Drug General Information (ID: DDIIWTBKHQ)
Drug Name			Lansoprazole		Drug Info		Tolevamer		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Proton Pump Inhibitors				Potassium-Binding Resin
Structure

Mechanism of Lansoprazole-Tolevamer Interaction (Severity Level: Moderate)
Increased risk of hypomagnesemia Click to Show/Hide Mechanism Graph
Drug Name		Lansoprazole				Tolevamer
Mechanism		Hypomagnesemia				Hypomagnesemia
Key Mechanism Factor 1
		Factor Name		Hypomagnesemia
		Factor Description		Hypomagnesemia is a condition that occurs when you have too much magnesium in your body. Symptoms of hypomagnesemia include: nausea, vomiting, neurological damage, abnormally low blood pressure (hypotension), flushing, and headaches.
Mechanism Description		Increased risk of hypomagnesemia by the combination of Lansoprazole and Tolevamer

Recommended Action
Management		Monitoring of serum magnesium levels is recommended prior to initiation of therapy and periodically thereafter if prolonged treatment with a proton pump inhibitor is anticipated or when combined with other agents that can cause hypomagnesemia such as diuretics, aminoglycosides, cation exchange resins, amphotericin B, cetuximab, cisplatin, cyclosporine, foscarnet, panitumumab, pentamidine, and tacrolimus. Patients should be advised to seek immediate medical attention if they develop potential signs and symptoms of hypomagnesemia such as palpitations, arrhythmia, muscle spasm, tremor, or convulsions. In children, abnormal heart rates may cause fatigue, upset stomach, dizziness, and lightheadedness. Magnesium replacement as well as discontinuation of the PPI may be required in some patients.

References
1	Product Information. Nexium (esomeprazole) Astra-Zeneca Pharmaceuticals, Wilmington, DE.
2	Wohlt PD, Zheng L, Gunderson S, Balzar SA, Johnson BD, Fish JT "Recommendations for the use of medications with continuous enteral nutrition." Am J Health Syst Pharm 66 (2009): 1438-67. [PMID: 19667002]
3	FDA. U.S. Food and Drug Administration "FDA Drug Safety Communication: Low magnesium levels can be associated with long-term use of proton pump inhibitor drugs (PPIs).".