Proton Pump Inhibitors Available in Liquid or Crushable Forms
Lansoprazole is available as an orally disintegrating tablet (ODT) that can be taken without water, making it the most suitable PPI option for patients who have difficulty swallowing tablets or capsules. 1, 2
Available PPI Formulations for Patients with Swallowing Difficulties
Lansoprazole Formulations
- Orally Disintegrating Tablet (ODT):
- First PPI available as an orally disintegrating tablet 1
- Disintegrates rapidly when placed on the tongue 2
- Can be taken with or without water 1
- Bioequivalent to standard lansoprazole capsules 2
- Particularly beneficial for:
- Patients with active lifestyles who don't always have water available
- Patients with difficulty swallowing
- Elderly patients 1
Other PPI Options
- PPI Capsules with Enteric-Coated Granules:
- Several PPIs (omeprazole, lansoprazole, esomeprazole) are manufactured as capsules containing enteric-coated granules 3
- These granules can be:
- Mixed with soft foods (applesauce, yogurt)
- Mixed with fruit juices before oral administration
- Administered via gastrostomy or nasogastric feeding tubes (omeprazole and lansoprazole specifically) as suspensions in sodium bicarbonate 3
Clinical Considerations When Choosing a PPI
Efficacy Considerations
- All PPIs have similar efficacy profiles when used at equivalent doses 4
- Higher-potency PPIs (esomeprazole, rabeprazole) may be preferred for certain conditions requiring stronger acid suppression 4
- Pantoprazole should be avoided when maximum acid suppression is needed 4
Administration Timing
- PPIs should be taken 30-60 minutes before meals for optimal efficacy 5
- Lansoprazole ODT maintains the same bioavailability as standard capsules, so dosing recommendations remain the same 1
Patient Acceptance
- Clinical studies show that the vast majority of patients find the mouth feel of lansoprazole ODT acceptable and easy to take 2
Common Pitfalls to Avoid
- Inappropriate formulation selection: Choosing standard tablets or capsules for patients with dysphagia can lead to poor adherence and treatment failure
- Improper administration: Crushing standard PPI tablets can destroy the enteric coating and reduce efficacy
- Inadequate dosing: Using too low a dose of PPI, particularly in patients with severe acid-related disorders 5
- Medication interactions: Some PPIs (particularly omeprazole) may interact with medications metabolized by the CYP450 system 5
Lansoprazole ODT provides an excellent option for patients who have difficulty swallowing standard PPI formulations while maintaining equivalent efficacy to standard formulations.