The Redbama 40mg Atlantic medicine treats stomach - duodenal ulcer (6 blisters x 10 tablets)

Dosage form Box of 6 blisters x 10 tablets
Specifications Pantoprazole

Ingredient

Composition information	Content
Pantoprazole	40mg

Uses

indications

Redbama 40 mg drug is indicated in the following cases:

Destroy Helicobacter Pylori: Used in combination with two appropriate antibiotics (see the dose and usage) in patients with peptic ulcer, in order to reduce the recurrence of duodenal and stomach ulcers caused by this bacteria. An increase in disease excretion.

Pantoprazole is an alternative benzimidazole that inhibits the excretion of the acid secretion in the stomach by inhibiting selective in proton pumps in the stomach wall.

pantoprazole is converted into forms of active metabolic forms in the acidic environment of the stomach into the stomach due to inhibition of H+, K+ - ATPASE is the final stage of the production of hydrochloric acid. The inhibition of Pantoprazole depends on the dosage and has a simultaneous impact on the basic excretory process and increases the production of hydrochloride acid.

On most patients, symptoms will improve after 2 weeks. As with other H2 receptor inhibitors and inhibitors, Pantoprazole's treatment can cause acid reduction in the stomach and thus increasing gastrin concentration according to the reduced acid ratio. Gastrin increased process is reversible.

Because Pantoprazole is attached to the enzyme located far from the middle of the surface cell receptor, it can independently affect the excretion of hydrochloric acid of other stimulants such as acetylcholine, histamine, gastrin and this effect is the same if using pantoprazole in oral or intravenous.

Dynamic pharmacokinetics

Pantoprazole is quickly absorbed and reaches the maximum concentration in plasma after taking a single dose of 40 mg. On average, about 2 - 2.5 hours after oral, the drug reaches the maximum concentration in the serum is 1 - 1.5 µg/ml, this concentration remains the same after many treatments. The distribution volume is about 0.15 l/kg and the clearance is about 0.1 l/h/kg.

The last half -life of the drug is about 1 hour. There are only a few cases of slow elimination. Due to the selective activity of Pantoprazole in the cover cells, half -life of the excretion of non -linear activity with the time of prolonged impact of the drug (inhibitors of gastric acid secretion).

The pharmacokinetics of the drug does not change after the single dose or reminded treatment. At a dose of about 10 to 80 mg, the plasma dynamics of Pantoprazole are almost linearly when oral and intravenous treatment.

Pantoprazole ratio combined with serum protein is about 98%. The active ingredient is almost completely metabolized in the liver. The metabolic forms of Pantoprazole are excreted mainly in the kidneys (accounting for 80%), the rest is excreted in feces. The main metabolites both in serum and kidneys are Desmethylpantoprazole - the form of metabolism due to sulphate combination. Half of the excretion of the main metabolites (about 1.5 hours) is not much longer than the half -life elimination of Pantoprazole.

Birth

pantoprazole is completely absorbed after drinking. Birth full of tablets should reach 77%. The same food does not affect the area under the AUC curve, the maximum concentration of the drug in the serum and therefore does not affect bioavailability. There is a variation of the delay period (the time to achieve the values due to the above bioavailability) may increase due to the food used.

Pharmacokinetic properties in patients/groups of special patients

No need to reduce the dose of pantoprazole in patients with poor renal function (including patients who are in the feces). As above healthy volunteers, the sale time of short pantoprazole. Only a small amount of pantoprazole is separated. Although the main metabolites have a slow selling time at an average level (2-3 hours), it is still excreted quickly and therefore no accumulation occurs.

In patients with cirrhosis (Type A and B according to the classification of Child) The selling time value increases from 3-6 hours and the value of the area under the AUC curve increases according to the coefficient of 3 - 5, the maximum concentration of the active ingredient in serum only increases slightly with a factor of 1.3 times when compared to healthy people.

There may be a slight increase in the area under the curve and the maximum concentration in the serum on the healthy volunteer in the older group when the taller group is younger but not clinically related.

Before taking The Redbama 40mg Atlantic medicine treats stomach - duodenal ulcer (6 blisters x 10 tablets)

How to use

Take oral use.

Do not chew or crush pantoprazole but have to drink whole tablets with water, an hour before breakfast. In Helicobacter Pylori, need to take the second pantoprazole tablet before dinner.

Normally, when treating combined drugs, the drug time is 7 days can last for 2 weeks. To ensure healing of ulcers can extend the pantoprazole treatment time, but it is necessary to consider recommended dose for duodenal ulcer and stomach ulcers. In general, it is possible to heal duodenal ulcers within 2 weeks. If the 2 -week treatment period is not enough, in most cases it can heal duodenum ulcers when using pantoprazole for another 2 weeks.

Because there is not enough clinical experience for long -term treatment, pantoprazole treatment must not exceed 8 weeks.

