[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Proton pump inhibitors (PPIs)](https://durgical.com/en/pharmacology/classes/proton-pump-inhibitors/) › Lansoprazole

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# Lansoprazole

A proton pump inhibitor for ulcers, reflux and H. pylori. Its capsule granules can be sprinkled on soft food or given through a nasogastric tube.

Updated 2026-11-01

- Class: [Proton pump inhibitors (PPIs)](https://durgical.com/en/pharmacology/classes/proton-pump-inhibitors/)
- Transporter: Gastric H⁺/K⁺-ATPase (proton pump), α subunit
- ATC code: A02BC03

⇄**Gastric H⁺/K⁺-ATPase (proton pump), α subunit**Lansoprazole

ⓘ The crystal is the pig gastric pump bound to vonoprazan, a reversible acid blocker; the figure highlights Cys813, the cysteine to which activated lansoprazole bonds covalently.

**Target in 3D:** Gastric H⁺/K⁺-ATPase (proton pump), α subunit. PDB structure 5YLU (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/5YLU) · Drag to rotate · pinch to zoom

## Mechanism of action

Lansoprazole is a PPI prodrug. In the acidic canaliculus of the parietal cell it becomes a reactive sulfenamide that bonds covalently to cysteines of the H⁺/K⁺-ATPase and blocks the last step of acid secretion. Basal and stimulated acid fall until the cell makes new pumps.

- Collects in the acidic canaliculus of the parietal cell
- Acid activates it into a reactive sulfenamide
- A covalent bond to Cys813 locks the H⁺/K⁺ pump
- Acid stays low until new pumps are made

## Pharmacokinetics

**Absorption**
Delayed-release capsules and orally disintegrating tablets, taken before meals; capsule granules can be mixed with soft foods or apple juice.

**Metabolism**
Liver, through CYP3A and CYP2C19.

**Half-life**
Short in plasma, but the effect on the pump lasts much longer.

## Indications

- Active duodenal ulcer, maintenance of healed duodenal ulcer and benign gastric ulcer. [Peptic ulcer disease →](https://durgical.com/en/conditions/peptic-ulcer-disease/)
- H. pylori eradication with amoxicillin and clarithromycin (triple therapy). [Helicobacter pylori gastritis →](https://durgical.com/en/conditions/helicobacter-pylori-gastritis/)
- Healing and risk reduction of NSAID-associated gastric ulcer. [Peptic ulcer disease →](https://durgical.com/en/conditions/peptic-ulcer-disease/)
- Symptomatic reflux and erosive oesophagitis, from 1 year of age. [Gastro-oesophageal reflux disease (GERD) →](https://durgical.com/en/conditions/gastro-oesophageal-reflux-disease/)
- Zollinger–Ellison syndrome and other hypersecretory states. [Zollinger-Ellison syndrome (gastrinoma) →](https://durgical.com/en/conditions/zollinger-ellison-syndrome/)

## Adverse effects

### Common

- Diarrhoea
- Abdominal pain
- Headache

### Serious (rare, important)

- Acute tubulointerstitial nephritis
- Clostridioides difficile diarrhoea
- Fractures with long, high-dose use
- Low magnesium and vitamin B12 deficiency with prolonged use
- Cutaneous or systemic lupus erythematosus; fundic gland polyps

## Contraindications

- Hypersensitivity to lansoprazole or other substituted benzimidazoles
- Use with rilpivirine-containing products

## Key interactions

**Theophylline**
Faster theophylline clearance; its level is checked when lansoprazole is started or stopped.

**Tacrolimus**
Higher tacrolimus exposure, especially in transplant patients who metabolise CYP2C19 slowly.

**Methotrexate (mainly high doses)**
Methotrexate levels may rise and stay high longer.

**Warfarin**
INR and prothrombin time can rise; the INR is monitored.

**Drugs that need acid to be absorbed (ketoconazole, itraconazole, iron salts, atazanavir)**
Lower absorption and effect.

## What is monitored

- Magnesium in long-term treatment
- INR on warfarin and levels of tacrolimus or theophylline
- Periodic review of whether it is still needed

## Administration and safety

- Taken before meals
- Capsules are swallowed whole or opened and the intact granules sprinkled on a soft food such as applesauce or yoghurt; the granules are not chewed or crushed
- Through a nasogastric tube, the intact granules are mixed only with the juice and volume set in the label
- Orally disintegrating tablets dissolve on the tongue

## Nursing care

- Choose the form that suits the patient: whole capsule, sprinkled granules, tube or disintegrating tablet
- Flush the nasogastric tube after giving the granules so they do not block it
- Check tacrolimus, theophylline or INR when lansoprazole is started or stopped
- Teach the patient to report watery diarrhoea or rash

## Pregnancy and breastfeeding

Published observational studies overall do not show adverse pregnancy outcomes with lansoprazole; it is used when needed.

## Memory aid

«LANSoprazole LANDS anywhere»: on applesauce, through a tube or melting on the tongue, the granules still land on the pump.

## Test yourself

Think of the answer, then tap the question to see it.

## How can lansoprazole be given to a patient who cannot swallow capsules?

The capsule is opened and the intact granules are sprinkled on a soft food, mixed with juice, or given through a nasogastric tube; orally disintegrating tablets also exist.

## Which immunosuppressant may rise with lansoprazole, especially in slow CYP2C19 metabolisers?

Tacrolimus.

## Which antibiotics are combined with lansoprazole in triple therapy for H. pylori?

Amoxicillin and clarithromycin.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/lansoprazole/)

## Related drugs

- [Omeprazole](https://durgical.com/en/pharmacology/omeprazole/)
- [Esomeprazole](https://durgical.com/en/pharmacology/esomeprazole/)
- [Pantoprazole](https://durgical.com/en/pharmacology/pantoprazole/)

## Related conditions

- [Peptic ulcer disease](https://durgical.com/en/conditions/peptic-ulcer-disease/)
- [Helicobacter pylori gastritis](https://durgical.com/en/conditions/helicobacter-pylori-gastritis/)
- [Gastro-oesophageal reflux disease (GERD)](https://durgical.com/en/conditions/gastro-oesophageal-reflux-disease/)
- [Zollinger-Ellison syndrome (gastrinoma)](https://durgical.com/en/conditions/zollinger-ellison-syndrome/)

[← Back to the class: Proton pump inhibitors (PPIs)](https://durgical.com/en/pharmacology/classes/proton-pump-inhibitors/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - LANSOPRAZOLE capsule, delayed release](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=427cf924-be17-47dc-8f77-115fa2f3fe17) (DailyMed (U.S. National Library of Medicine), 2026); [Lansoprazole: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a695020.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [RCSB PDB - 5YLU: Crystal structure of the gastric proton pump complexed with vonoprazan](https://www.rcsb.org/structure/5YLU) (RCSB Protein Data Bank, 2026).

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Representative model, for educational purposes only.

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License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/lansoprazole/