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Instigar contains the active substance dexlansoprazole, which is a proton pump inhibitor (PPI). PPIs reduce the amount of acid that your stomach makes. Instigar is used in adults and adolescents aged 12 years and above for the following: Treatment of erosive reflux oesophagitis (inflammation with damage to the lining of the oesophagus (food pipe)) Maintenance of healed erosive reflux oesophagitis and maintenance of relief of heartburn Short-term treatment of heartburn and acid regurgitation associated with symptomatic non-erosive gastro-oesophageal reflux disease (GORD). GORD is a condition where stomach acid leaks out of the stomach and comes up into the oesophagus (acid reflux). By reducing the amount of stomach acid Instigar can heal the damage of the oesophagus and relieve symptoms that can happen with the above conditions and stop them from coming back. How to use The recommended dose for adults is as follows: Treatment of erosive reflux oesophagitis: take 60 mg once daily for 4 weeks. Your doctor may prescribe an additional 4 weeks. Maintenance of healed erosive reflux oesophagitis and maintenance of relief of heartburn in patients where prolonged acid suppression is needed: take 30 mg once daily for up to 6 months. Treatment of heartburn and acid regurgitation associated with symptomatic non-erosive gastro-oesophageal reflux disease (GORD): take 30 mg once daily for up to 4 weeks. The recommended dose for adolescents aged 12 to 17 years is as follows: Treatment of erosive reflux oesophagitis: take 60 mg once daily for 4 weeks. Your doctor may prescribe an additional 4 weeks. Maintenance of healed erosive reflux oesophagitis and maintenance of relief of heartburn in patients where prolonged acid suppression is needed: take 30 mg once daily. Your doctor will define total treatment time. Treatment of heartburn and acid regurgitation associated with symptomatic non-erosive gastro-oesophageal reflux disease (GORD): take 30 mg once daily for up to 4 weeks. Warnings and precautions Do not take Instigar If you are allergic to dexlansoprazole or any of the other ingredients of this medicine. Warnings and precautions Talk to your doctor before taking or while you are taking Instigar: If you have liver problems. Your doctor may have to adjust your dosage. If you have stomach problems. Your doctor may perform an additional investigation called an endoscopy (where a very small camera is inserted down your oesophagus to look into your stomach), which can help to exclude more serious causes of your symptoms. If you take a proton pump inhibitor like Instigar, especially over a period of more than one year, may slightly increase your risk of fracture in the hip, wrist or spine. Tell your doctor if you have osteoporosis (reduced bone density) or if your doctor has told you that you are at risk of getting osteoporosis (for example, if you are taking steroids). If you take Instigar on a long-term basis (longer than 1 year). Your doctor will probably ask to see you regularly so he can check how well you are doing. Tell your doctor if you notice any new symptoms or if any of your symptoms are getting worse. If you take other medicines such as digoxin (for the treatment of heart problems) or diuretics (‘water tablets’). If you have low vitamin B12 levels or have risk factors for low vitamin B12 levels and receive long-term treatment with Instigar. As with all acid reducing agents, Instigar may lead to a reduced absorption of vitamin B12. If you have ever had a skin reaction after treatment with a medicine similar to Instigar that reduces stomach acid. Side Effects If you get any of the following side effects, stop taking these capsules and tell your doctor immediately, or contact the casualty department at your nearest hospital: Hypersensitivity or serious allergic reactions (frequency not known) such as rash, face swelling, throat tightness, difficulty breathing Anaphylactic shock or serious, severe and sudden allergic reaction (frequency not known) with symptoms such as shortness of breath, confusion, pale colour, severe skin eruptions, throat tightness, weakness, gasping for air and unconsciousness. The most frequently reported side effects (common – may affect up to 1 in 10 people) were: Diarrhoea, abdominal pain, headache, feeling sick (nausea), abdominal discomfort, gas (flatulence), constipation and benign polyps in the stomach. Storage Information Store below 30°C. Drug Interactions Check with your doctor before taking Instigar if you are taking any of the following medicines: HIV protease inhibitors such as atazanavir and nelfinavir (to treat HIV) Ketoconazole, itraconazole, rifampicin (to treat infections) Erlotinib (to treat cancer) Digoxin (to treat heart problems) Tacrolimus (to prevent transplant rejection) Fluvoxamine (to treat depression and other psychiatric diseases) Warfarin (to prevent thrombosis) Antacids (to treat heartburn or acid regurgitation) Sucralfate (for healing ulcers) St John’s wort (Hypericum perforatum) (to treat mild depression) Methotrexate (to treat cancer) Ingredients The active substance is dexlansoprazole.
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