Panto-denk 20 tablets treat mild reflux disease (2 blisters x 14 tablets)

Dosage form Box of 2 blisters x 14 tablets
Specifications Pantoprazole

Ingredient

Composition information	Content
Pantoprazole	20mg

Uses

Indications

Panto-denk Denk Pharma is indicated in the following cases:

Treatment of mild reflux disease and related symptoms (such as heartburn, heartburn, losing noise).

Preventing the colon's stomach ulcer caused by non -selective steroid anti -inflammatory drugs (NSAID) in patients with risks of continuous treatment with NSAIDs.

Pharmacy

Pantoprazol is a benzimidazole derivative, which inhibits gastric acid secretion by a special reaction to the proton pump of the wall cell. Pantoprazol converts into activity in the acid compartment of the wall cell, where it inhibits the enzyme H*/k* atpase, meaning that at the end of the production of acid production in the stomach.

The inhibition of the drug depends on the dose and the drug affects both the basic excretion and when stimulated the acid of the stomach. As with other proton pump inhibitors and H2 receptor blockers, the acid of the stomach is reduced when treated with pantoprazole, resulting in an increase in gastrin levels corresponding to the acid reduction.

Gastrin levels can be reversed. When Pantoprazole is linked to the peripheral part of the enzyme to the level of receptor, it can affect the excretion of the stomach's acid secretion despite the stimulation of other substances (acetylcholin, histamine, gastrin). Gastrin concentration when hungry increases during treatment with pantoprazol.

When used in a short time, Gastrin concentration usually does not exceed the threshold.

When using pantoprazol long -term, Gastrin levels doubled in most cases.

pharmacokinetics

General pharmacokinetics

Pantoprazol is absorbed quickly. The whole active ingredient achieves the concentration right after taking the dose of 20 mg of pantoprazol. On average, the peak concentration in the serum is about 1 - 1.5 Ug/ml achieved after 2 hours of taking the medication and maintaining the constant after taking many doses. The distribution is about 0.15 l/kg; The clearance is about 0.1 l/h/kg. The last half life is calculated about 1 hour.

Due to the special activation of pantoprazol in wall cells, half -life eliminated is not related to too long impact time (acid excretion inhibition). About 98% Pantoprazol binds to serum protein.

Pantoprazol is almost only decomposed in the liver. Most metabolites (about 80%) excreted through the kidneys, the rest excreted through feces. The main metabolites are Desmethyl Pantoprazol linked to sulfate found both in serum and in the urine.

The half -life of this major metabolic substance (about 1.5 hours) longer than half of Pantoprazol.

Birth

pantoprazol is completely absorbed after drinking.

The absolute bioavailability of the pill is found about 77%.

There is no impact of food or anti -acid substances used simultaneously on AUC, the peak concentration in the serum and thus both bioavailability.

However, food that can slow down the absorption for up to 2 hours or longer.

Before taking Panto-denk 20 tablets treat mild reflux disease (2 blisters x 14 tablets)

How to use

Do not chew or crush panto-denk tablets, but only swallow whole tablets with a little water.

Dosage

Adults and children aged 12 and older

Mild reflux disease and related symptoms (such as heartburn, heartburn, losing noise) is recommended as 1 panto-denk 20 tablet daily. In general, symptoms are improved within 2-4 weeks and for regular esophagitis one treatment is 4 weeks.

If after a treatment is not as expected, it will usually be achieved in the next 4 weeks. Once the symptoms have been achieved, the recurrence of symptoms will be controlled to use 20 mg of pantoprazol once a day. If the appropriate symptom control cannot be maintained with the required treatment, it is advisable to consider switching to maintenance treatment mode.

Long-term treatment and prevention of recurrence of reflux esophagitis in long-term treatment, the maintenance dose is recommended to be used a panto-denk 20 daily and may increase the dose of up to 40 mg of pantoprazol in the event of a recurrence. After one treatment at a dose of 40 mg of pantoprazol, a dose of up to 20 mg of pantoprazol may be reduced. In long -term treatment, the treatment period exceeds a year is only applied after careful consideration between benefits and risks, because the safety of the drug used for many years has not been fully established.

Adults

Preventing the colon's stomach ulcer caused by nonsteroidal anti -inflammatory drugs (NSAIDs) in patients at risk of continuous treatment for these drugs. The recommended oral dose is daily using a panto-denk 20.

Patients with liver failure

For patients with severe liver failure, daily dose must not exceed 20 mg of pantoprazol.

Patients with kidney failure and older patients

No dose adjustment for patients with renal impairment and older patients.

Children under 12 years old

Do not use Panto-Denk 20 for children under 12 years of age without the appropriate data for this age group.

