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lansoprazole + amoxicillin + clarithromycin (Lansap)

✓ Approved

Takeda · ATP4A · Small Molecule

What is lansoprazole + amoxicillin + clarithromycin?

lansoprazole + amoxicillin + clarithromycin is a small molecule developed by Takeda. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand NamesLansap
CompanyTakeda
Drug ClassSmall Molecule
Molecular TargetATP4A
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, Takeda

Mechanism of Action

Molecular Targets

lansoprazole + amoxicillin + clarithromycin acts on 1 molecular target:

ATP4AATPase H+/K+ transporting subunit alpha (ATP6A)
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Therapeutic Indications

lansoprazole + amoxicillin + clarithromycin is developed for 2 unique indications across 2 therapeutic areas.

Therapeutic AreaConditionPhase
Gastrointestinal disordersGastric ulcer✓ Approved
Infections and infestationsHelicobacter infection✓ Approved

Related Research Articles

PubMedClinical pharmacology and therapeutics2026-10-15

Reprocessing Mass Spectra from Therapeutic Drug Monitoring to Unveil Proton Pump Inhibitor Use and Quantify Phenoconversion of Escitalopram Metabolism in CYP2C19-Genotyped Patients.

Hole Kristine K, Wollmann Birgit M BM, Stingl Julia Carolin JC, Molden Espen E

Escitalopram is a frequently prescribed antidepressant drug. CYP2C19 genotype is a major determinant of escitalopram metabolism and treatment outcome. However, real-life studies show a high degree of genotype-phenotype mismatch in escitalopram metabolism. The present study aimed to identify comedication with proton pump inhibitors (PPIs) and quantify phenoconversion of escitalopram metabolism in CYP2C19-genotyped patients by reprocessing high-resolution mass spectra from therapeutic drug monitoring (TDM) analyses. Patients were included from a combined TDM/pharmacogenetics (PGx) laboratory facility in Oslo, Norway. TDM profiles of escitalopram and CYP2C19 genotypes were available in the laboratory database. Reprocessing of high-resolution mass spectra by exact mass and fragment detection identified possible comedication with pantoprazole, esomeprazole/omeprazole or lansoprazole using mzCloud reference library. Patients were grouped as normal metabolizers (NMs), intermediate metabolizers (IMs), poor metabolizers (PMs), rapid metabolizers (RM), or ultrarapid metabolizers (UM). Primary outcome measure was N-desmethylescitalopram-to-escitalopram metabolic ratio (MR; CYP2C19 biomarker) in UMs vs. PMs. 2818 patients were included, constituting 2373 without and 445 (15.8%) with PPIs. Most patients were females (64.2%). Regarding CYP2C19 phenotype distribution, the cohort comprised 39.3% NMs, 29.3% IMs, 2.6% PMs, 24.6% RMs, and 4.2% UMs. Escitalopram MR was 4.5-fold higher in CYP2C19 UMs vs. PMs without PPIs (P < 0.001), while this difference was 2.8-fold in pantoprazole users (P < 0.001), and 1.8-fold in esomeprazole/omeprazole users (P = 0.2). In conclusion, PPIs show significant phenoconversion of CYP2C19-mediated escitalopram metabolism with esomeprazole/omeprazole exhibiting a stronger effect than pantoprazole. The novel method for identification of interacting comedications in TDM samples illustrates the innovative potential of high-resolution mass spectrometry in precision medicine.

PMID 42876187
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PubMedBurns : journal of the International Society for Burn Injuries2026-10-14

Non-genetic factors play a more important role in lansoprazole metabolism than CYP2C19 pharmacogenetic profiles in European patients with burns.

Mlcuchova Natalie N, Bohm Jan J, Janosek Jaroslav J, Zendulka Ondrej O et al.

Single nucleotide variants in the CYP2C19 gene, as well as some non-genetic factors, are associated with the effectiveness of most proton pump inhibitors used for stress ulcer prophylaxis and should be considered in personalized treatment. In this study, we aimed to determine the CYP2C19*2 and *17 haplogenotypes by qPCR and the concentration of lansoprazole and its metabolites using HPLC in 50 burn patients from the European population on their first-ever lansoprazole prophylaxis. While CYP2C19 pharmacogenetic profiling in patients with burns played no significant role in predicting their ability to metabolize lansoprazole, associations of non-genetic factors with lansoprazole metabolism, such as age, sex, BMI, smoking, or substance abuse, were detected. Our results suggest that when prescribing lansoprazole to prevent stress ulcers in burn patients from the European population, the effect of genetic predispositions might be lower than that of other factors. Generalizability to other populations with different genetic backgrounds is, however, limited, and further studies with larger groups of CYP2C19*2 carriers in an acute setting are needed.

PMID 42874519
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PubMedLuminescence : the journal of biological and chemical luminescence2026-10-14

Engineering PEG-Modified Fe2O3 Nanostructures for Enhanced Photocatalytic Degradation of Pesticide and Antibiotic Pollutants in Water.

Nesrat Hocine Sadam HS, Mosbahi Dalila Saidane DS, Laouini Salah Eddine SE, Aouadi Abdelatif A et al.

