Age-Dependent Pharmacokinetics of Lansoprazole in Neonates and Infants

Zhang, Weijiang; Kukulka, Michael; Witt, Galen; Sutkowski-Markmann, Debra; North, Janine; Atkinson, Stuart

doi:10.2165/00148581-200810040-00005

Cited by 22 publications

(6 citation statements)

References 24 publications

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“…A consistent finding from pharmacokinetic studies of PPIs in neonates and infants is a significantly reduced plasma drug clearance in the first month of life, which is associated with a reciprocal increase in systemic exposure (as measured by dose‐normalized area under the plasma concentration vs. time curve (AUC)) 14 , 15 , 16 . Also, as reflected by composite data for apparent pantoprazole clearance over the first 5 months of postnatal life (), there is considerable variability in the pharmacokinetics of the drug produced by development and, potentially, CYP2C19 polymorphism.…”

Section: The Proton Pump Inhibitorsmentioning

confidence: 87%

Failure of Proton Pump Inhibitors to Treat GERD in Neonates and Infants: A Question of Drug, Diagnosis, or Design

Shakhnovich

Ward

Kearns

2012

Clin Pharmacol Ther

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The only time you don't fail is the last time you try anything-and it works. " -William StrongDistressful symptoms associated with gastroesophageal reflux constitute a clinical description of gastroesophageal reflux disease, a pathologic condition commonly treated with proton pump inhibitors (PPIs). Despite their pervasive use in neonates and infants, PPIs have not been approved for gastroesophageal reflux disease treatment in this population. This creates a therapeutic conundrum: namely, whether to institute PPI treatment based on knowledge and experience or to withhold it consequent to absence of labeling for young infants.

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Section: The Proton Pump Inhibitorsmentioning

confidence: 87%

Failure of Proton Pump Inhibitors to Treat GERD in Neonates and Infants: A Question of Drug, Diagnosis, or Design

Shakhnovich

Ward

Kearns

2012

Clin Pharmacol Ther

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“…The increased metabolic capacity, instead, is present in children (1-6 years), so an increased dose of PPIs according to weight should be considered [26]. Moreover, several studies have shown that preterm infants and term neonates present an immaturity of drugmetabolizing enzyme pathways (CYP2C19, CYP3A4) [27,28], and this could explain the higher systemic exposure to PPIs in this population than in older children [29][30][31].…”

Section: Pharmacokinetics Of Ppis In Pediatricsmentioning

confidence: 99%

Proton Pump Inhibitors in Pediatrics: Evaluation of Efficacy in GERD Therapy

Romano

Chiaro²,

Comito³

et al. 2011

CCP

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Gastroesophageal reflux (GER) is defined as the passage of gastric contents into the esophagus. It occurs in healthy infants and can be considered physiological process. Uncomplicated GER can present with recurrent vomiting or regurgitation without any other symptoms and is usually managed by educating, reassuring, and guiding the parent without other intervention. GER disease (GERD) refers to the appearance of troublesome symptoms or complications (erosive esophagitis, ulceration, Barrett's esophagus) and may warrant acid suppression. Proton Pump Inhibitors (PPIs) are the most effective pharmacologic agents available for the treatment of children with GERD. In the pediatric practice only omeprazole, lansoprazole and esomeprazole are available over the first year of life. The empiric use in infants with nonspecific symptoms (excessive crying, regurgitation, feeding refusal, chronic cough) is frequent without randomized controlled study. Our paper will focus on the correct indications, dosages, duration of treatment and safety of PPI use in pediatric population.

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“…B. 0,3 mg/kg Körperge-wicht und Tag), um eine Überdosierung zu verhindern [23]. Eine Verschreibung von PPI sollte bei Säuglingen deswegen besonders restriktiv und nicht nur auf Basis von Symptomen gehandhabt werden.…”

Section: E Bisher Ist Kein Protonenpumpeninhibitor Für Das Alter Unteunclassified

Gastroösophageale Refluxkrankheit im Kindes- und Jugendalter

Prell

Koletzko

2011

Gastroenterologe

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Age-Dependent Pharmacokinetics of Lansoprazole in Neonates and Infants

Abstract: The pharmacokinetics of lansoprazole in pediatric patients are age dependent, with those aged 10 weeks-1 year. Thus, pediatric patients aged 10 weeks to achieve similar plasma exposure.

Cited by 22 publications

References 24 publications

Failure of Proton Pump Inhibitors to Treat GERD in Neonates and Infants: A Question of Drug, Diagnosis, or Design

Failure of Proton Pump Inhibitors to Treat GERD in Neonates and Infants: A Question of Drug, Diagnosis, or Design

Proton Pump Inhibitors in Pediatrics: Evaluation of Efficacy in GERD Therapy

Gastroösophageale Refluxkrankheit im Kindes- und Jugendalter

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