Panto-denk 40 tablets treat duodenal ulcer, stomach ulcer (2 blisters x 14 tablets)

Dosage form Box of 2 blisters x 14 tablets
Specifications Pantoprazole

Ingredient

Composition information	Content
Pantoprazole	40mg

Uses

Indications

Panto-denk 40 drugs are indicated in the following cases:

duodenum ulcer.

Stomach ulcer. Thick.

Pantoprazol converts into activity in the acid compartment of the wall cells, where it inhibits the H+/K+ ATPASE enzyme, which means 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.

For most patients, drugs mitigate symptoms within 2 weeks.

As with other proton pump inhibitors and H2 receptor blockers, the acid of the stomach is reduced when treated with pantoprazol, resulting in an increase in gastrin levels corresponding to the acid reduction. The increase in 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). This effect is the same regardless of oral or intravenous use.

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 for a long time, Gastrin levels doubled in most cases. However, an increase in excessive gastrin concentration occurs only in special cases. As a result, there is a slight increase in the stomach -specific endocrine cells (only for glandular hyperplasia) in a few cases of long -term pantoprazol. However, based on the research results so far, the development of warnings for cancer (non -typical increase) or stomach cancer can be removed from humans.

Based on research data on organisms, the effects on the thyroid gland and liver enzyme parameters are not excluded unless using pantoprazol for a year.

pharmacokinetic

Pantoprazol is absorbed quickly. The whole active ingredient achieves the concentration right after taking the 40 mg dose of pantoprazol. On average, the peak concentration in the serum is about 2-3 PG/mL achieved after 2.5 hours of taking the drug 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 of life was calculated about 1 hour. In a few cases, some patients are slowly eliminated. Due to the special activation of pantoprazol in wall cells, half -life eliminated is not related to too long impact time (acid excretion inhibition).

Pharmacokinetic properties are no different after taking a dose or repeating many doses. In the dosage range of 10 - 80 mg, Pantoprazol has almost linearly dynamic kinetic properties after oral and after intravenous injection.

About 98% Pantoprazol is linked 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 chemical substance Desmethyl pantoprazol is linked to sulfate found both in serum and in the urine. The half -life of this major metabolites (about 1.5 hours) longer than half a life of pantoprazol is negligible.

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.

Specialized patient groups: No need to reduce the dose for patients with renal failure (including the patient). Half life on healthy objects is short. Pantoprazol is criticized in a very short time. Although the half -life of the main metabolites is a little extended (2-3 hours), it does not accumulate while the excretion is still fast.

In patients with cirrhosis (Child- Pugh phase A or b), half -life extends to the values between 7 and 9 hours and the AUC value increases according to the factor of 5 - 7. However, the peak concentration only increases slightly with a factor of 1.5 compared to healthy subjects. The slight increase of AUC and CMAX values in the elderly compared to young people also does not mean clinical.

Before taking Panto-denk 40 tablets treat duodenal ulcer, stomach ulcer (2 blisters x 14 tablets)

How to use

Do not chew or crush Panto-Denk 40 but only swallow whole tablets with a little water.

In most cases, duodenal ulcer will heal for 2 weeks, if after 2 weeks is not enough, most cases will achieve results after the next 2 weeks.

For stomach ulcers and reflux esophagitis, usually a cure for disease is 4 weeks. If not enough, usually continue to treat for another 4 weeks will achieve results.

Combined treatment for stealing Helicobacter pylori bacteria, the treatment must be 7 days, ending the 7 -day ending can continue to use Pantoprazol to ensure healing of ulcers.

For duodenal ulcers, treatment time may have to be added 1 to 3 weeks.

For stomach ulcers, the treatment time may have to be added for 3 to 7 weeks.

Dosage

Adults and children aged 12 and older

Medium and severe reflux disease

The recommended oral dose is 1 panto-denk 40 tablet.

In special cases, especially patients who have not responded to treatment with other drugs, the dose may double (meaning daily use 2 panto-denk 40 tablets).

Stomach and duodenum ulcers

If only treated with Panto-Denk 40, according to the following dose instructions:

For peptic ulcer every day, use a panto-denk 40.

To treat Zollinger-Elison syndrome long and other disorders due to excessive gastric acid secretion, the starting dose is recommended 80 mg (meaning using 2 Panto-Denk 40 tablets). The dose is then adjusted according to the level of acid secretion.

When daily use higher than 80 mg, it must be divided into two times to drink. Temporary dose can be increased to 160 mg of pantoprazol per day. However, it is not longer than necessary to control acid secretion.

When treating Zollinger-Elison syndrome and disorders due to excessive gastric acid secretion, unlimited treatment time and can last as long as clinical requirements.

Except for Helicobacter pylori bacteria

Dosage is 40 mg pantoprazol, 2 times a day by one of the following 3 combinations:

Pantoprazol 40 mg + Clarithromycin 500 mg + Amoxicillin 1000 mg. The second pantoprazol tablet is taken before dinner.

Patients with liver failure

For patients with severe liver failure, daily dosage in the following days fades down to one tablet (40 mg of pantoprazol).

Patients with renal failure

No dose adjustment for patients with renal failure.

Older patients

For older patients, daily dose must not exceed 40 mg Pantoprazol.

Children under 12 years old

Do not use Panto-Denk 40 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?

Symptoms

The overdose data of proton pump inhibitors in humans is limited.

