Nolpaza 40mg Krka tablets treat gastroesophageal reflux disease, gastrointestinal ulcer (1 blister x 14 tablets)

Dosage form Box of 1 blister x 14 tablets
Specifications Pantoprazole

Ingredient

Composition information	Content
Pantoprazole	40mg

Uses

Indications

Nolpaza 40 mg is indicated in the following cases:

Gastroesophageal reflux disease (gerd).

Gastrointestinal ulcer. Proton pump, inhibiting the final stage in the process of forming acids in the stomach with a valence assimilation link with enzyme system (H+, K+)-ATPASE at the secretion surface of the cell into the stomach. This mechanism leads to inhibition of both common stomach acid secretion mechanisms and stimulated agents. The cohesion with the enamel system (H+, K+)-ATPASE will cause an acid secretion effect for more than 24 hours for all tested doses.

pharmacokinetics

Pantoprazol's peak concentration in plasma reaches about 2 - 2.5 hours after drinking. About 98% of pantoprazol connects to plasma proteins.

The drug is widely metabolized in the liver, mainly through Cytochrome P450 Isoenzyme CYP2C19, wallylpantoprazol wall; A small amount is also metabolized by CYP3A4, CYP2D6 and CYP2C9.

Metabolic substances are mainly eliminated (about 80%) through the urine, the rest is eliminated through the bile. The last waste time is about 1 hour, lasting longer in patients with liver failure, about 3-6 hours in cirrhosis patients.

Before taking Nolpaza 40mg Krka tablets treat gastroesophageal reflux disease, gastrointestinal ulcer (1 blister x 14 tablets)

How to use

Nolpaza 40 mg is taken orally.

Take once a day in the morning. Swallowing whole tablets, not crushed or chewed.

Dosage

Adults

Gastroesophageal reflux syndrome (GERD)

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

Maintenance dose: 20 - 40 mg per day.

Case of recurrence: 20 mg/day.

Gastrointestinal ulcer

Common dose: 40 mg x 1 time/day. Treatment period from 2-4 weeks for duodenal ulcers or 4-8 weeks for benign stomach ulcers.

Helicobacter pylori

Use a combination therapeutic regimen 1 week (1-WEMEK TRIPLE THERAPY): Pantoprazol 40 mg x 2 times/day in combination with Clarithromycin 500 mg x 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

20 mg/day.

Zollinger syndrome - Ellison

Starting dose: 80 mg/day. The dose can be used up to 240 mg/day. If used over 80 mg/day, should be divided into 2 times.

Special subjects

Patients with liver failure

Maximum dose: 20 mg/day or 40 mg/day for daily dose.

Patients with renal failure

Maximum dose: 40 mg/day.

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?

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. Do not use double the prescribed dose.

Side Effects

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

When using Nolpaza 40 mg, you may experience unwanted effects (ADR).

Common

Fatigue, headache

weakness, dizziness, dizziness.

itching.

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

Nolpaza 40 mg drug is contraindicated in the following case:

Hypersensitivity to pantoprazol, with any component of the drug or other benzimidazol derivatives (such as Esomeprazol, Lansoprazol, Omeprazol, Rabeprazol).

Precautions when used

This drug is only used by prescription.

Read the instructions carefully before use. If you need more information, please consult your doctor or pharmacist.

Notify the doctor with unwanted effects when using the drug. Leave the medicine out of reach of children.

Do not use overdue drugs printed on the packaging.

Patients with liver failure:

In patients with severe liver failure, regular liver enzymes should be monitored when treated with pantoprazol, especially when long -term treatment. In case of increased liver enzymes should stop using the drug.

Use simultaneously with NSAIDs:

The use of Nolpaza 20 mg to prevent duodenal ulcer and | The duodenum caused by non -selective nonsteroidal anti -inflammatory drugs (NSAIDs) should be chosen for patients who need to treat NSAID continuously and are at risk of thick skin complications. Increased risk should be assessed according to personal risk factors, for example: elderly (> 65 years old), a history of stomach ulcer, duodenum or bleeding on the stomach - bowel.

