Pantocid

Description

Pantocid Tablet: Your Guide to Use

Generic Name: Pantoprazole Sodium Sesquihydrate Manufacturer: Sun Pharmaceutical Industries Ltd. Availability: Available in Nepal.

Pantocid Tablet is a proton pump inhibitor (PPI) that works by reducing stomach acid production. It does this by blocking a key enzyme (H+/K+ ATPase) in the stomach’s parietal cells, inhibiting both normal and stimulated acid secretion.

What Pantocid is Used For (Indications)

Pantocid Tablet treats various conditions caused by too much stomach acid, including:

• Peptic Ulcer Disease: Ulcers in the stomach or duodenum.
• H. pylori Infection: Part of a treatment regimen to eradicate this bacterium.
• Gastro-oesophageal Reflux Disease (GERD): Chronic heartburn and acid reflux.
• Zollinger-Ellison Syndrome: A rare condition causing excessive stomach acid.
• Oesophagitis: Inflammation of the esophagus.
• Acid-related Dyspepsia: Indigestion caused by stomach acid.
• NSAID-associated Ulceration: Ulcers caused by non-steroidal anti-inflammatory drugs.
• Ulcers resistant to H2 receptor antagonists: When other acid-reducing medications aren’t effective.
• Gastrointestinal (GI) bleeding from stress: To prevent or treat bleeding in the digestive tract due to stress.
• Prophylaxis for acid aspiration syndrome: To prevent acid from entering the lungs during anesthesia induction.

How to Take Pantocid (Dosage & Administration)

Pantocid can be taken orally (PO) as a tablet or given intravenously (IV) as an injection.

Adult Dosing

• Erosive Esophagitis Associated with GERD:
  • Treatment: 40 mg orally once daily for 8-16 weeks.
  • Maintenance: 40 mg orally once daily to keep healing.
  • IV alternative: 40 mg IV once daily for 7-10 days.
• Short-term GERD Treatment (when oral isn’t possible):
  • 40 mg via IV infusion over 15 minutes, once daily for 7-10 days. Switch to oral once you can swallow.
• Zollinger-Ellison Syndrome:
  • Oral: 40 mg once daily. Doses up to 240 mg/day have been used.
  • IV: 80 mg via IV infusion every 8-12 hours for up to 7 days. Switch to oral once you can 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.

Special Populations:

• Elderly: No dose adjustment needed.
• Hepatic Impairment (Liver Issues): Maximum dose is 20 mg/day or 40 mg on alternate days.
• Renal Impairment (Kidney Issues): No dose adjustment needed.

Child Dosing (for Erosive Esophagitis Associated with GERD)

• Under 5 years: Safety and effectiveness haven’t been established.
• 5 years and older:
  • 15 kg to <40 kg: 20 mg orally once daily for up to 8 weeks.
  • 40 kg or more: 40 mg orally once daily for up to 8 weeks.

How to Administer

• 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: Can be taken with or without food.

IV Preparation and Administration

• For GERD with erosive esophagitis (15-minute infusion): Reconstitute with 10 mL Normal Saline (NS). Then, dilute this with 100 mL D5W, NS, or Lactated Ringer’s (LR) to a final concentration of 0.4 mg/mL.
• For Zollinger-Ellison syndrome:
  • 15-minute infusion: Reconstitute each vial with 10 mL NS. Combine 2 vials and dilute with 80 mL D5W, NS, or LR to a total volume of 100 mL (concentration 0.8 mg/mL).
  • 2-minute injection: Reconstitute with 10 mL NS to a final concentration of 4 mg/mL.

IV Administration Rates:

• Infuse over 15 minutes.
• Do not exceed 3 mg/min (7 mL/min) for GERD.
• Do not exceed 6 mg/min (7 mL/min) for conditions causing excessive acid secretion.

Important Considerations

When Not to Use (Contraindications)

Do not use Pantocid if you are taking:

• Rilpivirine
• Atazanavir
• Nelfinavir

Also, do not use Pantocid if you are breastfeeding.

Important Precautions

• Your doctor should rule out gastric malignancy (stomach cancer) before you start Pantocid.
• If you are prone to zinc deficiency and receiving IV therapy, consider zinc supplementation.
• Discuss with your doctor if you are pregnant.
• Monitoring: Your doctor will monitor your magnesium levels before starting treatment and periodically during long-term use.

Pregnancy and Lactation

• It’s unknown if pantoprazole passes into breast milk, so it’s not recommended for breastfeeding mothers.

Potential Drug Interactions

Pantocid can interact with other medications. Tell your doctor about all medicines you take.

• Increased risk: Digoxin-induced heart problems, low magnesium levels with diuretics.
• May increase the effects of warfarin (a blood thinner), potentially increasing INR and prothrombin time.
• May increase blood levels of methotrexate and saquinavir.
• Delayed absorption/decreased effectiveness: Sucralfate (delayed absorption), ketoconazole, and itraconazole (decreased absorption).
• Potentially Fatal: May significantly reduce the effectiveness of rilpivirine, atazanavir, and nelfinavir.

Possible Side Effects (Adverse Effects)

Most side effects are mild and common:

• Common (1-10%): Headache (>4%), abdominal pain (4%), diarrhea (4%), chest pain (4%), pruritus (itching) (4%), rash (4%), vomiting (>4%), facial edema (<4%), generalized edema (<2%), constipation (<4%), flatulence (<4%), hyperglycemia (1%), nausea (1%), photosensitivity (<2%).

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

• Allergic reactions (angioedema, anaphylaxis)
• Atrophic gastritis (stomach inflammation)
• Eye problems (anterior ischemic optic neuropathy)
• Severe liver damage (hepatocellular damage leading to hepatic failure)
• Kidney inflammation (interstitial nephritis)
• Pancreatitis (inflammation of the pancreas)
• Pancytopenia (reduction in all blood cell types)
• Rhabdomyolysis (muscle breakdown)
• Severe skin reactions (Stevens-Johnson syndrome, fatal toxic epidermal necrolysis, erythema multiforme)

Disclaimer: This information about Pantocid Tablet is for general knowledge only and isn’t a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider for any health concerns or before making any decisions related to your health or treatment.