"Lantsid": instructions for use, description of the drug, analogues, reviews

Lancid is a drug (capsules) that corresponds to the group of drugs used for conditions associated with acidity disorders. The instructions for use highlight the following features:

How to dissolve vascular plaques, normalize blood circulation, blood pressure and forget the way to the pharmacy

• Sold only with a doctor's prescription
• During pregnancy: contraindicated
• When breastfeeding: contraindicated
• In childhood: with caution
• For liver dysfunction: with caution
• In old age: with caution

Compound

One Lancid capsule, depending on the dosage, may contain 15 or 30 mg of lansoprazole.

List of excipients

Mannitol, lactose monohydrate, sucrose, povidone, hypromellose phthalate, cetyl alcohol.

List of hard gelatin capsule ingredients

Included in the body and cap: gelatin, sodium lauryl sulfate, propyl parahydroxybenzoate, methyl parahydroxybenzoate, titanium dioxide, water. Dyes differ depending on the dosage: 15 mg - brilliant blue dye, quinoline yellow dye are used; 30 mg - crimson dye (Ponceau 4R).

Pharmacodynamics and pharmacokinetics

Lancid is highly lipophilic and is able to easily penetrate the cells of the stomach, concentrate in them and protect, increasing the secretion of bicarbonates. In addition, the formation of hydrochloric acid slows down even when using a therapeutic dose of 30 mg (by 80–97%), without affecting gastrointestinal motility. An increase in effect is observed on days 1-4 and when the drug is discontinued, secretory activity is gradually restored.

Pharmacokinetic information

Absorption is high and the maximum concentration when taking 30 mg is observed after 1.5–2 hours and reaches 0.75–1.15 mg/l. Binding in the blood occurs by 98%. The half-life is from 1.3 to 1.7 hours. Metabolism is active in the liver, excretion of metabolites by the kidneys (14–23%), the rest through the intestines.

Side effects

• Digestive system: increased or decreased appetite, nausea, abdominal pain, diarrhea or constipation, development of ulcerative colitis, candidiasis, hyperbilirubinemia.
• Nervous system: headache, malaise, dizziness, depression, drowsiness, anxiety.
• Respiratory system: cough, pharyngitis, upper respiratory tract infections, rhinitis, flu-like syndrome.
• Hematopoietic organs: thrombocytopenia, complicated by hemorrhagic manifestations, anemia.
• Allergic side reactions: photosensitivity, skin rash, erythema multiforme.
• Other: myalgia, alopecia.

special instructions

Before starting therapy, it is necessary to exclude the presence of a malignant process (especially with a stomach ulcer), since treatment, masking symptoms, can delay the correct diagnosis.

