A proton pump inhibitor, often chosen over omeprazole where clopidogrel is involved. Same benefits, same need for review.
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Lansoprazole is a proton pump inhibitor, working the same way as omeprazole — shutting down the acid pumps in the stomach lining rather than neutralising acid already produced.
The practical difference between the two is mostly in their interactions. Lansoprazole is generally preferred for anyone taking clopidogrel, because omeprazole reduces how well clopidogrel works.
It also comes as an orodispersible tablet that melts on the tongue, which suits anyone who struggles to swallow capsules.
Once daily, 30 to 60 minutes before your first meal. This is not optional detail — proton pumps activate when you eat, and the drug needs to be circulating before that happens. Taken after food it is substantially less effective.
Swallow capsules whole. The orodispersible tablet is placed on the tongue and allowed to disperse, with or without water.
Full effect takes a few days.
Do not stop a long course suddenly. Rebound acid production after abrupt withdrawal feels worse than the original problem, which is exactly why people conclude they cannot live without it. Taper down instead.
Short term: headache, diarrhoea or constipation, nausea, wind. Generally well tolerated.
The long-term considerations are the reason a PPI should carry a review date rather than an open-ended repeat:
None of this makes it a bad drug. It makes it one that should be reviewed periodically rather than continued by inertia for a decade.
More important than any contraindication are the warning signs. Do not simply take a PPI for indigestion if you have difficulty swallowing, unexplained weight loss, persistent vomiting, black stools, or you are over 55 with new symptoms.
PPIs are very good at suppressing the symptoms of something that needs investigating — which is precisely the danger. Those features need assessment first.
Clopidogrel — this is where lansoprazole has the advantage. Omeprazole reduces clopidogrel's antiplatelet effect; lansoprazole is the usual alternative.
Other interactions: methotrexate, digoxin, some antifungals, and levothyroxine — reduced acid means reduced absorption.
Monitoring for long-term users: B12, magnesium, and consideration of bone health. Above all, a periodic honest review of whether it is still needed.
Yes — and as with omeprazole, the more valuable consultation is often about whether you should still be taking it.
What that involves: establishing why it was started, whether the original problem has resolved, whether red flags are present, and whether H. pylori was ever tested for. That last one is frequently skipped and is a treatable cause rather than a lifelong one.
Stopping safely is where a consultation earns its fee. A structured taper with advice on managing rebound acid is something almost nobody is offered, and long-term PPI use without review is among the commonest findings in a medication review.
What we will not do is prescribe a PPI to mask symptoms that warrant investigation. Where red flags are present we arrange endoscopy referral instead.
This page is information, not an offer to supply.
Lansoprazole is prescription-only in the UK, unlike low-dose omeprazole which you can buy from a pharmacy. It is nonetheless a cheap generic.
On a private prescription you pay the drug cost plus the dispensing fee, usually comparable to the England NHS prescription charge of around £10. NHS prescriptions are free in Wales.
Over-the-counter omeprazole is the cheaper route and does much the same job. There is no need to pay for a consultation to obtain a PPI for occasional heartburn, and we would say so.
It costs considerably more and is only worth it if you genuinely cannot swallow capsules. It is no more effective.
As with all PPIs, stopping abruptly after long-term use produces rebound acid. Symptoms return, often more sharply than before, and settle within two to four weeks.
That rebound is very commonly mistaken for proof that the drug is still needed.
It interacts far less with clopidogrel than omeprazole does. If you take clopidogrel after a stent or a stroke and need acid suppression, lansoprazole or pantoprazole is the preferred option.
That switch is genuinely important and routinely missed, because both drugs are thought of as interchangeable.
Barrett's oesophagus, a previous bleeding ulcer, severe oesophagitis, or long-term NSAID use with risk factors.
In those situations continuing is correct — the aim of a review is the right decision, not automatic withdrawal.
Four groups matter, and they matter for different reasons.
Medicines that need stomach acid to be absorbed. Lansoprazole works by removing that acid, so it reduces uptake of levothyroxine, iron tablets, some antifungals such as ketoconazole and itraconazole, and certain HIV medicines. Levothyroxine is the one that catches people out — a stable thyroid dose can drift once a PPI is started, and it is rarely connected.
Medicines whose levels rise. Methotrexate and digoxin both need care.
Clopidogrel — the exception that favours lansoprazole. Omeprazole reduces how well clopidogrel works; lansoprazole and pantoprazole do not, meaningfully. If you take clopidogrel and omeprazole together, that is worth raising.
Anti-inflammatories, which is the reverse situation. If you take naproxen, ibuprofen or another NSAID regularly, the PPI is not an interaction — it is protection, and it is frequently the reason lansoprazole was started.
Antacids are fine, spaced a couple of hours apart. Alcohol does not interact with lansoprazole, though it aggravates reflux in its own right.
Mention lansoprazole whenever you list your medicines, including to a pharmacist. It is easy to forget a drug you have taken for years.
They work the same way and are similarly effective. The practical differences are that low-dose omeprazole is available over the counter and lansoprazole is not, and that lansoprazole interacts far less with clopidogrel.
30 to 60 minutes before breakfast. PPIs only block acid pumps that are active, and eating activates them.
Taken at bedtime on an empty stomach it works much less well, which is a very common mistake.
Rebound acid secretion — a temporary overshoot after months of suppression.
It settles within two to four weeks and does not mean you need it permanently. Step the dose down rather than stopping outright.
Yes, if you have not been. It is a treatable cause of ulcers and reflux, and clearing it can remove the need for ongoing treatment.
Stop the PPI two weeks before testing or the result may be falsely negative.
Generally yes where there is an indication, with modest associations reported for fracture risk, low magnesium and B12 absorption.
The issue is usually not the drug but the absence of any review.
It is a reason to be on lansoprazole rather than omeprazole. Omeprazole reduces clopidogrel's effectiveness.
If you are on omeprazole and clopidogrel together, raise it — it is a straightforward and worthwhile switch.
Trouble swallowing, weight loss you did not intend, persistent vomiting, black stools, or anaemia.
Those need investigation. Suppressing acid can delay the diagnosis.
Yes, spaced a couple of hours apart. Antacids act within minutes and are useful while a PPI is being reduced.
Clinically reviewed by Dr Mohammad Zubair Khan, GMC 7563469
Last reviewed
August 24, 2026
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