Pantec

Description

Pantec 40mg Tablet is a medication manufactured by Concept Pharmaceuticals Ltd. and contains Pantoprazole Sodium Sesquihydrate as its active ingredient. It’s a proton pump inhibitor (PPI) used to reduce stomach acid and treat various acid-related conditions.

Key Uses (Indications)

Pantec is primarily used for:

• Peptic ulcer disease (both duodenal and gastric ulcers)
• H. pylori infection (often in combination with antibiotics)
• Gastro-oesophageal reflux disease (GERD) and erosive esophagitis associated with it
• Zollinger-Ellison syndrome (a condition causing excessive stomach acid production)
• Oesophagitis
• Acid-related dyspepsia (indigestion)
• NSAID-associated ulceration (ulcers caused by non-steroidal anti-inflammatory drugs)
• Ulcers resistant to H2 receptor antagonists
• Gastrointestinal (GI) bleeding from stress
• Prophylaxis for acid aspiration syndrome during anesthesia induction

Dosage Information

Adults:

• Erosive Esophagitis Associated With GERD:
  • Treatment: 40 mg orally once daily for 8-16 weeks.
  • Maintenance of healing: 40 mg orally once daily.
  • Alternatively, 40 mg intravenously (IV) once daily for 7-10 days.
• Short-term Treatment of GERD (when oral therapy is not possible): 40 mg IV infusion over 15 minutes once daily for 7-10 days; switch to oral once able to swallow.
• Zollinger-Ellison Syndrome: 40 mg orally once daily; doses up to 240 mg/day have been administered. Alternatively, 80 mg IV infusion every 8-12 hours for up to 7 days; switch to oral once able to swallow.
• Peptic Ulcer Disease:
  • Duodenal ulcer: 40 mg orally once daily for 2-4 weeks.
  • Gastric ulcer: 40 mg orally once daily for 4-8 weeks.

Elderly: No dosage adjustment is typically needed.

Hepatic Impairment: Maximum dose is 20 mg/day or 40 mg on alternate days.

Children (>5 years for Erosive Esophagitis Associated With GERD):

• 15 kg to <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.
• <5 years: Safety and efficacy are not established.

Renal Impairment: No dosage adjustment is needed.

Administration

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

Intravenous (IV) Administration:

• For GERD with a history of erosive esophagitis (15-minute infusion): Reconstitute with 10 mL of normal saline (NS), then further dilute with 100 mL of D5W, NS, or Lactated Ringer’s (LR) 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).
  • 2-minute injection: Reconstitute with 10 mL NS to a final concentration of 4 mg/mL.

Important Considerations

• Contraindications: Do not use with rilpivirine, atazanavir, and nelfinavir. Not recommended during lactation.
• Precautions:
  • Gastric malignancy should be ruled out before starting treatment.
  • Consider zinc supplementation during IV therapy for patients prone to zinc deficiency.
  • Use with caution during pregnancy.
  • Monitor magnesium levels before starting and periodically during prolonged use.
• Adverse Effects (Common): Headache, abdominal pain, diarrhea, constipation, nausea, vomiting, rash, pruritus (itching), flatulence, hyperglycemia, chest pain, facial edema, generalized edema, and photosensitivity.
• Drug Interactions:
  • May increase the risk of digoxin-induced cardiotoxic effects.
  • Increased risk of hypomagnesaemia with diuretics.
  • May increase INR and prothrombin time of warfarin.
  • May increase serum concentration of methotrexate and saquinavir.
  • Delayed absorption and decreased bioavailability with sucralfate.
  • Decreased absorption of ketoconazole and itraconazole.
  • Potentially Fatal: May decrease serum levels and pharmacological effects of rilpivirine, atazanavir, and nelfinavir.

How it Works (Mechanism of Action)

Pantoprazole is a proton pump inhibitor (PPI). It works by blocking the final step of acid secretion in the stomach. It specifically inhibits the H+/K+ ATPase enzyme system, which is located in the gastric parietal cells. This inhibition reduces both basal (resting) and stimulated acid production in the stomach.

Availability and Price

Pantec 40mg Tablet is available in Nepal, manufactured by Concept Pharmaceuticals Ltd. A pack of 100 tablets has a retail price of 8.00 NPR.