|Trade names||Kapidex, Dexilant, others|
|Drug class||Proton pump inhibitor|
|Excretion||50% renal and 47% in the feces|
|Chemical and physical data|
|Molar mass||369.363 g/mol g·mol−1|
|3D model (JSmol)|
|(what is this?)|
Dexlansoprazole, sold under the trade name Dexilant among others, is a medication which reduces stomach acid. It is used to treat gastroesophageal reflux disease. Effectiveness is similar to other proton pump inhibitors (PPIs). It is taken by mouth.
Common side effects include diarrhea, abdominal pain, and nausea. Serious side effects may include osteoporosis, low blood magnesium, Clostridium difficile infection, anaphylaxis, and pneumonia. Use in pregnancy and breastfeeding is of unclear safety. It works by blocking H+/K+-ATPase in the parietal cells of the stomach.
Dexlansoprazole was approved for medical use in the United States in 2009. In the United States the wholesale cost for a month is about US$270. In Canada this amount costs about 71.50 CAD in 2016 making it the most expensive PPI available at the time. In 2016 it was the 190th most prescribed medication in the United States with more than 3 million prescriptions.
Dexlansoprazole is used to heal and maintain healing of erosive esophagitis and to treat heartburn associated with gastroesophageal reflux disease (GERD). It lasts longer than lansoprazole, to which it is chemically related, and needs to be taken less often. There is not good evidence that it works better than other PPIs.
The most significant adverse reactions (≥2%) reported in clinical trials were diarrhea, abdominal pain, bloating, nausea, upper respiratory tract infection, vomiting, and flatulence.
Mechanism of action
Dexlansoprazole is the (R)-(+)-enantiomer of lansoprazole, which is a racemic mixture of its (R)-(+) and (S)-(−)-enantiomers. The Takeda drug has a dual release pharmaceutical formulation, with two types of granules of dexlansoprazole, each with a coating that dissolves at a different pH level.
Dexlansoprazole ((R)-(+)-lansoprazole) has the same binding affinity to the proton pump as the (S)-enantiomer, but is associated with a three- to five-fold greater area under the plasma drug concentration time curve (AUC) compared with (S)-lansoprazole. With its dual release pharmaceutical formulation, the first quick release produces a plasma peak concentration about one hour after application, with a second delayed release producing another peak about four hours later. As of November 2009[update], clinical relevance of this form of release has yet to be shown.
Since Kapidex was approved in 2009, there have been reports of dispensing errors because of confusion with the drugs Casodex (bicalutamide) and Kadian (morphine), which have very different uses from Kapidex and from each other. In 2010, the FDA approved a name change for Kapidex to avoid confusion with the two other medications and Takeda began marketing it under the new name Dexilant. It is also available in Bangladesh for the first time as Dexilend by Ziska Pharmaceuticals. It is also available in Bangladesh as Dexogut by Popular Pharmaceuticals and Delanix by Incepta Pharmaceuticals.
- Product Information: DEXILANT® delayed release oral capsules, dexlansoprazole delayed release oral capsules. Takeda Pharmaceuticals, Inc., Deerfield, IL, 2010. Revised: September 2012
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- "The Top 300 of 2019". clincalc.com. Retrieved 22 December 2018.
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- FDA Approves KAPIDEX (dexlansoprazole) delayed release capsules for the Treatment of GERD
- Metz DC, Vakily M, Dixit T, Mulford D (May 2009). "Review article: dual delayed release formulation of dexlansoprazole MR, a novel approach to overcome the limitations of conventional single release proton pump inhibitor therapy". Alimentary Pharmacology & Therapeutics. 29 (9): 928–37. doi:10.1111/j.1365-2036.2009.03984.x. PMID 19298580.
- "KAPIDEX (dexlansoprazole) Renamed DEXILANT in U.S. to Avoid Name Confusion". Takeda. 4 March 2010.