Acitop

Description

Acitop Tablet: Uses, Dosage, and Important Information

Acitop Tablet, containing the active ingredient Pantoprazole Sodium Sesquihydrate, is a medication manufactured by Aristo Pharmaceuticals Ltd. It’s available in Nepal and is a type of proton pump inhibitor (PPI) used to reduce stomach acid.

What is Acitop Tablet Used For?

Acitop Tablet is used to treat conditions related to excessive stomach acid, including:

• Peptic ulcer disease (ulcers in the stomach or small intestine)
• H. pylori infection (often used in combination with antibiotics)
• Gastro-oesophageal reflux disease (GERD), including erosive esophagitis (damage to the esophagus from acid reflux)
• Zollinger-Ellison syndrome (a condition causing excessive stomach acid production)
• Oesophagitis (inflammation of the esophagus)
• Acid-related dyspepsia (indigestion)
• NSAID-associated ulceration (ulcers caused by non-steroidal anti-inflammatory drugs)
• Ulcers resistant to H2 receptor antagonists (another class of acid-reducing drugs)
• Gastrointestinal (GI) bleeding from stress
• Prophylaxis for acid aspiration syndrome during the induction of anesthesia (to prevent stomach acid from entering the lungs during surgery)

How to Take Acitop Tablet

Acitop Tablet can be taken orally or administered intravenously (IV) when oral therapy isn’t possible.

Oral Dosage

• Erosive Esophagitis Associated with GERD:
  • Treatment: 40 mg once daily for 8-16 weeks.
  • Maintenance of healing: 40 mg once daily.
• Short-term Treatment of GERD (when IV therapy is switched to oral): Follow doctor’s instructions.
• Zollinger-Ellison Syndrome: 40 mg once daily. Doses up to 240 mg/day may be administered in some patients.
• Peptic Ulcer Disease:
  • Duodenal ulcer: 40 mg once daily for 2-4 weeks.
  • Gastric ulcer: 40 mg once daily for 4-8 weeks.

Administration Notes for Oral Tablets:

• Controlled-release tablets: Take on an empty stomach, about 1 hour before meals. Swallow the tablet whole; do not chew or crush it.
• Normal release tablets: May be taken with or without food.

Intravenous (IV) Dosage

• Erosive Esophagitis Associated with GERD (when oral therapy is inappropriate/not possible): 40 mg IV infusion over 15 minutes once daily for 7-10 days. Switch to oral therapy once the patient is able to swallow.
• Zollinger-Ellison Syndrome: 80 mg IV infusion every 8-12 hours for up to 7 days. Switch to oral therapy once the patient is able to swallow.

IV Preparation and Administration:

• For GERD with a history of erosive esophagitis (15-minute infusion): Reconstitute the vial with 10 mL Normal Saline (NS), then further dilute with 100 mL of Dextrose 5% in Water (D5W), NS, or Lactated Ringer’s (LR) solution to a final concentration of 0.4 mg/mL. Infuse over 15 minutes, not exceeding 3 mg/min (7 mL/min).
• For Zollinger-Ellison syndrome (15-minute infusion): Reconstitute each vial with 10 mL NS. Combine 2 vials and further dilute with 80 mL D5W, NS, or LR to a total volume of 100 mL (concentration 0.8 mg/mL). Infuse over 15 minutes, not exceeding 6 mg/min (7 mL/min).
• For Zollinger-Ellison syndrome (2-minute injection): Reconstitute with 10 mL NS to a final concentration of 4 mg/mL.

Dosage Adjustments

• Elderly: No dosage adjustment is typically needed.
• Hepatic impairment (liver problems): The maximum dose is 20 mg once daily or 40 mg on alternate days.
• Renal impairment (kidney problems): No dosage adjustment is typically needed.

Pediatric Dosage

• Erosive Esophagitis Associated with GERD:
  • Under 5 years: Safety and effectiveness have not been established.
  • 5 years and older:
    • 15 kg to less than 40 kg: 20 mg orally once daily for up to 8 weeks.
    • 40 kg or greater: 40 mg orally once daily for up to 8 weeks.

Important Considerations

Do Not Use If You Are:

• Taking rilpivirine, atazanavir, or nelfinavir (antiviral medications), as Acitop can significantly decrease their effectiveness.
• Breastfeeding, as it’s not known if pantoprazole passes into breast milk, and it’s generally not recommended.

Use With Caution If:

• You have gastric malignancy (stomach cancer). Your doctor should rule this out before starting treatment, as Acitop can mask symptoms.
• You are prone to zinc deficiency, as zinc supplementation might be considered during IV therapy.
• You are pregnant. Discuss with your doctor.
• You are on prolonged use of Acitop; your doctor may monitor your magnesium levels periodically.

Potential Drug Interactions:

Acitop can interact with several medications. It’s crucial to inform your doctor or pharmacist about all prescription, over-the-counter, and herbal supplements you are taking.

• Increased risk of side effects with:
  • Digoxin: Increased risk of heart-related side effects.
  • Diuretics (water pills): Increased risk of low magnesium levels (hypomagnesaemia).
  • Warfarin (blood thinner): May increase INR and prothrombin time, raising the risk of bleeding.
  • Methotrexate and Saquinavir: May increase their serum concentrations.
• Decreased absorption and/or effectiveness of:
  • Sucralfate: Delayed absorption and decreased effectiveness; separate administration by approximately 2 hours.
  • Ketoconazole, Itraconazole: Decreased absorption of these antifungal medications.
  • Rilpivirine, Atazanavir, Nelfinavir: Potentially fatal decrease in serum levels and pharmacological effects of these antiviral drugs. Concomitant use is contraindicated.

Possible Side Effects

Common side effects (1-10%) may include:

• Headache
• Abdominal pain
• Diarrhea
• Constipation
• Rash
• Pruritus (itching)
• Vomiting
• Nausea
• Flatulence (gas)
• Chest pain
• Facial edema (swelling)
• Generalized edema (swelling)
• Hyperglycemia (high blood sugar)
• Photosensitivity (increased sensitivity to sunlight)

Less common but potentially serious side effects (frequency not defined) include:

• Angioedema (severe allergic swelling)
• Atrophic gastritis (inflammation leading to stomach lining thinning)
• Anterior ischemic optic neuropathy (vision loss)
• Hepatocellular damage leading to hepatic failure (liver damage)
• Interstitial nephritis (kidney inflammation)
• Pancreatitis (inflammation of the pancreas)
• Pancytopenia (deficiency of all blood cell types)
• Rhabdomyolysis (muscle breakdown)
• Risk of anaphylaxis (severe allergic reaction)
• Stevens-Johnson syndrome, fatal toxic epidermal necrolysis, erythema multiforme (severe skin reactions)

How Acitop Tablet Works

Pantoprazole belongs to a class of drugs called proton pump inhibitors (PPIs). It works by blocking the final step of acid secretion in the stomach. It specifically inhibits the H+/K+ ATPase enzyme system (the “proton pump”) in the gastric parietal cells. By doing so, Acitop reduces both the normal background acid production (basal) and acid production stimulated by food or other factors.

Disclaimer: This information about Acitop Tablet is for general knowledge only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.