Pesticide and pharmaceutical contaminants in water have become an important environmental challenge because of their persistence, toxicity, and limited removal by conventional treatment methods. In this work, iron oxide nanoparticles (Fe2O3NPs) and polyethylene glycol-coated iron oxide nanoparticles (Fe2O3@PEG NPs) were synthesized and tested for photocatalytic degradation of organic pollutants in aqueous media. The obtained materials were characterized using XRD, FTIR, UV-Vis spectroscopy, and SEM analyses. The XRD patterns confirmed the formation of crystalline hematite (α-Fe2O3), with average crystallite sizes of 21.26 nm for Fe2O3 and 19.02 nm for Fe2O3@PEG. FTIR spectra indicated successful PEG coating, whereas UV-Vis analysis revealed direct band-gap energies of 2.09 and 2.00 eV, respectively. Photocatalytic performance was investigated through the degradation of chlorpyrifos and amoxicillin under UV light. The Fe2O3@PEG material showed better activity, reaching 95.84% degradation of chlorpyrifos after 120 min and 95.03% removal of amoxicillin within 60 min. Kinetic results were consistent with a pseudo-first-order model. The improved efficiency of the modified material was mainly related to better dispersion, enhanced surface interaction, and lower charge recombination.

PMID 42870510
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PubMedRespiratory medicine case reports2026-10-14

Chronic streptococcal pneumonia presenting as a chest wall mass: An unusual case of malakoplakia.

Al Zuwayny Ali Husam AH, Muppuri Meghana M, Karunanathan Abiramy A, Kim David D et al.

Malakoplakia is a rare disorder of defective macrophage bactericidal function associated with gram-negative organisms. Pulmonary involvement is uncommon, and association with Streptococcus pneumoniae is exceedingly rare, often mimicking thoracic malignancy. 72-year-old man with a 50-pack-year smoking history and chronic alcohol use presented with cough, dyspnea, fever, weight loss and a tender left chest wall mass. Computed tomography demonstrated a 10.9 × 6.2 cm mass traversing multiple tissue planes with mediastinal lymphadenopathy raising concern for malignancy. Cultures grew Streptococcus pneumoniae. Lung biopsy revealed Periodic Acid-Schiff positive macrophages with chronic inflammatory infiltrate and histiocytes without evidence of malignancy, confirming pulmonary malakoplakia. He received ceftriaxone followed by amoxicillin-clavulanate alongside surgical debridement, achieving clinical improvement. Re-biopsy confirmed the absence of malignancy. This case illustrates the importance of correlating a detailed, potentially suspicious history with an appropriate and comprehensive microbiologic, surgical, radiographic, and histopathological evaluation process, which leads to a maximally effective intervention.

PMID 42871414
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PubMedExpert review of clinical pharmacology2026-10-13

Efficacy of minocycline-containing bismuth quadruple therapy for Helicobacter pylori infection: a single-center retrospective study.

Wang Xiaomin X, Dong Liyan L, Lin Guo G, Jiang Zhixin Z et al.

Increasing antibiotic resistance has undermined Helicobacter pylori eradication. Despite a low resistance to minocycline, clinical evidence for minocycline-containing bismuth quadruple therapy (MCQT) limited. This retrospective study aimed to evaluate the clinical efficacy of MCQT. Patients who had Helicobacter pylori infection by 13C-urea breath testing at our department from October 2024 to July 2025 were screened. They were classified into MCQT (minocycline-amoxicillin-acid-inhibitors-bismuth [MAAB], minocycline-clarithromycin-acid-inhibitors-bismuth [MCAB], and minocycline-levofloxacin-acid-inhibitors-bismuth [MLAB]) and non-MCQT (amoxicillin-clarithromycin-acid-inhibitors-bismuth [ACAB] and amoxicillin-levofloxacin-acid-inhibitors-bismuth [ALAB]). Four comparisons (MAAB vs. ACAB, MCAB vs. ACAB, MLAB vs. ALAB, and MAAB vs. ALAB) were separately performed in treatment‑naïve and treatment‑experienced patients. Logistic regression analyses were used to identify the influence factors. Overall, 687 treatment-naïve and 92 treatment-experienced Helicobacter pylori patients were included. MAAB demonstrated significantly higher eradication rates than ACAB in both groups (P = 0.020, P = 0.016), with no significant differences in other comparisons. Multivariate logistic regression analysis indicated that female was independently associated with a higher eradication rate in treatment-naïve patients in three comparisons (MAAB vs. ACAB, P = 0.021; MCAB vs. ACAB, P = 0.009; MAAB vs. ALAB, P = 0.043). MCQT achieve favorable Helicobacter pylori eradication rates in both treatment-naïve and treatment-experienced patients, and MAAB demonstrates a significantly higher eradication rate than ACAB.

PMID 42865300
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PubMedHelicobacter2026-10-13

Management Strategies for Helicobacter pylori-Application of the Stewardship Principles.

Megraud Francis F, Bessède Emilie E, Matysiak-Budnik Tamara T

The management strategies for Helicobacter pylori treatment are still diverse, especially because of the unequal availability of the drugs needed. In addition, the development of resistance to some antibiotics leads to unsatisfactory results. The role of H. pylori in gastric cancer, which allows the possibility of prevention in the general population by eradicating the bacteria, is a stimulus to have well-established regimens. This article presents the antimicrobial stewardship principles that can guarantee appropriate treatment. The optimization of the clarithromycin-based triple therapy includes antimicrobial susceptibility testing for clarithromycin, a higher dose of amoxicillin than in the original regimen, more than twice a day, and a proton pump inhibitor (PPI) like rabeprazole or esomeprazole, all administered for 2 weeks. The other regimen often used, the bismuth quadruple therapy, is optimal with the 3-in-1 capsule and a standard or high dose of PPI. In all cases, an eradication control must be performed after 4 to 6 weeks. The so-called concomitant treatment does not meet stewardship principles. The availability of Potassium-Competitive Acid Blockers (P-CABs) in some countries could allow the use of a dual therapy with only amoxicillin, but it must be confirmed by proper trials in Western countries.

PMID 42867262
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