Pantoprazole - instructions for use, analogs, reviews and release forms (tablets of 20 mg and 40 mg) of the drug for the treatment of ulcers, gastritis, gastric esophagitis and duodenal ulcer in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Pantoprazole. There are reviews of visitors to the site - consumers of this medication, as well as opinions of specialists on the use of Pantoprazole in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Pantoprazole in the presence of existing structural analogues. Use for the treatment of ulcers, gastritis,esophagitis of the stomach and duodenum in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Pantoprazole - inhibitor of H-K-ATPase. It blocks the final stage of the secretion of hydrochloric acid, reduces the level of basal and stimulated (regardless of the type of stimulus) secretion of hydrochloric acid in the stomach. With duodenal ulcer associated with Helicobacter pylori (Helicobacter), this reduction in gastric secretion increases the sensitivity of the microorganism to antibiotics. Pantoprazole has its own antimicrobial activity against Helicobacter pylori.

Composition

Pantoprazole sodium + excipients.

Pharmacokinetics

Quickly and completely absorbed after ingestion. Absolute bioavailability of 70-80% (mean 77%). Binding to plasma proteins is 98%. Very weakly penetrates the blood-brain barrier (GEB), is secreted into breast milk. Admission of antacids or food does not affect AUC, Cmax and bioavailability. Pharmacokinetics is linear in the dose range of 10-80 mg (in proportion to the increase in dose, AUC and Cmax increase). Metabolised in the liver (oxidation, dealkylation, conjugation).Has a low affinity for the cytochrome P450 system, in the metabolism, mainly the isozymes CYP3A4 and CYP2C19 are involved. The main metabolites are demethylpentoprazole and 2 sulfated conjugates. It is excreted mainly in the urine (82%) in the form of metabolites, in a small amount found in the stool. Do not cumulate.

Indications

• peptic ulcer of the stomach or duodenum in the phase of exacerbation;
• Zollinger-Ellison syndrome;
• eradication of Helicobacter pylori (in combination with antibiotic therapy);
• dyspepsia (nausea, vomiting, flatulence and other symptoms);
• reflux esophagitis.

Forms of release

Tablets, coated with a coating of 20 mg and 40 mg (sometimes mistakenly called capsules).

Instructions for use and dosing regimen

Inside. The tablet should be swallowed whole, not chewing and not breaking, squeezed with a small amount of liquid, before meals, usually before breakfast. When taking twice a second dose of the drug is recommended before dinner.

Peptic ulcer of the stomach and duodenum, erosive gastritis (including those associated with the intake of NSAIDs)

The recommended dose is 40-80 mg per day. The course of treatment 2 weeks with exacerbation of duodenal ulcer and 4-8 weeks with exacerbation of gastric ulcer.

Anti-relapse treatment of peptic ulcer of the stomach and duodenum - 20 mg per day.

Eradication of Helicobacter pylori

As a triple therapy, the following combinations are used:

1. Pantoprazole 20-40 mg twice a day + amoxicillin 1000 mg twice a day + clarithromycin 500 mg 2 times a day. The course of treatment is 7-14 days.
2. Pantoprazole 20-40 mg 2 times a day + metronidazole 500 mg 2 times a day + clarithromycin 500 mg 2 times a day. The course of treatment is 7-14 days.
3. Pantoprazole 20-40 mg 2 times a day + amoxicillin 1000 mg 2 times a day + metronidazole 500 mg 2 times a day. The course of treatment is 7-14 days.

After the end of the combination therapy, the drug Pantoprazole may be continued to heal ulcers. With a duodenal ulcer, taking Pantoprazole may be extended from 1 to 3 weeks.

Patients with severe renal impairment (Cl creatinine less than 20 ml / min) or who are on hemodialysis eradication therapy Helicobacter pylori is not assigned.

Treatment of symptoms of GERD of mild severity (such as heartburn, nausea, acidic eructation)

The recommended dose of the drug is 20 mg per day. To achieve positive dynamics in the removal of symptoms may require taking the drug for 2-3 days, but to completely eliminate the symptoms may require taking the drug for 7 days.If the condition worsens during the first 3 days of treatment, a specialist consultation is recommended. The drug should be discontinued immediately after the symptoms disappear.

Zollinger-Ellison Syndrome

The recommended dose is 40-80 mg per day. In patients with severe impairment of liver function, the dose should be reduced to 40 mg once every 2 days. In this case it is necessary to control the biochemical parameters of the blood. When the activity of liver enzymes increases, the drug should be discontinued.

Side effect

• diarrhea;
• nausea;
• pain in the upper abdomen;
• flatulence;
• headache;
• weakness;
• dizziness;
• initial manifestations of depressive states;
• visual impairment;
• rash;
• itching;
• weakness;
• dizziness;
• edema;
• fever.

Contraindications

• dyspepsia of neurotic genesis;
• malignant diseases of the digestive tract;
• Children under 6 years of age (no experience of use);
• increased sensitivity to pantoprazole.

Application in pregnancy and lactation

If it is necessary to use Pantoprazole during pregnancy, it is necessary to evaluate the prospective benefit to the mother and the potential risk to the fetus.

If it is necessary to use during lactation, the question of stopping breastfeeding should be resolved.

In experimental studies, it has been established that pantoprazole is excreted in breast milk.

Use in children

Contraindicated in children under 6 years of age (no clinical data on the use of the drug in this age group).

special instructions

Before the start of therapy, the possibility of a malignant neoplasm in the stomach and esophagus should be excluded, since the use of Pantoprazole reduces the severity of the symptoms and may delay the establishment of the correct diagnosis. The diagnosis of reflux esophagitis requires mandatory endoscopic confirmation.

When used in patients with impaired liver function, the activity of liver enzymes in the blood plasma should be regularly monitored and when pantoprazole is removed, pantoprazole should be withdrawn.

Drug Interactions

With the simultaneous use of pantoprazole can change the absorption of drugs, the absorption of which depends on the pH of the gastric contents (ketoconazole).

Due to the fact that pantoprazole is metabolized in the liver by the enzymatic system of cytochrome P450, it is impossible to exclude the possibility of drug interaction with drugs,metabolized by the same enzyme system.

Analogues of the drug Pantoprazole

Structural analogs for the active substance:

• Zipantola;
• Controllers;
• Crosatide;
• Nolpaz;
• Pantaz;
• Pantoprazole Canon;
• Panum;
• Pepazol;
• Pienenum;
• Puloreph;
• Sunpras;
• Ulter.

Analogues for the pharmacological group (proton pump inhibitors):

• Acrylase;
• Vimovo;
• Gastrozole;
• Dexylant;
• Demeprazole;
• A zerocide;
• Zolser;
• Zulbeks;
• Controllers;
• Crosatide;
• Lanzabel;
• Lanzap;
• Lansoprazole;
• Lancid;
• Losek;
• Loenzar;
• Nexium;
• Nolpaz;
• Нофлюкс;
• Omez;
• Omez Insta;
• Omeprazole;
• Omepros;
• Omeface;
• Omizak;
• Omitox;
• Ontime;
• Ortanol;
• Ozid;
• Pantaz;
• Pantoprazole Canon;
• Panum;
• Parries;
• Pepazol;
• Pepticum;
• Pylobact;
• Plem;
• Rabelock;
• Rabeprazole;
• Romesque;
• Sunpras;
• Ulzol;
• Ulcozol;
• Ulter;
• Ultop;
• Hirabesol;
• Helithrix;
• Helicid;
• Cisagast;
• Esomeprazole;
• Emanera;
• Epicurus.

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