Signs and symptoms of an overdose may be: fast heartbeat, vasodilation, chicken sleep, confusion, headache, blurred vision, abdominal pain, nausea and vomiting.

Handling

Stomach washing, active carbon, symptomatic treatment and support.

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 removal method does not eliminate the drug.

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 Panto-Denk 40, 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, dizzy, headache.

Skin: skin rash, urticaria.

Systemic: weakness, dizziness, dizziness, insomnia.

Skin: itching.

Systemic body: sweating, peripheral edema, discomfort, anaphylaxis. Inhibiting, tinnitus, tremor, confusion, hallucinations, abnormalities.

Ion disorders: Hemati sodium.

Instructions on how to handle ADR

Notify the doctor any unwanted effects related to the use of the drug.

Warnings

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

Contraindicated

Panto-denkn 40 contraindications in the following cases:

Hypersensitivity to active ingredients, soybeans, peanuts, or any excipients of the drug. Regarding the safety and effectiveness of Pantoprazol in combination treatments for these patients.

Caution when using

among patients with Zollinger-Ellison syndrome or other disorders due to excessive gastric acid secretion and long-term treatment, as well as other acid inhibitors, Pantoprazol can lead to poor absorption of vitamin B12 (cyanocobalamin) due to the consequences This issue should be considered if such clinical symptoms occur.

It is necessary to eliminate the possibility of malignant tumors based on the beginning of some warning signs (such as unwanted weight loss, vomiting many times, swallowing difficulty, vomiting blood, anemia, or suspected black blood) or stomach ulcers because of pantoprazol treatment can cover symptoms and slow diagnosis. If the symptoms lasts after 4 weeks, although the appropriate treatment is appropriate, it is necessary to consider other surveys.

Needs to adjust the dose for patients with severe liver failure.

For patients with severe liver failure, liver enzyme monitoring is required to be monitored regularly during treatment, especially for patients with long -term treatment. If the liver enzyme increases, it must be stopped.

All measures to reduce gastric acid include proton pump inhibitors that increase the number of common bacteria in the small intestine. Treatment with acidic blockers leads to slight increase in risk of small gastric infections, such as Salmonella and Campylobacter.

Magne of blood

In patients treated with proton pump inhibitors such as Pantoprazol for a minimum of 3 months and in most cases in a year there is a report on heavy magnesium deficiency.

The heavy manifestations of the lack of magnesium such as weakness, spasticity, delirium, convulsions, dizziness, ventricular arrhythmia may occur, but they may start silently and be overlooked.

In most affected patients, Magne deficiency is improved after Magne supplementation and stop using Proton pump inhibitors.

For patients who have to be treated for a long time or take proton pump inhibitors with digoxin or drugs that cause magnesium deficiency (such as diuretics), health workers must check the magnesium levels before starting treatment with proton pump inhibitors and periodically during treatment.

fracture

Proton pump inhibitors, especially if used in high doses and for a long time (over 1 year) can increase a little risk that causes hip bone, wrist bone, spine is largely in the elderly or have known risk factors.The studies have shown that proton pump inhibitors may increase the general risk of 10-40%. Some of this increase may be due to other 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 amount.

So far, there is no experience in treating children under 12 years old.

This drug contains maltitol, patients with rare genetic problems with fructose intolerance cannot be used Panto-Denk 40.

The ability to drive and operate machinery

Panto-Denk 40 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 40 should only be used during breastfeeding if the benefit for the mother is greater than the potential risk for the fetus.

Medicinal interaction

Panto-Denk 40 can reduce the absorption of drugs that depend on pH (for example, ketoconazol or intraconazole).

The reality shows that: when using 300 mg of Atazanavir or 100 mg of ritonavir with omeprazol (40 mg once a day) or 400 mg Atazanavir and Lansoprazol (one dose of 60 mg) on healthy objects have led to a significant reduction in the bioavailability of Atazanavir. The absorption of Atazanavir depends on the pH, so it is not used simultaneously proton pump inhibitors such as Pantoprazol with Atazanavir.The active ingredient of Panto-Denk 40 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. However, there are no clinical significance interactions proved in studies with some such drugs or substances.

Studies have been conducted with carbamazepin, caffeine, diazepam, diclofenac, digoxin, ethanol, glibenclamid, metoprolol, naproxen, nifedipine, phenytoin, piroxicam, theophylllin and a contraceptive medicine.Despite the non -observable interaction in clinical studies when using Phenprocoumon or Warfarin simultaneously, after the after -sales experience, there are a few special cases that reported the coagulation time/Inr (International Normalized Ratio) when treated 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.

There is no interaction when used simultaneously with anti -acid drugs.

In human pharmacokinetic interactive studies, Pantoprazol has been used in combination with some appropriate antibiotics (clarithromycin, metronidazol, amoxicillin) and does not see any clinical interactions that occur.

Severe muscle pain and bone pain may occur when using methotrexat along with Pantoprazol.

Storage

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

Other drugs

Disclaimer

Every effort has been made to ensure that the information provided by Drugslib.com is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Drugslib.com information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Drugslib.com does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Drugslib.com's drug information does not endorse drugs, diagnose patients or recommend therapy. Drugslib.com's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Drugslib.com does not assume any responsibility for any aspect of healthcare administered with the aid of information Drugslib.com provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.