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? Monitor the activity of the heart, blood pressure. If vomiting is prolonged, water and electrolytes must be monitored. Because Pantoprazol is strongly attached to plasma proteins, the method of separation does not eliminate the drug.

What to do when forgetting 1 dose? However, if the time to relax with the next dose is too short, skip the dose and continue the calendar of the drug. Do not use double dose to compensate for missed dose.

Side Effects

When using Panto-Denk Denk Pharma, you may experience unwanted effects (ADR).

Common, ADR> 1/100

Body: tired, dizzy, headache.

Skin: skin rash, urticaria.

Body: weakness, dizziness, dizziness, insomnia.

Skin: 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

Panto-denk Denk Pharma is contraindicated in the following cases:

Hypersensitivity to active ingredients, soybeans, peanuts, or any excipients of the drug.

Be cautious when using

for patients with liver impairment, liver enzyme monitoring during treatment with pantoprazol, especially when long -term treatment. In the case of increased liver enzymes, panto-denk 20.

The use of Panto-Denk 20 to prevent colon colitis caused by nonsteroidal anti-inflammatory drugs (NSAIDs) needs to be limited in patients who require continuous treatment with NSAIDs and patients at high risk of developing small gastric stomach complications. It is necessary to assess increased risks on the basis of specific risk factors such as increased age (over 65 years), a history of colon stomach or bleeding in the gastrointestinal tract on the small intestine.

Vitamin B12 malabsorption may occur with Pantoprazol as a result of a deficient hydrochloric acid. This problem should be considered, especially for patients with long -term treatment with separate risk factors that are less absorbed in vitamin B12 or the amount of vitamin B12 reserves is reduced. It is necessary to rule out the possibility of malignant tumor based on the beginning of some suspected warning signs or have stomach ulcers because the treatment with Pantoprazol can cover symptoms and slow down the diagnosis.

If the symptoms are persistent, although appropriate treatment, it is necessary to consider other screening. Need to regularly monitor patients with long -term treatment, especially when treatment exceeds a year. It is necessary to check patients without response to treatment after 4 weeks.

Magne deficiency: In most patients affected, the lack of magnesium is improved after the replacement of magnesium and stop using proton pump inhibitors. For patients who need long -term treatment or use proton pump inhibitors with digoxin or drugs that cause magnesium deficiency (such as diuretics), health workers must check the magnesium level before starting treatment with proton pump inhibitors and periodically during treatment.

fractures: Proton pump inhibitors especially if taken high doses and for a long time (over 1 year) can increase a little risk that causes hip bone, wrist bone, spine, mostly in the elderly or have other known risk factors. Patients at risk of osteoporosis must be carefully cared for under the current clinical instructions and they need to use vitamin D and calcium in appropriate amounts.

What drugs contain Maititol, patients with rare genetic problems with non-tolerance fructose cannot use Panto-Denk 20.

The ability to drive and operate machinery

Panto-Denk does not affect the ability to drive and operate the machine. However, some unwanted effects such as dizziness, or blurred vision can affect the patient's reaction ability to weaken the ability to drive and operate the machine.

Pregnancy

Clinical experience in pregnant women is limited. In reproductive studies on organisms, people observe mild toxicity on the fetus. Therefore, this drug is only used with caution for pregnant women.

Breastfeeding period

unknown pantoprazol moves into human milk. Panto-Denk 20 should only be used during breastfeeding if the benefits for the mother are greater than the potential risk for the baby.

Medicinal interaction

Panto-Denk 20 can reduce the absorption of drugs that depend on pH (for example, ketoconazol or intraconazo). Atazanavir absorption depends on pH; Therefore, do not simultaneously use proton pump inhibitors like pantoprazol with Atazanavir.

The active ingredient of Panto-Denk 20 is metabolized through the P450 enzyme system in the liver. It is not possible to rule out the interaction of pantoprazol with other drugs or other substances that are also metabolized with the same enzyme system. Studies have been conducted with carbamazepin, caffeine, diazepam, diclofenac, digoxin, ethanol, glibenclamid, metoprolol, naproxen, nifedipine, phenytoin, piroxicam, theophylllin, and a oral contraceptive drug.

According to the after -sales experience, there are a few specific cases that reported the coagulation time/Inr (Intemational Normalized Ratio) when treating Phenprocoumon or Warfarin simultaneously. Therefore, in patients treated with anticoagulants, blood coagulation/IrN should be monitored before starting and after the end of treatment with pantoprazol and when using unpredictable pantoprazol.

Functional pain and bone pain can occur when using methotrexat along with Pantoprazol.

Storage

Store at temperatures below 30 ° C. Stay out of reach of children.

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