Dosage

recommended dose

In patients with stomach and duodenal ulcer, Helicobacter pylori infection (positive), need to kill bacteria by combined therapy. Depending on the type of drug resistance, recommend the following combination treatment regimens to kill Helicobacter pylori:

Regimen 1: 2 times a day x (1 pantoprazole + 1000 mg amoxicillin + 500 mg clarithromycin). Pantoprazole + 1000 mg amoxicillin + 500 mg metronidazole).

duodenum ulcer, stomach ulcer and reflux esophagitis, most of the usual doses 1 pantoprazole daily. Reason, patients should start treatment at a dose of 80 mg/day (2 tablets/day). Then increase or decrease the dose as required by measuring the concentration of gastric acid secretion to orient. With a dose of over 80 mg/day, it is necessary to divide and take the drug 2 times. The temporary dose may be increased over 160 mg pantoprazole/day but not treated longer than the necessary time for stomach acid to be adjusted. Pantoprazole, every two days. In addition, while using pantoprazole need to monitor liver enzymes, if the increased liver enzymes must stop taking the drug immediately.

For elderly people or kidney failure, do not overdose ordinary Pantoprazole 40 mg. Except for the use of combined therapy to kill H.pylori, then pantoprazole must be used twice as usual (2 x 40 mg/day) in a week of treatment.

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 do

do when using overdose? In case of overdose and clinical poisoning symptoms, the application of common detoxification rules.

In an emergency, call the 115 emergency center immediately or go to the nearest local health station.

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 Redbama 40 mg, you may experience unwanted effects (ADR).

Unwanted effects are divided by the following levels: Popular (> 1/100, 1/1000, 1/10000,

On blood and immune system

Very rare such as: leukopenia, thrombocytopenia.

Gastrointestinal disorders

common: upper abdominal pain, diarrhea, constipation or flatulence.

less common: nausea, vomiting.

Rarely cases of dry mouth.

Systemic and local disorders

Very rare: peripheral edema.

Liver disorder

Severe liver damage is rarely seen.

immune system disorders

Very rare anaphylactic reactions including anaphylaxis in very few cases.

Examination

Very rare: increased liver enzymes (Transaminase, γ - GT), increased triglycerides, body temperature.

musculoskeletal disorders and connective tissue

Rare: joint pain.

Very rare: muscle pain.

Nervous system disorders

Popular: headache.

Less common: dizziness, vision disorders (blurred vision).

Mental disorders

Rare: depression.

Kidney and urinary disorders

Interstitial nephritis is in very few cases.

Skin disorders and subcutaneous organizations

Sometimes allergic reactions such as itching and skin rash, rare cases of urticaria, angioedema or serious allergic reactions on the skin such as Steven - Johnson syndrome, polymorphic erythematosus, lyell syndrome, light sensitivity.

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

Redbama 40 mg is contraindicated in the following cases:

Do not use pantoprazole for cases where there is a history of sensitive to any ingredients of the drug or any drug used in combined treatments.

pantoprazole should not be used in combined therapy to kill H.P in patients with medium to severe liver and kidney dysfunction, because there is currently no safety and effectiveness of Pantoprazole in combined therapy to kill H.P in these patients.

Be cautious when using

do not indicate pantoprazole for mild digestive disorders such as nerve indigestion.

In the drug combination therapy, it is necessary to pay attention to the characteristics of the combined drug.

Before treatment with Pantoprazole, it is necessary to eliminate the possibility of malignant stomach ulcers or malignant esophagitis, because treatment with Pantoprazole may temporarily lose symptoms of malignant ulcer disease, so it can slow down cancer diagnosis.

Diagnosis of reflux esophagitis should be confirmed by endoscopy.

There is no experience in treating Pantoprazole in children.

For patients with Zollinger - Ellison syndrome and the condition of increased diseases that need long -term treatment, Pantoprazole is like other acidic blockers, which can reduce the absorption of vitamin B12 (cyanocobalamin) caused by reduced or no acid secretion. This should be noted when there are clinical symptoms in each individual.

The ability to drive and operate machinery

is currently unclear the effect of the drug when used for drivers or operating machinery.

Pregnancy

Clinical experience of pantoprazole when used during pregnancy is limited. In animal reproductive studies, the signs of toxicity on the mild fetus are recorded at a dose of over 5 mg/kg.

The period of breastfeeding

There is no information on the post of Pantoprazole through breast milk. Therefore, only pantoprazole when the mother's benefits are considered greater than the risk of the fetus and the baby.

Drug interaction

pantoprazole may reduce the absorption of drugs that depend on pH (e.g. ketoconazole).

The active ingredient of Pantoprazole is metabolized in the liver thanks to the cytochrome P450 enzyme system. It does not exclude the possibility of pantoprazole interacting with other drugs metabolic and cytochrome P450 enzyme system. However, the clinical clinical has not seen significant interactions in specific trials with some drugs or compounds of the above -mentioned properties such as carbamazepine, caffeine, diazepam, digoxine, ethanol, glibenclamide, metoprolol, nifedipine, phenprocoumon, phenytoin, theophyllline, warfarine and other oral contraceptives by drink.

Do not observe drug interactions when treated simultaneously with phenprocoumon and wafarin in clinical pharmacokinetic studies, there are very few cases of changing the rate of ordinary international chemistry Inr stated in the drug circulation report when coordinated treatment. Therefore, in patients treated with coumarin -style anticoagulants, prothrombin/INR is required to monitor the ratio of prothrombin/INR time at the beginning, end or when there is an abnormal treatment with pantoprazole.

also do not see pantoprazole interacting with antacids (treat stomach pain) when taken at the same time.

There is no interaction with antibiotics used in combination (clarithromycine, metronidazol, amoxicylline) in the treatment of Helicobacter pylori.

Storage

Leave at a temperature lower than 300C.

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