• Clarithromycin. Long-term use of antibiotics can lead to the formation of colonies with an increased number of insensitive bacteria and fungi. In case of superinfection, appropriate therapy must be prescribed. Liver dysfunction (increased concentrations of liver enzymes in the blood plasma, hepatocellular and/or cholestatic hepatitis with or without jaundice) has been reported with the use of clarithromycin. Liver dysfunction can be severe but is usually reversible. There have been cases of fatal liver failure, mainly associated with the presence of serious concomitant diseases and/or concomitant use of other drugs. If signs and symptoms of hepatitis such as anorexia appear. jaundice, darkening of urine, abdominal tenderness on palpation, it is necessary to immediately stop clarithromycin therapy. In the presence of chronic liver diseases, regular monitoring of blood plasma enzymes is necessary. During treatment with almost all antibacterial agents, including clarithromycin, cases of pseudomembranous colitis have been described, the severity of which can vary mild to life-threatening. Antibacterial drugs can change the normal intestinal microflora, which can lead to the growth of Clostridium difficile. Pseudomembranous colitis caused by Clostridium difficile should be suspected in all patients who experience diarrhea after using antibacterial agents. After a course of antibiotic therapy, careful medical monitoring of the patient is necessary. Cases of the development of pseudomembranous colitis have been described 2 months after taking antibiotics. Clarithromycin should be used with caution in patients with coronary heart disease (CHD), severe heart failure, hypomagnesemia, severe bradycardia (less than 50 beats/min), as well as when used simultaneously with antiarrhythmic drugs drugs of class IA (quinidine, procainamide) and class III (dofetilide, amiodarone, sotalol). In these conditions and while taking clarithromycin with these drugs, you should regularly monitor the electrocardiogram for an increase in the QT interval. It is possible to develop cross-resistance to clarithromycin and other macrolide antibiotics, as well as lincomycin and clindamycin. In the event of acute hypersensitivity reactions, such as anaphylactic reaction, Stevens-Johnson syndrome, toxic epidermal necrolysis, drug rash with eosinophilia and systemic symptoms (DRESS syndrome), Henoch-Schönlein purpura, discontinue clarithromycin immediately and initiate appropriate therapy. Worsening of symptoms has been reported in patients taking clarithromycin myasthenia gravis. In case of combined use with warfarin or other indirect anticoagulants, it is necessary to monitor MHO and prothrombin time.
• Amoxicillin: Before starting amoxicillin, it is necessary to obtain a detailed history regarding previous hypersensitivity reactions to penicillins, cephalosporins or other allergens. Serious and sometimes fatal hypersensitivity reactions (anaphylactic reactions) to penicillins have been described. The risk of such reactions is highest in patients with a history of hypersensitivity reactions to penicillins. If allergic reactions occur, you must stop taking amoxicillin and start therapy with an antibiotic from a different group. In case of serious hypersensitivity reactions, appropriate measures should be taken immediately. Epinephrine administration, oxygen therapy, intravenous corticosteroids, and airway management, including intubation, may also be required. It is necessary to refrain from using amoxicillin if infectious mononucleosis is suspected, since in patients with this disease, amoxicillin can cause a morbilliform skin rash, making diagnosis difficult. Long-term treatment amoxicillin sometimes leads to excessive proliferation of insensitive microorganisms. During the use of amoxicillin, it is recommended to periodically evaluate renal, liver and hematopoietic function. Amoxicillin should be used with caution in patients with impaired liver function. Liver function should be monitored on a regular basis. In patients with impaired renal function, the dose of amoxicillin should be reduced according to the degree of impairment. Amoxicillin can provoke nonspecific binding of immunoglobulins and albumins to the red blood cell membrane, which can cause a false-positive reaction in the Coombs test. Crystalluria very rarely occurs in patients with reduced diuresis. When carrying out amoxicillin therapy, adequate fluid intake and maintaining sufficient diuresis are extremely important. In patients with cholangitis or cholecystitis, antibiotics can be prescribed only if the disease is mild and in the absence of cholestasis. During therapy with amoxicillin, it is necessary to remember the possible development of superinfection (usually caused by bacteria of the genus Pseudomonas spp. or fungi of the genus Candida). In this case, amoxicillin therapy should be discontinued and/or appropriate treatment should be prescribed. If severe diarrhea persists, antibiotic-induced pseudomembranous colitis, which may be life-threatening, should be suspected (watery stool mixed with blood and mucus; dull widespread or colicky abdominal pain; fever, sometimes tenesmus). In such cases, amoxicillin should be immediately discontinued and pathogen-specific treatment, such as vancomycin, should be prescribed. In this case, drugs that reduce gastrointestinal perilstatics are contraindicated. The excretion of amoxicillin leads to its high content in the urine, which can lead to false-positive results when determining glucose in urine (for example, Benedict's test, Fehling's test). In this case, it is recommended to use the glucose oxidase method for determining the concentration of glucose in the urine. If simultaneous use of amoxicillin with anticoagulants is necessary, prothrombin time or INR should be carefully monitored when prescribing or discontinuing amoxicillin. When using estrogen-containing oral contraceptives and amoxicillin simultaneously, other or additional methods should be used if possible contraception. Particular caution is recommended for patients with allergic diathesis or bronchial asthma, a history of gastrointestinal diseases (in particular, colitis caused by antibiotic treatment). When taking amoxicillin for a long time, nystatin, levorin or other antifungal drugs should be prescribed simultaneously. During treatment It is not recommended to drink alcohol.
• Lansoprazole. It is recommended to avoid the combined use of proton pump inhibitors and clopidogrel. When used together, the risk of recurrent myocardial infarction, hospitalization for a heart attack or unstable angina, stroke, and repeated revascularization increases. If co-administration is absolutely necessary, patients should be closely monitored. It is recommended to avoid the combined use of proton pump inhibitors and antiretroviral drugs in HIV-infected patients. If combined use with atazanavir/ritonavir is necessary, it is recommended to maintain a 12-hour interval between taking lansoprazole and these drugs, and not to exceed the dose of lansoprazole 30 mg. When used together with antiretroviral drugs (indinavir, nelfinavir, atazanavir), as well as ketoconazole, itraconazole, posaconazole, cefpodoxime, cefuroxime and ampicillin, monitoring for their effectiveness and the emergence of resistance is necessary. Concomitant use with imatinib may increase the risk of adverse reactions (potential interaction via CYP3A4), especially in individuals with a history of severe allergic reactions. Due to the increased risk of myotoxicity, patients patients taking atorvastatin, lovastatin or simvastatin should be carefully monitored during concomitant use of lansoprazole. In patients taking concomitant warfarin, prothrombin time and MHO should be monitored. Long-term use of proton pump inhibitors increases the risk of infection (including Salmonella, Campylobacter, Clostridium difficile). The benefit of preventing bleeding from the upper gastrointestinal tract must be weighed against the potential risk of developing ventilator-associated pneumonia. Long-term use of proton pump inhibitors increases the risk of fractures in women during menopause. During treatment, alcohol should be avoided. Pharmacogenetic factor. The effectiveness of the drug depends on the genetic polymorphism of CYP2C19. In patients classified as “slow metabolizers” (RM-type), the effectiveness is higher; eradication of Helicobacter pylori is significantly more often achieved compared to “fast metabolizers” (homEM-type), even against the background of resistance to clarithromycin. “O syndrome if recommendations are followed.” The duration of use is not typical for lansoprazole.

