Mefogin 40mg Bilim Ilac Treatment of gastrointestinal ulcers, diseases due to Zolliger syndrome - Ellison (14 tablets)

Dosage form Box of 14 tablets
Specifications Pantoprazol

Ingredient

Composition information	Content
Pantoprazol	40mg

Uses

indicated

Gastro -ulcerative - duodenum. Learning

Classification: inhibit the proton pump.

ATC Code: a02bc02.

Pantoprazol is a derivative of benzimidazol, which has an inhibition of gastric acid secretion by inhibiting selective in the proton pump in the stomach wall.

pantoprazol is converted into active metabolic forms in the acidic environment of the stomach into the stomach due to inhibition of H+, K+-atpase, as the final stage of the production of hydrochloric acid in the stomach. The inhibition depends on the dose and impact simultaneously on both the basic excretion and increase in the production of hydrochloride acid. Most patients reduce symptoms within 2 weeks. Like proton pump inhibitors and H2 receptor inhibitors, treating with pantoprazol causes reduced gastric acid, thus increasing the rate of gastrin ratio according to the reduced acid levels. The process of increasing gastric gastrin levels is reversible. Because Pantoprazole is connected to the enzyme far away from the middle of the surface cell receptor, it can independently affect the excretion of hydrochloride acid of other stimulants such as (acetylcholine, histamine, gastrin). This impact is the same even when the drug is indicated by oral or veins.

Gastrin indicators increase after using pantoprazol. When taking the drug in a short time, most of these indicators do not exceed the upper limit of normal levels. In long -term treatments, most cases of Gastrin doubled. However, excessive increasing occurs only in a few cases. As a result, there is a slight to medium increase from specific endocrine cells (ECL) in the stomach recorded in a small group of patients using Pantoprazol for a long time. However, according to some studies, the formation of precursors of carcinoids (non -typical increase) or stomach carcinoids found in experimental animals is not found in humans.

pharmacokinetics

absorption:

Mefogin 40 mg is a tablet of tablets soluble in the intestine, so the drug only absorbs after entering the stomach. Oral dose 40 mg Pantorazole quickly absorbed and reached Peak 2-3 mcg/ml concentration after about 2.5 hours. The first metabolic drug is small, and the full bioavailability reaches 77%. Simultaneous use of acid resistance does not affect absorption. Take Mefogin 40 mg with food can slow the absorption of the drug for up to 2 hours or more, but does not change the maximum concentration of the drug (CMAX) and the area under the curve (AUC).

Distribution:

The distribution volume is about 0.15 l/kg and the clearance is about 0.1 l/h/kg. The ratio of plasma protein binding is about 98%.

Metabolism:

The drug is almost completely metabolized in the liver through the Cytochrome P450 (CYP) system. Metabolism regardless of the line used. The main metabolic path is reducing methyl by CYP2C19, continuing the sulfate, another metabolic path includes oxidation by CYP3A4. There is no evidence that the metabolism of Mefogin 40 mg has a significant pharmacological effect.

Elimination:

After taking Mefogin 40 mg, about 71% of the dose is eliminated in the urine and 18% excreted in the feces. The form does not change without metabolism through the kidney. Half life of the drug's exhaust is about 1 hour.

Characteristics of patients/special groups

Requirements do not reduce the dose when taking Pantoprazol in patients with limited renal function (including prime patient). Because in healthy patients, half -life for semi -waste of short pantoprazol. Only a small amount of pantoprazol may be separated. Although the main metabolites have half-life for semi-slow emissions (2-3 hours).

The pharmacokinetics of the drug does not change when treating the single dose or repeat treatment. At a dose of about 10 to 80 mg, the plasma dynamic of Pantoprazol is almost linearly when oral treatment and vein.

Pantoprazol quickly absorbed and reached the maximum plasma concentration only after taking a single dose of 40 mg. Pantoprazol is completely absorbed after drinking. Full bioavailability from the form of tablets can reach 77%. The food that does not affect the area under the AUC curve and the maximum drug concentration in the serum, thus does not affect the bioavailability of the drug. On average, about 2.5 hours after taking the drug reaches the maximum concentration in the serum is 2-3 mcg/ml, this concentration remains the same after many treatments. Half life of the last semi -waste of the drug is about 1 hour. There are only a few cases of slow elimination. Due to the selective activity of Pantoprazol in cover cells, half -life of the excretion of non -linear active ingredients with the period of prolonged impact of the drug (inhibitors of gastric acid excretion).

Before taking Mefogin 40mg Bilim Ilac Treatment of gastrointestinal ulcers, diseases due to Zolliger syndrome - Ellison (14 tablets)

How to use

Do not chew, grind or break Mefogin 40 mg but should take whole tablets with water for 1 hour before breakfast.

In the treatment of H. pylori, it is necessary to take Mefogin 40 mg before dinner.

Dosage

unless otherwise recommended by the physician, the recommended dose for the treatment of stomach - duodenal ulcer and esophageal reflux is a tablet of mefogin -melted tablets 40 mg daily. Overall can heal duodenal ulcers within 2 weeks, can last for 2 weeks if necessary. Stomach ulcers and esophageal reflux takes 4 weeks to heal, can last for another 4 weeks if necessary. Patient with peptic ulcerative with H. Pylori needs a combination therapy to kill all pathogenic bacteria. To kill H. pylori bacteria, one of the following regimens can be used:

Mefogin -soluble tablets 40 mg, 2 times/day,

1000 mg of Amoxicillin 2 times/day,,

500 mg Clarithromycin 2 times/day.

