Hard Pantoprazole Stada 40mg Capsules treat gastroesophageal reflux (4 blisters x 7 capsules)

Dosage form Box of 4 blisters x 7 tablets
Specifications Pantoprazole

Ingredient

Composition information	Content
Pantoprazole	40mg

Uses

Indications

Pantoprazol Stada 40mg is indicated in the following cases:

Gastroesophageal reflux disease (GERD).

Pantoprazole is a proton pump breast, preventing the final step in the process of forming acid in the stomach by covalent bond with enzyme system (H+, K+) - ATPase at the surface of the cell secretion into the stomach. This effect leads to inhibition of both basic stomach acid secretion mechanisms and stimulant agents. The monk binds to the enamel system (H+, K+ - ATPASE provides an anti -secret effect for more than 24 hours at all doses.

Dynamic pharmacy

Pantoprazole is absorbed quickly and reaches a plasma nail level after drinking about 2 - 2.5 hours. Oral bioavailability tablets in the intestine is about 77%, there is no difference when taking single or multiple doses. About 98% of pantoprazolee binds to 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.

Metabolic substances are weakened through urine (about 80%). The rest is eliminated through the bile. The sale time is also about 1 hour and lasts longer in patients with liver failure; In patients with cirrhosis, the time for sale is about 3-6 hours. Although the sale time in slow metabolic people is reported from 3.5 to 10 hours, there is a very small accumulation that occurs at the dose once a day.

Before taking Hard Pantoprazole Stada 40mg Capsules treat gastroesophageal reflux (4 blisters x 7 capsules)

How to use

Pantoprazol Stada is used orally. Should drink once a day in the morning. Before eating.

Dosage

Gastroesophageal reflux disease - esophagus

Common dose: From 20 - 40 mg x 1 time/day for 4 weeks, can last up to 8 weeks if needed.

Maintain treatment: Continuing treatment at a dose of 20 - 40 mg daily; For cases of recurrence, the treatment regime requires a daily dose of 20 mg.

Gastrointestinal ulcer

The usual dose is 40 mg x 1 time/day. Treatment time is from 2-4 weeks for duodenal ulcers or 4-8 weeks for benign stomach ulcers. To eliminate Helicobacter Pylori, it is possible to combine pantoprazole with two antibiotics in a therapeutic regimen combined with trio 1 week. Effective regimen includes pantoprazole 40 mg 2 times/day in combination with Clarithromycin 500 mg 2 times/day and amoxicillin 1 g x 2 times/day or metronidazol 400 mg x 2 times/day.

Prevention of nonsteroidal anti -inflammatory drugs

The dose of 20 mg per day.

Increasing disease secretion (Zollinger syndrome - Ellison)

The starting dose is 80 mg daily, adjusting the dose if needed. The dose can be used up to 240 mg daily. If the daily dose is over 80 mg, it should be divided into 2 times.

Patients with liver failure

Need to reduce pantoprazole dose in patients with severe hepatic failure or daily dose. The maximum daily dose must not exceed 20 mg or the daily dose must not exceed 40 mg.

Patients with renal failure

Maximum daily dose must not exceed 40 mg.

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? There are also reports in patients who use the same amount of pantoprazole 400 mg and a group of patients who use the same pantoprazole 600 mg without any side effects.

pantoprazole is not excluded through hemorrhage. In case of overdose, symptomatic treatment should be treated and supported.

What to do when forgetting 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 Pantoprazol Stada 40mg, you may experience unwanted effects (ADR).

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

Common, 1/100 ≤ ADR ≤ 1/10

Body: Fatigue, headache.

Skin: skin, urticaria.

Muscle joints: muscle pain, joint pain.

Uncommon, 1/1000 ≤ ADR ≤ 1/100

Body: weakness, dizziness, dizziness.

Skin: itching.

Liver: Increased liver enzyme.

Rare, 1/10,000 ≤ ADR ≤ 1/1000

Systemic: sweating, peripheral edema, discomfort, anaphylaxis.

Skin: lumpy, 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.

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

Pantoprazol Stada 40 mg is contraindicated in the following cases:

Hypersensitivity to Pantoprazole, any other ingredient or other Benzimidazol derivatives (such as Esomeprazol, Lansoprazol, Omeprazol. Rabepcazol).

Precautions when using

long -term treatment

Using proton pump inhibitors, especially when taking high doses and for a long time (> 1 year), may increase the risk of hip, wrist and backbone fractures, mainly occurs in the elderly or when there are other risk factors. Observatory studies show that proton pump inhibitors increase the risk of fractures from 10 to 40%, some can be caused by other factors. Patients at risk of osteoporosis must be cared for under the current clinical instructions and need adequate vitamin D and calcium.

Magnesi blood

There has been a report on severe blood magnesi on patients treated with proton pump inhibitors for at least 3 months and most cases of treatment for about 1 year. Symptoms of severe blood magmesi may occur such as fatigue, muscle spasms, delirium, convulsions, dizziness and ventricular arrhythmia but the above symptoms may occur dull and not be noticed. In the majority of patients with hypoglycemia, the disease is improved after supplementing the magnesium and stopping the use of proton pump inhibitors.

Be careful to measure Magnesi concentration before starting treatment and periodically while treating patients who need long -term treatment or must use proton pump inhibitors simultaneously with digoxin or those that cause blood magnesia (for example diuretics).

Impact on the digestive system

Symptom response with pantoprazole does not prevent the progression of stomach tumors.

It is necessary to eliminate malignant gastrointestinal ulcer before taking the drug because Pantoprazole can cover symptoms so it is a late diagnosis.

impact on the liver

There has been a slight and transient increase in Serum (SGPT) when treated with oral pantoprazole.

Cyanocobalamin poor absorption

Reducing gastric acid or gastric acidosis due to daily treatment with acid secretion inhibitors for a long time (more than 3 years) can reduce the absorption of cyanocobalamin.

Children

Safety and effectiveness of drugs in children under the age of 18 have not been established.

The ability to drive and operate machinery

The drug can cause side effects such as dizziness and visual disorders. If these side effects occur. Patients should not drive or operate machinery.

Pregnancy

There are no adequate and Pantoprazole -controlled studies on pregnant women. Animal studies show that the drug has reproductive toxicity. Unknown risks in humans. Pantoprazole should not be used during pregnancy except in the case.

Breastfeeding period

The drug is distributed in breast milk, stop breastfeeding or stop taking the drug due to the potential risk of breastfeeding.

Medicinal interaction

The drug with pH dependent of the stomach

Theoretical pharmacological interactions may occur when used simultaneously pantoprazole with drugs with pH -dependent absorption of the stomach (such as ampicillin ester, iron salt, ketoconazol); Can increase or decrease the absorption of the drug when increasing the pH of the stomach.

Metabolic drugs through the liver enzyme system

Pantoprazole is widely metabolized in the liver, mainly through Cytochrom P450 (CYP) ISOENZYM 2C19, less metabolism through isenzyme CYP3A4, CYP2D6 and CYP2C9. However, clinical trials show that there is no important interaction between pantoprazole and other drugs that metabolize through the same isenzyme.

warfarin

Increase international standardization indicators (INR) and prothrombin time when using simultaneous warfarin with proton pump inhibitors, including pantoprazole. Abnormal bleeding and death; Monitor the increase of Inr and prothrombin time when using simultaneously pantoprazole with warfarin.

Sucralfat

can slow down the absorption of the bioavailability of proton pump inhibitors, which should be taken at least 30 minutes before using proton pumps.

Storage

In closed packaging, dry place. The temperature does not exceed 30 ° C.

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