Dexlansoprazole

Dexlansoprazole is a proton pump inhibitor (dual delayed-release) medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

Dexlansoprazole is commonly prescribed for:

• Gastro-oesophageal reflux disease (GERD) — relief of heartburn and acid regurgitation
• Erosive oesophagitis — healing of acid-damaged food pipe and maintenance of healing
• Non-erosive reflux disease (NERD) — symptomatic heartburn without visible erosions
• Night-time heartburn — its prolonged action helps control overnight acid symptoms

Doctors may also use it in other acid-related conditions where extended acid suppression is desirable. The exact indication and duration of treatment should always be decided by a registered physician after proper evaluation.

The usual adult dose of Dexlansoprazole ranges from 30 mg to 60 mg once daily, depending on the condition:

• Healing of erosive oesophagitis: commonly 60 mg once daily for up to 8 weeks
• Maintenance and symptomatic GERD: commonly 30 mg once daily for 4 weeks or as advised

Dexlansoprazole can generally be taken with or without food. The capsule should be swallowed whole and not chewed or crushed unless your doctor advises an alternative method. The exact dose and duration must be decided by a registered doctor. In children, use and dosing are weight- and age-based and should only be given on a doctor's prescription.

Dexlansoprazole is generally well tolerated. Possible side effects include:

• Common: diarrhoea, abdominal pain, nausea, flatulence, headache
• Less common: constipation, dizziness, dry mouth, skin rash
• With long-term use: low magnesium levels, vitamin B12 deficiency, slightly increased risk of bone fracture and certain gut infections

Most side effects are mild and settle on their own. Seek medical help promptly if you develop severe or persistent diarrhoea, unusual muscle cramps, irregular heartbeat, or signs of an allergic reaction such as swelling of the face or difficulty breathing.

Before taking Dexlansoprazole, keep these precautions in mind:

• Tell your doctor about liver disease, low magnesium, osteoporosis or previous fractures
• Long-term use should be reviewed periodically by a doctor; use the lowest effective dose
• PPIs may mask symptoms of stomach cancer — alarm symptoms such as weight loss, vomiting blood or black stools need urgent evaluation first
• Long courses may slightly increase the risk of Clostridioides difficile diarrhoea and may affect magnesium and vitamin B12 levels
• Do not stop or extend treatment on your own; follow your doctor's plan

Dexlansoprazole can interact with several medicines, mainly by reducing stomach acid or affecting liver enzymes:

• Drugs needing acid for absorption: ketoconazole, itraconazole, iron salts and some HIV medicines (e.g. atazanavir, rilpivirine) may work less well
• Clopidogrel: possible reduced antiplatelet effect; your doctor will weigh the risk
• Warfarin: bleeding risk may change; INR monitoring may be needed
• Methotrexate: high-dose methotrexate levels may rise
• Digoxin and tacrolimus: levels may be altered

Always tell your doctor and pharmacist about every medicine, supplement and herbal product you take.

Dexlansoprazole should not be used in the following situations:

• Known hypersensitivity to dexlansoprazole, other proton pump inhibitors, or any ingredient of the product
• Co-administration with rilpivirine-containing HIV medicines, where acid suppression markedly reduces drug absorption
• Previous serious reaction to a PPI, such as acute interstitial nephritis or severe skin reaction

Use with extra caution, under medical supervision, in severe liver disease. If you have ever reacted badly to any acid-reducing medicine, inform your doctor before starting treatment.

Pregnancy: There are limited human data on dexlansoprazole in pregnancy. Animal studies have not shown clear harm, but it should be used only if the expected benefit justifies any potential risk, and only on a doctor's advice. Doctors often prefer agents with longer safety records during pregnancy.

Lactation: It is not known with certainty whether dexlansoprazole passes into human breast milk; related PPIs appear in milk in small amounts. A breastfeeding mother should use it only if her doctor judges it necessary, weighing benefit to the mother against any possible effect on the infant.

Store below 30°C in a cool, dry place, away from direct sunlight and moisture. Keep the in its original blister or container until use. Keep all medicines out of the reach and sight of children. Do not use after the expiry date printed on the pack, and do not store in humid places such as the bathroom.