Symptoms of stomach cancer:

If there is any symptoms of stomach cancer (unintentional weight loss, recurrent vomiting, difficulty swallowing, hemorrhage, anemia, fever) or when suspected stomach ulcers should eliminate malignant treatment due to pantoprazol treatment can cover symptoms and slow down the diagnosis of cancer.

Simultaneous use with Antazanavir:

Concomitant use of Antazanavir with proton pump inhibitors is not recommended. If
is simultaneously used, it is necessary to closely monitor clinical (viral load). Increase the dose of
Antanavir to 400 mg along with 100 mg of ritonavir. The dose of pantoprazol does not exceed 20 mg every
day.

affect the absorption of vitamin B12:

In patients with Zollinger-Elison syndrome and other cases of increased secretion of acid secretion
requires long-term treatment, pantoprazol as well as other acid secretary inhibitors that can reduce steaming
Cyanocobalamin) due to drugs that reduce acid secretion in the stomach.

Prolonged treatment:

Special prolonged treatment for more than 1 year needs to be monitored regularly.

Gastrointestinal infections caused by bacteria:

Pantoprazol is like other ppi drugs, which can increase the unexpected number of microwaves in the above digestive tract. Treatment with Nolpaza can lead to a slight increase in the risk of gastrointestinal infections caused by bacteria such as Salmonella, Campylobacter and C. Difficile.

Magnesium reduction:

Severe blood magnesium decreased has been reported in patients treated with pantoprazol for at least
3 months and most patients treated for 1 year. The serious manifestations of Magnesium
bloody such as fatigue, lumbar pain, delirium, convulsions, dizziness and ventricular arrhyths may occur,
However, they often manifest silently and may be missed. Hypotenia reduction of blood magnesium can be improved after adding magnesium and stopping PPI treatment. Patients with long -term treatment
with ppi and digoxin or other medications that reduce blood magnesium such as diuretics should be monitored
blood magnesium levels before starting ppi and periodic treatment during treatment.

Fracture:

Proton pump inhibitors, especially if high doses and. Lasting over 1 year can increase the risk of hip, wrist, spine fractures, mainly in the elderly or people with other risk factors. Studies show that PPI increases the risk of fractures by 10-40%. Patients
are at risk of osteoporosis that needs to be fully cared for and supplemented with calcium, vitamin D.

Selling lupus skin lesions (SCLE):

There are very few reports that shows that SCLE is related to proton pump inhibitors. However, if the
lesions occur, especially in the skin exposed to the sun, accompanied by joint pain, the patient
should immediately notify the doctor. Consider stopping PPL if necessary.

affect test results:

Increased chronograpnin levels can hinder the diagnosis of nerve tumors, so it is necessary to stop
at least 5 days before CGA testing. If CGA and Gastrin do not return to the scope of reference
after the first measurement, the measurement must be repeated 14 days after stopping with PPI.

Nolpaza contains sorbitol:

Nolpaza contains sorbitol, patients with rare genetic problems in absorption of fructose should not use the drug.

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 is no adequate and Pantoprazol control on pregnant women. Women who are pregnant should not use pantoprazol except for the necessary cases.

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

drugs with pH -dependent absorption of the stomach: Theoretically, the ability to interact with dynamic pharmacokinetics when using simultaneously pantoprazol with drugs with pH dependent 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.

The drug acts on the liver enzyme system: Pantoprazol is widely metabolized in the liver, mainly through Cytochrome P-450 (CYP) ISOENZE 2C19, less metabolism via ISOENZE CYP3A4, CYP2D6 and CYP2C9. However, clinical trials show that there is no important clinical interaction between Pantoprazol and other drugs metabolized through the same isenzyme.

warfarin: Ability to increase the Inr and prothrombin time when using simultaneous warfarin with proton pump inhibitors, including pantoprazol. The risk of abnormal bleeding and death; Need to monitor the increase of the Inr and prothrombin time when Pantoprazol is simultaneously used with Warfarin.

Sucralfat: can slow down the absorption and reduction of the bioavailability of proton pump inhibitors (such as Lansoprazol, Omeprazol); Take the proton pump inhibitors at least 30 minutes before using sucralfat.

Storage

In closed packaging, at temperatures below 30 ° C.

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