Mefogin -soluble tablets 40 mg, 2 times/day,

500 mg Metronidazole 2 times/day,,

500 mg Clarithromycin 2 times/day.

Mefogin -soluble tablets 40 mg, 2 times/day,

1000 mg of Amoxicillin 2 times/day,,

500 mg of metronidazol 2 times/day.

Collaborative therapy should be used continuously for 7-14 days unless there is a physician's instructions.

If the patient is not infected with H. pylori or cannot use a combination therapy, Mefogin 40 mg can be used to treat stomach -duodenal ulcer.

Stomach ulcer, duodenal ulcer, serious and medium reflux esophagitis:

1 Mefogin 40 mg daily for patients with duodenal ulcer, stomach ulcer, reflux esophagitis. In special cases, the dose can be doubled (up to 2 tablets/day) especially when not responding to other treatment regimens.

Zollinger-Eleson syndrome and other disorders related to disease secretion:

For prolonged treatment of Zollingzer-Elison syndrome and physical disorders, patients should start at a dose of 80 mg per day (2 Mefogin 40 mg tablets). The dose can then be adjusted to increase or decrease based on the amount of acid. The dose of 80 mg/day must be divided into 2 drinks. The temporary dose may be increased to 160 mg/day, but should not be used for a long time for the patient to reach the appropriate acid level.

During the treatment of Zollinger-Elison syndrome and other cases of increased diseases, no need to limit the pantoprazol dose, depending on the clinical reality.

Patients with renal failure: Maximum dose: 40 mg of mefogin per day for patients with impaired renal function.

Patients with liver failure: In patients with severe liver dysfunction, it is reduced to 1 dose of 40 mg pantoprazol daily. In addition, for these patients, liver enzymes should be monitored during treatment with Pantoprazol 40 mg. Treatment should be stopped with mefogin 40 mg if the liver enzyme value increases.

Pediatric patients: No reports related to use in young children.

Elderly patients: Do not exceed the dose of 40 mg/day in elderly patients.What do

do when overdose? The signs and symptoms of an overdose may be a slightly fast heart rate, vasodilation, sleep, confusion, headache, blurred vision, abdominal pain, nausea and vomiting.

Handling: gastrointestinal, using activated carbon, symptomatic treatment and support.

Monitor the activity of the heart, blood pressure. If vomiting is prolonged, water and electrolytes must be monitored.

Because Pantoprazole is strongly attached to plasma proteins, the method of separation does not eliminate the drug.

What to do when you forget 1 dose?

Side Effects

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

Common, ADR> 1/100:

Body: tired, dizzy, headache

Body: weakness, dizziness, dizziness, insomnia.

Skin: itching.

Systemic: Sweating, peripheral edema, discomfort, anaphylaxis. Gastrointestinal: stomatitis, belching, digestive disorders gender.

Warnings

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

contraindicated

allergies to any ingredients of the drug.

Be cautious when using

should not be used to treat mild gastrointestinal disorders such as indigestion. by endoscopy. Acid, pantoprazol can reduce the absorption of vitamin B12 (cyanocobalamin). This should be considered when accompanied by clinical symptoms. (as ketoconazole). However, clinically has not seen any significant interactions in specific tests with some drugs or compounds such as carbamazepine, caffeine, diazepam, diclofenac, digoxin, ethanol, glibenclamide, metoprolol, naproxen, nifedipine, phenytoin, piroxicam, theophylyline Drink. Therefore, patients treated with coumarin anticoagulants should be controlled Prothrombin/Inr time after use, termination or during non -regular use of pantoprazol.

The effect of the drug on driving and operating machinery

No data.

Using drugs for women during pregnancy and lactation

Pregnancy:

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

Animal studies have shown Pantoprazol through the placenta fence, but have not been observed the effect of teratogenicity. Doses of 15 mg/kg slowed up the fetus. Only use pantoprazol when really necessary during pregnancy.

Breastfeeding period:

It is not known whether Pantoprazol will excrete in human milk or not. However, Pantoprazol and its metabolites excreted through milk in mice. Based on the potential of cancer in the mouse of Pantoprazol, it is necessary to consider stopping breastfeeding or stopping the drug, depending on the benefit of Pantoprazol with the mother.

Drug interaction

Although Pantoprazol is metabolized through the cytochrom P450 enzyme system in the liver, it does not inhibit or activate this enzyme activity. There is no clinical interaction that is noticeable about the interaction between pantoprazol and common drugs such as diazepam, phenytoin, nifedipine, theophylin, digoxin, warfarin or oral contraceptive pills.

Like other proton pump inhibitors, Pantoprazol can reduce the absorption of some drugs that their absorption depends on the stomach pH such as ketoconazole, iTraconazole. Severe muscle pain and bone pain may occur when using methotrexat along with pantoprazol.

Storage

Store in a cool dry place, avoid light, store at a temperature not exceeding 30 ° C.

Keep the drug out of reach of children.

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