Effect on the ability to drive machinery and a car. During treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions, as the drug can cause weakness, drowsiness and dizziness.

Lancid, instructions for use (method and dosage)

Capsules should be taken orally, swallowed and without chewing.

Recommended daily dose and course for various diseases

• ulcerative defects in the stomach and duodenum and stress ulcers: 30 mg in the morning, before meals; the course usually lasts 2-4 weeks;
• varying degrees of erosive-ulcerative esophagitis: 30-60 mg; the course usually lasts 4-8 weeks;
• reflux esophagitis: 30 mg 4 weeks;
• tumors in the islet apparatus of the pancreas: the dose must be selected individually in order to achieve a level of basal acid production of no more than 10 millimol/h;
• eradication of Helicobacter pylori - 60 mg, divided into 2 doses in combination with antibiotics, for example: Clarithromycin Amoxicillin, estimated course - 1 week;
• non-ulcer indigestion: 15-30 mg for 2-4 weeks.

Correction for special patient groups

These include elderly patients, as well as those suffering from liver failure - treatment is initially carried out using half the dose, and then gradually increased to at least 30 mg.

Reviews

Most patients speak only positively about the drug Lancid (analogues of the medication were presented above). Consumers claim that after several days of treatment, the unpleasant symptoms of a peptic ulcer immediately disappear. Moreover, in combination with other medications, this remedy promotes the rapid healing of erosions and ulcers on the mucous membrane of the gastrointestinal tract.

The disadvantages of this medicine include a large number of adverse reactions. Although, if you comply with all the doctor’s requirements, their occurrence can be avoided.

Interaction

• With drugs metabolized in the liver via microsomal oxidation, their elimination slows down, these also include Diazepam, Phenytoin, indirect anticoagulants, and Theophylline clearance decreases by 10%.
• With weak acids, their pH-dependent absorption slows down, with bases, on the contrary, absorption accelerates. Lancid interferes with the absorption of Ampicillin, Ketoconazole, iron salts, and Digoxin.
• With Sucralfate, the bioavailability of lansoprazole is reduced by 30%, which requires maintaining an interval between doses of 30-40 minutes.
• With antacids, the recommended interval is 1-2 hours with a slowdown and reduction in their absorption when combining drugs.

Contraindications

• hypersensitivity to any component of the drugs (main substance and/or auxiliary components), to macrolides, to penicillins, cephalosporins, carbapenems;
• simultaneous use of clarithromycin with the following drugs: astemizole, cisapride, pimozide, terfenadine; with ergot alkaloids, for example, ergotamine, dihydroergotamine; with midazolam for oral administration;
• simultaneous use of clarithromycin with HMG-CoA reductase inhibitors (statins), which are largely metabolized by the CYP3A4 isoenzyme (lovastatin, simvastatin), due to an increased risk of myopathy, including rhabdomyolysis;
• simultaneous use of clarithromycin with colchicine in patients with impaired liver and kidney function;
• patients with a history of QT interval prolongation,

ventricular arrhythmia or ventricular tachycardia of the “pirouette” type;

• patients with hypokalemia (risk of QT interval prolongation);
• patients with severe liver failure occurring simultaneously with renal failure;
• patients with a history of cholestatic jaundice/hepatitis that developed while using clarithromycin;
• with porphyria;
• during breastfeeding and pregnancy;
• patients with atopic dermatitis, bronchial asthma, hay fever, infectious mononucleosis, lymphocytic leukemia, liver failure, gastrointestinal diseases in history (especially colitis associated with the use of antibiotics),
• children under 18 years of age;
• in the presence of sucrase/isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption.

With caution. Moderate to severe renal failure, moderate to severe liver failure, myasthenia gravis (possible increased symptoms), simultaneous use with drugs that are metabolized by the CYP3A isoenzyme (for example, carbamazepine, cilostazol, cyclosporine, disopyramide, methylprednisolone, omeprazole, indirect anticoagulants (eg, warfarin), quinidine, rifabutin, sildenafil, tacrolimus, vinblastine); simultaneous use with drugs that induce the CYP3A4 isoenzyme (for example, rifampicin, phenytoin, carbamazepine, phenobarbital, St. John's wort); simultaneous use with benzodiazepines, such as alprazolam, triazolam, midazolam for intravenous use; simultaneous use with calcium channel blockers that are metabolized by the CYP3A4 isoenzyme (for example, verapamil, amlodipine, diltiazem); patients with coronary heart disease (CHD), severe heart failure, hypomagnesemia, severe bradycardia (less than 50 beats/min), as well as patients simultaneously taking class IA (quinidine, procainamide) and class III antiarrhythmic drugs (dofetilide, amiodarone, sotalol), old age, a history of bleeding, allergic reactions (including a history), concomitant therapy with clopidogrel.