【藥品性質提示】 根據 2019 AGS Beers Criteria，本藥品為【潛在不適當用藥 (PIM)】，非下述情況之老年病患，不建議使用超過八周：潰瘍高風險族群(如長期使用口服類固醇、NSAID)、糜爛性食道炎(EE)、胃酸分泌過多、無法使用H2 antagonist者。

PPI Gastroesophageal reflux disease
1. Erosive (Treatment): Healing of all grades of erosive esophagitis: in patients ≥12 years of age for up to 8 weeks
2. Erosive (Maintain): Maintain healing and relief of heartburn for up to 6 months in adults and 16 weeks in patients 12-17 y/o
3. Symptomatic and nonerosive: Treatment in patients ≥12 years of age for 4 weeks

#仿單變更2022

Dexlansoprazole is a proton pump Inhibitors, which decreases acid secretion in gastric parietal cells through inhibition of (H+, K+)-ATPase enzyme system, blocking the final step in gastric acid production.

Absorption:
1. The dual delayed release formulation results in a plasma concentration-time profile with two distinct peaks: the first peak occurs 1~2 hours after administration, followed by a second peak within 4 ~5 hours
2. Bioavailability: May be increased when administered with food
Distribution:
Protein binding: 96-99%
Metabolism:
1. Hepatic via CYP2C19-mediated hydroxylation and CYP3A4-mediated oxidation
2. Followed by reduction to sulfate, glucuronide, and glutathione conjugates (inactive)
Elimination half-lifes:
1-2 hours

1. Hypersensitivity to lansoprazole or any component of the formulation
2. Concomitant use with products that contain rilpivirine

B; Recommendations for the treatment of GERD in pregnancy are available

Excretion in breast milk unknown/not recommended.

Common:
Diarrhea, abdominal pain, nausea, flatulence, vomiting; Upper respiratory tract infection
Warnings:
1. Gastric malignancy
2. Tubulointerstitial nephritis: symptoms including anorexia, malaise, nausea
3. Clostridioides difficile-associated diarrhea (CDAD)
4. Fractures: Patients on high-dose (multiple daily doses) or long-term therapy (≥1 year) should be monitored
5. Cutaneous and systemic lupus erythematosus: most patients improve 4 to 12 weeks after discontinuation
6. Vitamin B12 deficiency
7. Hypomagnesemia: Reported rarely, usually with prolonged PPI use of ≥3 months
8. Fundic gland polyps: nausea, vomiting, abdominal pain, GI bleeding and/or anemia may occur <20220110>

Dosage:
1. Erosive esophagitis (EE):
(1) Short-term treatment: 60 mg once daily for up to 8 weeks
(2) Maintenance of healed EE and symptomatic relief of heartburn: 30 mg once daily for up to 6 months.
2. Symptomatic GERD:
(1) Short-term treatment: 30 mg once daily for 4 weeks
(2) Note: Doses >30 mg do not provide additional benefit during maintenance phase.
Administration:
1. Capsules should be swallowed whole
2. For patients who are unable to swallow capsules, may open the capsule, sprinkle the intact granules onto 1 tablespoon of applesauce, and swallow intact granules immediately (do not chew granules); may also be opened for administration via NG tube or oral syringe