A.T Pantoprazol tab 40mg An Thien Treatment of Stomach - duodenal ulcer (10 blisters x 10 tablets)

Dosage form Box of 10 blisters x 10 tablets
Specifications Pantoprazol

Ingredient

Composition information	Content
Pantoprazol	40mg

Uses

indications

A.T Pantoprazol Tab is indicated in the following cases:

Treatment of gastric ulcer - duodenum.

Gastroesophageal reflux disease (gerd).

Pantoprazol is a proton pump inhibitor, inhibiting the final stage in the process of forming acid in the stomach with an inversely linked link with H+/K+ - ATPase enzyme (proton pump) at the stimulating surface of the acid excretion of the stomach into the stomach. Therefore, Pantoprazole inhibits both common stomach acid secretion mechanisms and stimulated agents.

Time to inhibit gastric acid excretion lasts more than 24 hours, although the sale time of pantoprazol is much shorter (0.7 - 1.9 hours).

Dynamic pharmacokinetics

Pantoprazole absorb well, reaching the highest concentration in plasma after drinking about 2 - 2.5 hours.

About 98% of pantoprazol associated with plasma proteins.

The drug is widely metabolized in the liver, mainly through Cytochrom P450 ISOENZYM CYP2C19, into Desmethylpantoprazole; A small amount is also metabolized by CYP3A4, CYP2D6 and CYP2C9.

In some people who lack the CYP2C19 enzyme system due to genetics that slow down the metabolism of pantoprazol, leading to an increase in drug levels in plasma.

The metabolites are mainly eliminated (about 80%) through urine, 18% through bile and feces.

Before taking A.T Pantoprazol tab 40mg An Thien Treatment of Stomach - duodenal ulcer (10 blisters x 10 tablets)

How to use

Take oral use.

Do not chew, drink whole tablets with water.

Should drink once a day in the morning, 1 hour before meals, drink with water.

Dosage

adults

Gastroesophageal reflux disease

Dosage 1 tablet/day, drink in the morning for 4 weeks, can last up to 8 weeks when necessary.

Maintain treatment: 1 tablet/day on demand.

Treatment of gastrointestinal ulcer

Take 1 capsule/day for 2-4 weeks for duodenal ulcer and 4 - 8 weeks for benign stomach ulcers.

Helicobacter pylori treatment

Coordinate with antibiotics in the treatment regimen, take 3 drugs in 14 days: Pantoprazol 40mg x 2 times/day + Clarithromycin 500mg x 2 times/day + Amoxicillin 1g x 2 times/day or Metronidazol 400mg x 2 times/day.

Treatment of pathological acid secretion such as Zollinger syndrome - Ellison

The dose starts 2 capsules/day/time, adjusting the dose according to the patient's response, up to 6 tablets/day. If the daily dose is over 2 tablets, it should be divided into 2 times.

For patients with severe liver failure

Use every day. Maximum dose of 2 days use 1 tablet.

For patients with renal failure

No dose adjustment.

Elderly

Maximum 1 tablet/day.

Children

The safety and effectiveness of pantoprazol in children has not been determined.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose?

Symptoms

Heart rate is slightly fast, vasodilation, sleeping, confusion, headache, blurred vision, abdominal pain, nausea and vomiting.

Handling

Stomach washing, active carbon, symptomatic treatment and support. Pantoprazole is not excluded through hemorrhage due to the circuit attaching to plasma proteins.

What to do when you forget a dose? However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Note that it should not be used double the prescribed dose.

Side Effects

When using A.T Pantoprazol Tab, you may experience unwanted effects (ADR).

Overall, Pantoprazol tolerates both well in short -term and long -term treatment. Proton pump inhibitors reduce acidity in the stomach, which can increase the risk of gastrointestinal infections.

Common, ADR> 1/100

Body: Tired, dizziness, headache.

Skin: skin, urticaria. digestive: dry mouth, nausea, vomiting, flatulence, abdominal pain, constipation, diarrhea.

Muscle joints: muscle pain, joint pain.

Uncommon, 1/1000

Body: weakness, dizziness, dizziness, insomnia.

Skin: itching.

Liver: Increased liver enzyme.

Rare, ADR

Systemic: sweating, peripheral edema, discomfort, anaphylaxis.

Skin: lumpy rash, acne, hair loss, peeling dermatitis, angioedema, diverse roses. digestive: stomatitis, belching, digestive disorders.

Eyes: blurred vision, fear of light.

nerve: Insomnia, sleep, agitation or inhibition, tinnitus, tremor, confusion, hallucinations, abnormalities.

Blood: Acidic leukemia, granulocytes, leukopenia, platelets.

Endocrine: impotence, helplessness in men.

Urinary: Hematitis, interstitial nephritis. liver: hepatitis, jaundice, cerebral disease in people with liver failure, increased triglycerides.

Ion disorders: Hemati sodium.

Instructions on how to handle ADR

When experiencing side effects of the drug, it is necessary to stop using and notify the doctor or go to the nearest medical facility for timely treatment.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

contraindicated

A.T Pantoprazol Tab in the following cases:

Sensitive to Pantoprazol or Benzimidazol derivatives or other ingredients of the drug.

