Pantostad 40 Stella Treatment Treatment of Gastroesophageal reflux (4 blisters x 7 tablets)
Dosage form Box of 4 blisters x 7 tablets
Specifications Pantoprazol
Ingredient
| Composition information | Content |
| Pantoprazol | 40mg |
Uses
Indications
Pantostad 40 is indicated in the following cases:
pantoprazole is a proton pump inhibitor, preventing the final step in the process of forming acid in the stomach by covalent bond with enamel system (H+, K+)- Atpase at the secret surface of the stomach cell wall. This effect leads to inhibition of both basic stomach acid secretion mechanisms and stimulant agents. The cohesion with the enamel system (H+, K+)-ATPASE provides an acid secretion effect for more than 24 hours at all doses.
pharmacokinetics
pantoprazole is quickly absorbed and reached the concentration of plasma nails after drinking about 2 - 2.5 hours.
Oral bioavailability tablets in the intestine is about 77%, there is no difference when taking a single or multi -dose.
About 98% Pantoprazolee is connected 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. The metabolites are weakened through urine (about 80%). The rest is eliminated through the bile.
Sales time after about 1 hour and longer lasting in patients with hepatic failure, in patients with cirrhosis of the sale time about 3 - 6 hours.
Although the sale time in the slow drug metabolic person is reported from 3.5 to 10 hours, there is a very small accumulation that occurs at the dose once a day.
Before taking Pantostad 40 Stella Treatment Treatment of Gastroesophageal reflux (4 blisters x 7 tablets)
How to use
pantostad 40 is used by oral. Should drink once a day in the morning, before eating.
Dosage
Gastroesophageal reflux disease - esophagus
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 1g x 2 times/day or Metronidazol 400 mg 2 times/day.
Prevention of nonsteroidal anti -inflammatory drugs
The dose of 20 mg per day.
The increase in diseases (Zollinger-Elison syndrome)
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 Pantostad 40 , 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: tired, headache .
DA: Ban Da, urticaria .
joint muscle: muscle pain, joint pain.
Uncommon, 1/1000 ≤ ADR ≤ 1/100
Body: weakness, dizziness, dizziness.
Skin: itching.
Liver: Increase liver enzyme.
Rare, 1/10,000 ≤ ADR ≤ 1/1000
Systemic: sweating, peripheral edema, discomfort, anaphylaxis.
Skin: lumpy rash, acne, hair loss, peeling dermatitis, angioedema, diverse roses.
Gastrointestinal: stomatitis, belching, digestive disorders .
Eyes: blurred vision, fear of light.
Neurological: Insomnia, Sleeping, agitation or inhibition, tinnitus, tremor, confusion, hallucinations, paresthesia.
Blood: Acidic leukemia, granulocytosis, leukopenia, thrombocytopenia.
endocrine: impotence.
Urinary: Hematitis, interstitial nephritis .
Hepatitis: 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
Pantostad 40 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 drug can cause side effects such as dizziness and visual disorders. If these side effects occur. Patients should not drive or operate machinery. 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. The drug is distributed in breast milk, stop breastfeeding or stop taking the drug due to the potential risk of breastfeeding. The drug with pH dependent of the stomach Theoretical pharmacological interaction may occur when using Pantoprazole with drugs with pH -dependent pH -dependent drugs (such as ampicillin ester, iron salt, ketoconazol). It 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, monitoring Inr and prothrombin time when using Pantoprazole with Warfarin simultaneously. Sucralfat can slow down the absorption and reduction of the bioavailability of proton pump inhibitors, which should be taken at at least 30 minutes before using the proton pump before taking sucralfat. Precautions when using
The ability to drive and operate machinery
Pregnancy
Breastfeeding period
Medicinal interaction
Storage
In closed packaging, dry place. The temperature does not exceed 30 ° C.
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