Pantoprazole

Pantoprazole has antiulcer properties.

[1],

Indications of the pantoprazole

It is used for such disorders:

• gastrinoma;
• exacerbated ulcerative pathology;
• destruction of the microbe Helicobacter pylori;
• GERD.

[2]

Release form

The release occurs in tablets, in an amount of 10 pieces inside the blister pack. In the box - 1 or 3 such blister plates.

[3]

Pharmacodynamics

The drug depresses the production of hydrochloric acid, affecting the lining cells - in the area of the proton pump. The active element turns into its active form inside the channels of the membranes of parietal glandulocytes and blocks the activity of the H ⁺ / K ⁺ -ATPase enzyme, that is, the last stage of binding of hydrochloric acid.

In many patients, improvement begins after 2 weeks of treatment. Like other drugs that block the activity of the proton pump and conductors of the form H2, Pantoprazole helps to reduce pH, and in addition to increasing the level of gastrin.

[4], [5], [6], [7], [8], [9]

Pharmacokinetics

The drug is actively absorbed, reaching peak values already with a one-time use. The average period for reaching the peak value of LS is 2.5 hours from the moment the tablet is taken.

The half-life is approximately 1 hour. Occasionally, cases with a delay in excretion were observed.

Synthesis with protein within the plasma reaches 98%. The unchanged substance is almost completely transformed inside the liver.

About 80% of the decomposition products are excreted through the kidneys, and the remainder is excreted with feces. The main metabolite is desmethylpentoprazole, the half-life of which is approximately 1.5 hours.

[10], [11], [12], [13], [14], [15]

Dosing and administration

Tablets can not be crushed or chewed - they are swallowed completely, washed down with water. Reception should occur before meals.

During the elimination of reflux pathology in mild form, as well as complications related to the disease (heartburn, pain during swallowing and belching with a sour taste), you must first take 20 mg of medication per day. Weakening manifestations of the disease is observed after approximately 0.5-1 month. To treat the esophagitis that developed as a result of pathology, a course lasting 1 month is required. If there is no result after this time, one should expect recovery in the new month. To avoid relapse, it is required to take 20 mg of medication once a day (if necessary). If it is not possible to support the above-described control of manifestations, it is permissible to consider the option of switching to permanent treatment.

During prolonged therapy with GERD, it is required to take a maintenance daily dose of 20 mg. If the patient has frequent relapses, it is necessary to increase the daily dose in half - to 40 mg. After eliminating the manifestations of relapses, it is possible to again reduce the size of the daily dose to 20 mg.

To prevent the development of an ulcer caused by the use of NSAIDs, people with risk factors for the occurrence of such a violation are required to take 20 mg of pantoprazole per day.

Elderly people and those who have problems in the work of the kidneys, you can not take more than 40 mg of medicine per day.

People with severe impairment of liver function are not allowed to take more than 20 mg of medication per day. Also, individuals in this group are required to constantly monitor the liver enzymes during treatment. If these values increase, the use of Pantoprazole should be stopped.

[16], [17], [18]

Use of the pantoprazole during pregnancy

The drug can be used during pregnancy only in the presence of life indications.

Pantoprazole is not used in breastfeeding.

Contraindications

The main contraindications:

• hypersensitivity to the constituents of the drug;
• hepatitis;
• hepatic cirrhosis, against which there is a functional liver failure in a severe degree.

Side effects of the pantoprazole

Taking medication can lead to the appearance of some side-effects:

• manifestations in the gastrointestinal tract: diarrhea, constipation, bloating, nausea, eructation, increased appetite, vomiting, abdominal pain, dryness of the oral mucosa, increased level of hepatic transaminases and GISO;
• disorders of the function of the NS and sensory organs: headaches, ear noise, depression and insomnia, and in addition tremor, asthenia, dizziness, paresthesia, sensation of drowsiness or nervousness, visual disturbances and photophobia;
• lesions of the urogenital system: impotence, hematuria and swelling;
• violations in the area of the skin: the appearance of acne, the development of exfoliative form of dermatitis or alopecia;
• signs of allergy: Quincke edema, hives, rashes and itching;
• other disorders: hyperglycemia and eosinophilia, fever, hypercholesterolemia, as well as hyperlipoproteinemia and myalgia.

Interactions with other drugs

The drug can weaken the absorption of drugs, the level of bioavailability of which varies depending on the pH (among such drugs - ketoconazole with itraconazole and atazanavir).

When using atazanavir, drugs that block the activity of the proton pump can not be used.

Although Pantoprazole is exposed to hepatic metabolism involving the hemoprotein P450, the drug-mediated interactions with carbamazepine, diclofenac, digoxin, diazepam, caffeine with napxen and nifedipine, as well as ethyl alcohol, glibenclamide, piroxicam with metoprolol, phenytoin with theophylline, and oral contraceptive is not found.

People taking anticoagulants from the coumarin group need to monitor the values of PTV, as well as INR during therapy with Pantoprazole, and after it is completed.

[19], [20], [21], [22]

Storage conditions

Pantoprazole is required to be kept out of the reach of children. The temperature should not exceed 25 ° C.

[23], [24], [25]

Special instructions

Reviews

Pantoprazole is considered to be quite effective in the treatment of GERD or ulcers. In their reviews, patients also note the low cost of the drug.

Side effects develop quite infrequently and usually in the case of non-compliance with instructions for the scheme of use.

[26], [27], [28]

Shelf life

Pantoprazole should be used for 3 years from the date of release of the drug.

[29], [30]