Praze Special Precautions

Use with caution in patients with history of hypersensitivity reactions to Lansoprazole, hepatic disorders or elderly patients.
Lansoprazole IV was shown to have high hemostatic effect based on the data up to 3 days after starting treatment. Once the patient is able to take medications orally, therapy should be switched to an oral formulation and this drug should not be administered aimlessly for a long period.
There is no clinical experience of treatment over 7 days in Japanese clinical trials.
At the treatment, the course of the disease should be closely observed and the minimum therapeutic necessity should be used according to the disease condition. If the Lansoprazole IV is ineffective, it should be switched to another treatment.
If the patient has projectile bleeding or oozing bleeding or is considered at risk for rapid bleeding such as the case of presence of exposed blood vessels, the patient should undergo endoscopic hemostasis such as heater probe or clipping.
It has been reported that visual disturbance occurred with use of a similar drug (omeprazole).
The administration of Lansoprazole IV may mask the symptoms of gastric cancer. It is necessary to ascertain the ulcer is not of a malignant nature before initiating the administration of Lansoprazole IV.
Use of proton-pump inhibitors may increase risk of Clostridium difficile-associated disease (CDAD), especially in hospitalized patients; consider CDAD diagnosis in patients with persistent diarrhea that does not improve. Use the lowest dose and shortest duration of proton-pump inhibitors therapy appropriate for the condition being treated.
Administration of proton-pump inhibitors has been associated with an increased risk for developing certain infections (e.g. community-acquired pneumonia).
Therapy with proton-pump inhibitors particularly in high dosages and/or prolonged periods of time (i.e.one year or longer), may be associated with an increased risk of osteoporosis-related fractures of the hip, wrist or spine.
Hypomagnesemia, symptomatic and asymptomatic, has been reported rarely in patients receiving long-term therapy (at least 3 months, most case more than 1 year of therapy) with proton-pump inhibitors, including lansoprazole. Clinically serious adverse effect associated with hypomagnesemia, which are similar to manifestations of hypocalcemia, include tetany, seizures, tremors, carpopedal spasm, cardiac arrhythmias (e.g. atrial fibrillation, supraventricular tachycardia) and abnormal QT interval.