Pantoprazole 20 & 40 mg

Pantoprazole 20 & 40

Gastrointestinal drugs

Gastrointestinal drugs > Acid-blocking and anti-ulcer drugs > Proton pump inhibitors

Tab = each tablet contains pantoprazole (in the form of sodium sesquihydrate) 20 mg and 40 mg enteric coated tablets

This medicine inhibits the production of acid in the stomach by inhibiting the K+/H+/ATPase pump.

Proton pump inhibitors inhibit gastric acid secretion by inhibiting the hydrogen-potassium adenosine triphosphate enzyme system in gastric mucosal cells.

Pantoprazole is used in the treatment of benign gastric and duodenal ulcers, helicobacter pylori-related ulcers, Zollinger-Ellison syndrome, reduction of stomach acid in surgery, and short-term prevention of reflux and disease treatment.

This medicine can be used in the treatment of indigestion and reflux disease, as well as in the prevention and treatment of ulcers associated with NSAIDs.

In patients who need chronic NSAID intake, the dose of Omeprazole should not be reduced after healing of the ulcer since it is possible for the ulcer to progress without any symptoms.

This medicine may hide the symptoms of stomach cancer. Therefore, high-risk patients should be checked for stomach malignancy before starting the treatment.

This drug can be taken to reduce the destruction of pancreatic enzymes supplements in patients with cystic fibrosis.

A high dose of this drug is used to control gastric acid secretion in Zollinger-Ellison syndrome.

Intravenous administration of pantoprazole along with endoscopic treatment of bleeding caused by severe gastrointestinal ulcers reduces the risk of rebleeding and the need for surgery.

The use of this medicine during pregnancy and breastfeeding should be carried out only under the advice of a specialist.

General characteristics of interactions:

Alkalizing stomach environment

Category X interactions to avoid:

Acalabrutinib, cefuroxime, dacomitinib, Dasatinib, delavirdine, erlotinib, nelfinavir, neratinib, pazopanib, Pexidartinib, Rilpivirine, Volpatasvir

Reducing the effects of medicines by Pantoprazole:

Acalabrutinib, atazanavir, bisphosphonate derivatives, bosutinib, capecitabine, cefditoren, cefpodoxime, cefuroxime, clopidogrel, cysteamine (systemic), dacomitinib, Dasatinib, Delavirdine, Doxycycline, erlotinib, gefitinib, indinavir, iron compounds, itraconazole, ketoconazole (systemic), ledipasvir, Mesalamine, multivitamin/mineral (containing A, D, E, K, folate and iron), mycophenolate, nelfinavir, neratinib, nilotinib, pazopanib, Pexidartinib, Posaconazole, Rilpivirine, Riociguat, risedronate, secretin, Selpercatinib, sorafenib, Velpatasvir

Reducing the effects of pantoprazole by drugs:

Lumacaftor and ivacaftor, tipranavir

Enhancement effects of drugs by pantoprazole:

Amphetamine, dexmethylphenidate, dextroamphetamine, itraconazole, methotrexate, methylphenidate, Raltegravir, risedronate, saquinavir, voriconazole

Increased effects of pantoprazole by drugs:

Ketoconazole (systemic), voriconazole

Interference with food:

Long-term treatment (2 years or more) may lead to malabsorption of dietary vitamin B12 and vitamin B12 deficiency.

This medicine should be used with caution in patients suffering from or having a history of chronic liver disease.

Long-term use of pantoprazole may cause deficiency of magnesium and vitamin B12 stores.

On top of that, long-term intake of pantoprazole for more than one year aggravates osteoporosis.

It is forbidden to prescribe this medicine to patients suspected of gastric cancer.

Common complications >10%:

Central nervous system: headache

Relatively common side effects (1-10%):

Cardiovascular: facial edema, edema, thrombophlebitis

Central nervous system: dizziness, depression

Skin: skin rash, hives, itching, skin sensitivity to light

Endocrine and metabolism: increased serum triglycerides

Gastrointestinal: diarrhea, abdominal pain, vomiting, constipation, flatulence, nausea, xerostomia

Hematology and oncology: leukopenia, thrombocytopenia

Hepatic: increased liver enzymes, hepatitis

Hypersensitivity: Hypersensitivity reaction

Neurological, muscular and skeletal: joint pain, increased creatine phosphokinase, muscle pain

Ocular: blurred vision (refractive error)

Respiratory: upper respiratory tract infection

Miscellaneous: Fever

Prevention of reflux disease (return of stomach acid into the esophagus):

20 mg should be taken once a day in the morning. In case of relapse, the dosage can be increased to 40 mg once a day.

Gastroesophageal reflux disease treatment:

40 mg once a day (preferably in the morning) for eight weeks.

The doctor may continue prescribing the medicine for and extra eight weeks if there is no improvement.

It is forbidden to take pantoprazole with nelfinavir and atazanavir, and if you take these drugs, be sure to inform your doctor.

In the treatment of stomach bacteria (Helicobacter) Pantoprazole may be prescribed along with several types of antibiotics for which it must be taken exactly according to the doctor’s prescribed time and dosage. 

Pantoprazole is also used in the treatment of gastric ulcer, gastric reflux as well as the reduction of digestive side effects of other medicines.

It is recommended to take the medicine one hour before breakfast. Pantoprazole is used to reduce stomach acid, though it does not affect the acid in the stomach. Thus, in case of severe cardialgia, you should see a doctor, especially in patients who suspect angina, since in many cases, angina and abdominal pain cannot be diagnosed without a checkup.

In case of osteoporosis, blood magnesium deficiency and hepatic disease, consult a doctor before taking pantoprazole. If you are pregnant and breastfeeding, it is forbidden to take pantoprazole.

Long-term intake of pantoprazole increases the risk of bone fractures, especially in the elderly.

Pantoprazole is not approved to be prescribed for children under 5 years of age.

Due to the fact that gastric acid destroys many microbes that enter the body through food, lack of it can reduce the body’s defense against bacterial and amoebic factors, so patients who take pantoprazole should pay more attention to health issues.

Store at a temperature below 30 degrees Celsius, in the original packaging, away from direct sunlight and humidity.