Lansoprazole Dosing for Gastrointestinal Protection in a 5-Year-Old Taking Ibuprofen
The recommended lansoprazole dose for a 5-year-old child weighing 16 kg taking Nurofen (ibuprofen) is 11-12 mg once daily (0.7 mg/kg/day). This dose provides appropriate gastric acid suppression for gastrointestinal protection while on NSAID therapy.
Dosage Calculation and Rationale
According to the FDA drug label for lansoprazole, the recommended pediatric dosage for children 1-11 years old is 0.7-3.0 mg/kg/day 1. For a 5-year-old child weighing 16 kg:
- Minimum dose: 0.7 mg/kg × 16 kg = 11.2 mg daily
- For gastroprotection while on NSAIDs, the lower end of the dosing range (0.7 mg/kg) is typically sufficient
The dose should be administered once daily, 30 minutes before a meal for optimal effect 2.
Administration Considerations
- Lansoprazole is available in child-friendly formulations including sprinkle capsules and orally disintegrating tablets 2
- The contents of sprinkle capsules can be mixed with soft foods or select juices if the child cannot swallow pills 2
- Morning administration is generally recommended for optimal acid suppression throughout the day
Duration of Therapy
Lansoprazole should be used for the shortest duration necessary while the child is taking Nurofen. The FDA label states that lansoprazole was not administered beyond 12 weeks in clinical studies for children 1-11 years of age 1. Therefore:
- Use lansoprazole only for the duration of Nurofen therapy
- If Nurofen is needed for more than 2 weeks, reassess the need for continued gastroprotection
- Do not exceed 12 weeks of continuous lansoprazole use without reassessment
Safety Considerations
Safety data from clinical studies show that lansoprazole is generally well-tolerated in children 1-11 years of age. The most common treatment-related adverse events reported were:
- Constipation (5%)
- Headache (3%) 1
No clinically significant changes in laboratory values were observed in pediatric studies, though mean serum gastrin levels increased from baseline during treatment 3.
Important Caveats
Confirm indication: Ensure gastroprotection is truly needed. Reserve PPIs for documented acid-related disorders or high-risk NSAID use 2.
Avoid in infants: Lansoprazole is not effective and not recommended for children under 1 year of age 1.
Use lowest effective dose: The American Academy of Pediatrics recommends using the lowest effective dose for the shortest duration necessary 2.
Regular reassessment: Regularly review the ongoing need for PPI therapy and document the specific indication 2.
Avoid long-term use: Long-term PPI use in children may be associated with increased risk of infections and other adverse effects 2.