Combining Helicobacter pylori killers in patients with kidney failure or severe liver failure.

Caution when using

Patients with liver failure:

In patients with severe liver failure, liver enzymes should be monitored during pantoprazol treatment, especially long -term use. In case of increasing liver enzyme, the drug should be stopped.

The presence of alarm symptoms:

The presence of any alarm symptoms (for example, significantly losing weight, recurrent vomiting, difficulty swallowing, vomiting of blood, anemia) and when being suspected of gastric ulcer, malignant diseases should be excluded. Treatment with pantoprazol may reduce symptoms and slow diagnosis.

Continuing to check should be considered if the symptoms do not decrease when appropriate treatment.

Simultaneous use with alazanavir:

Simultaneous use of Atazanavir with proton pump inhibitors is not recommended. If the combination of Atazanavir is required with a proton pump inhibitor, clinical monitoring is recommended with an increase in the dose of Atazanavir to 400 mg with 100 mg of ritonavir. The dose of pantoprazol does not exceed 20 mg per day.

Effects on the absorption of vitamin B12:

In patients with Zollinger-Eleson syndrome and other conditions of increased diseases need long-term treatment, Pantoprazol, as well as all other acid secretions can reduce the absorption of vitamin B12 (cyanocobalamin) due to reduced or deficient chlohydric gastric acid. This should be considered in patients who have reduced body reserves or risk factors that reduce the absorption of vitamin B12 when treated long -term or if observed with clinical symptoms.

Long -term treatment:

In long -term treatment, especially when the treatment time exceeds 1 year, it is necessary to monitor patients regularly.

Risk of fractures:

Proton pump inhibitors, especially when used in high doses and long -term treatment (> 1 year), can moderate the risk of hip, wrist and spine fractures, mostly in the elderly or in patients with other risk factors. Observing research shows that proton pump inhibitors may increase the risk of fractures by 10 - 40%. Patients at risk of osteoporosis should be taken care of and must be added with a full amount of vitamin D and calcium.

Gastrointestinal infections:

Pantoprazol, like all proton pump inhibitors (PPI), may increase the risk of the above gastrointestinal infection. Treatment with pantoprazol can lead to an increased risk of gastrointestinal infections caused by bacteria such as Salmonella and Campylobacter.

Magnesi blood:

Serious blood mites have been reported in patients treated with proton pump inhibitors (PPIS) such as Pantoprazol for at least 3 months, and in many cases in 1 year. The expression of Ha Magnesi such as fatigue, tetany, delirium, convulsions, dizziness and ventricular arrhythmia may occur but these symptoms may start silently and be ignored. Lowering blood magmesi is improved when supplemented with magnesi and stopped using PPI.

For patients expected to be treated for a long time or use PPIS with digoxin or the drug can cause blood magnesium (such as diuretics), health experts should consider measuring magnesium levels before starting treatment with PPI and periodically during treatment.

Lupus Red Red Red Reds:

Proton pump inhibitors are related to the rare cases of subcontracted lupus erythematosus. If the damage occurs, especially in areas exposed to the sun's sun, and if it comes with symptoms of joint pain, patients should consider stopping pantoprazol.

The ability to drive and operate machinery

drugs that do not have or negligible effect on the ability to drive or operate machinery. However, some unwanted effects of the drug such as dizziness and visual disorders may occur, if affected, patients should not drive or operate machinery.

Pregnancy

There is no adequate study when using Pantoprazol in humans during pregnancy.

Breastfeeding period

The drug can be secreted into breast milk, so it is necessary to consider stopping breastfeeding or stopping the drug.

Drug interaction

pantoprazol reduces the absorption of drugs simultaneously, their absorption depends on the stomach pH (ketoconazole, iron salt ...).

Although the pantoprazoi is metabolized through the liver cytochrom p450 enzyme system, there is no clinical interaction that is noticeable about the interaction between Pantoprazol and the drugs also metabolized through this enzyme such as Diazepam, Phenytoin, Nifedipin, Theophyllin, Digoxin, Oral contraceptive drugs.

Incraft the Inr and prothrombin time when using simultaneously warfarin with proton pump inhibitors, including pantoprazol.

Sucralfat slowed down the absorption and reduction of the bioavailability of pantoprazol so it should be taken at least 30 minutes before using sucralfat.

Methotrexate: Use highly high doses of methotrexate (e.g. 300mg) and proton pump inhibitors that increase the concentration of methotrexate which has been reported in some patients. In patients with high doses of methotrexate (such as cancer and psoriasis) pantoprazol suspension may need to be considered.

HIV treatment (Atazanavir): simultaneous use of Atazanavir and other HIV treatment drugs that depend on pH with proton pump inhibitors can significantly reduce the bioavailability of HIV treatment drugs and may affect the effectiveness of these drugs.

Therefore, it is not recommended to simultaneously use Proton and Azatanavir inhibitors.

Storage

In a dry place, avoid light, temperatures below 30 ° C.

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