — capsules swallowed whole with liquid, at least 30 minutes before food; capsules may be emptied but the contents must not be chewed or ground

Frequency: Once daily in the morning; twice daily (morning and evening) for H. pylori eradication

Max: Zollinger-Ellison syndrome: daily doses of up to 180 mg have been used; if the required daily dose exceeds 120 mg it should be given in two divided doses. Elderly: a daily dose of 30 mg should not be exceeded unless there are compelling clinical indications.

Dose by indication (UK SPC §4.2). Duodenal ulcer: 30 mg once daily for 2 weeks; if not fully healed, continue at the same dose for another 2 weeks. Gastric ulcer: 30 mg once daily for 4 weeks; may be continued at the same dose for another 4 weeks. Reflux oesophagitis: 30 mg once daily for 4 weeks; may be continued for another 4 weeks. Prophylaxis of reflux oesophagitis: 15 mg once daily, increased up to 30 mg daily as necessary. H. pylori eradication: 30 mg twice daily for 7 days, in combination with either clarithromycin 250-500 mg twice daily + amoxicillin 1 g twice daily, or clarithromycin 250 mg twice daily + metronidazole 400-500 mg twice daily (a lansoprazole 30 mg bd + amoxicillin 1 g bd + metronidazole 400-500 mg bd regimen has also been examined but gave lower eradication rates); follow official local guidance on resistance and duration (most commonly 7 days, sometimes up to 14 days). Treatment of NSAID-associated benign gastric and duodenal ulcers in patients requiring continued NSAID treatment: 30 mg once daily for 4 weeks, may continue for another 4 weeks; a longer course and/or higher dose may be needed for at-risk or difficult-to-heal ulcers. Prophylaxis of NSAID-associated gastric and duodenal ulcers in patients at risk (e.g. age over 65 or history of gastric or duodenal ulcer) requiring prolonged NSAID treatment: 15 mg once daily; if treatment fails, 30 mg once daily. Symptomatic gastro-oesophageal reflux disease: 15 mg or 30 mg daily, individually adjusted; if symptoms are not relieved within 4 weeks on 30 mg daily, further examinations are recommended. Zollinger-Ellison syndrome: recommended initial dose 60 mg once daily, individually adjusted, continued for as long as necessary. Hepatic impairment: patients with moderate or severe liver disease should be kept under regular supervision and a 50% reduction of the daily dose is recommended. Elderly: reduced clearance may require dose adjustment based on individual requirements. Paediatric: the UK SPC states that use is NOT recommended in children as clinical data are limited, and that treatment of small children below one year of age should be avoided. (For reference only, the US label gives paediatric dosing for symptomatic GERD/erosive oesophagitis: 1-11 years, 15 mg once daily if 30 kg or less and 30 mg once daily if over 30 kg, for up to 12 weeks; 12-17 years, 15 mg once daily for non-erosive GERD or 30 mg once daily for erosive oesophagitis for up to 8 weeks — this is NOT authorised in the UK SPC.)

Dose adjustments

Renal

There is no need for a dose adjustment in patients with impaired renal function (UK SPC §4.2).

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Recommended Dosage: See full prescribing information for complete dosing information for lansoprazole delayed-release capsules by indication and age group and dosage adjustment in patients with severe hepatic impairment. ( 2.1 , 2.2 , 2.3 ) Administration Instructions ( 2.4 ) Lansoprazole delayed-release capsules Should be swallowed whole. See full prescribing information for alternative administration options 2.1 Recommended Adult Dosage by Indication Indication Recommended Dose Frequency Duodenal Ulcers Short-Term Treatment 15 mg Once daily for 4 weeks Maintenance of Healed 15 mg Once daily Eradication of H. pylori to Reduce the Risk of Duodenal Ulcer Recurrence* Triple Therapy: …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2022-04-15. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Contraindications

Hypersensitivity to the active substance or to any of the excipients (UK SPC §4.3)
US labelling additionally contraindicates concomitant use with rilpivirine-containing products

Side effects

Headache and dizziness (common)
Nausea, diarrhoea, stomach ache, constipation, vomiting, flatulence, dry mouth or throat (common)
Benign fundic gland polyps (common)
Increase in liver enzyme levels; urticaria, itching, rash; fatigue (common)
Hypomagnesaemia (rare) — reported after at least three months and usually a year of PPI therapy; may present as fatigue, tetany, delirium, convulsions, dizziness or ventricular arrhythmia
Fracture of the hip, wrist or spine (rare); interstitial nephritis (very rare); Stevens-Johnson syndrome and toxic epidermal necrolysis (very rare)

Interactions

HIV protease inhibitors whose absorption depends on acidic intragastric pH, such as atazanavir and nelfinavir — co-administration is not recommended due to significant reduction in their bioavailability
Rilpivirine-containing products — concomitant use is contraindicated (US label)
Saquinavir — exposure may be increased when used with lansoprazole, potentially increasing toxicity (US label)
Vitamin B12 (cyanocobalamin) — absorption may be reduced due to hypo- or achlorhydria; consider in patients with reduced body stores or on long-term therapy
Sucralfate — take lansoprazole at least 30 minutes before sucralfate; antacids may be used concomitantly (US label)
Digoxin and drugs that may cause hypomagnesaemia — consider magnesium monitoring in patients expected to be on prolonged PPI treatment
Full UK SPC §4.5 was truncated in the fetched source — check the complete interactions section

Clinical monograph

How it works

It irreversibly inhibits the gastric H-K-ATPase (proton pump) in parietal cells, strongly reducing gastric acid secretion.

Prescribing in practice

Use the lowest effective dose for the shortest appropriate duration; review long-term use.
Long-term effects can include low magnesium, reduced vitamin B12 absorption, and a small increase in some infections and fractures.
It can mask the symptoms of gastric cancer — investigate alarm features before attributing them to reflux.

Monitoring

No routine monitoring for short courses; consider checking magnesium with long-term use or with other magnesium-lowering drugs, and review the ongoing need periodically.

Counselling the patient

Take it before food (typically 30–60 minutes before a meal).
Tell your clinician about difficulty swallowing, unintended weight loss, or black stools.

Evidence & guidelines

PPIs are first-line for GORD and peptic ulcer disease and for NSAID-associated gastroprotection in at-risk patients (NICE guidance).

Reference: NICE CG17 GORD; NICE NG12 H. pylori; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

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