Pantoloc

Description

Pantoloc Tablet: Key Information

Generic Name: Pantoprazole Sodium Sesquihydrate Manufacturer: Curex Pharmaceuticals Pvt. Ltd. Availability: Available in Nepal.

Pantoloc Tablet is a type of medicine called a proton pump inhibitor (PPI). It works by reducing the amount of acid produced in your stomach. It achieves this by blocking a specific enzyme system (H+/K+ ATPase) in the cells lining your stomach, which helps to inhibit both baseline and stimulated acid secretion.

What is Pantoloc Used For? (Indications)

Pantoloc Tablet treats various conditions caused by stomach acid, including:

• Peptic Ulcer Disease: Ulcers in the stomach or the first part of the small intestine.
• H. pylori infection: Used as part of a treatment plan to get rid of this bacteria.
• Gastro-oesophageal Reflux Disease (GERD): A chronic condition where stomach acid flows back into the esophagus, causing symptoms like heartburn.
• Zollinger-Ellison Syndrome: A rare condition that causes the stomach to produce too much acid.
• Oesophagitis: Inflammation of the esophagus, often due to acid reflux.
• Acid-related Dyspepsia: Indigestion symptoms linked to stomach acid.
• NSAID-associated Ulceration: Ulcers that develop from taking non-steroidal anti-inflammatory drugs.
• Ulcers resistant to H2 receptor antagonists: For ulcers that don’t respond to other acid-reducing medications.
• Gastrointestinal (GI) bleeding from stress: To help prevent or manage bleeding in the digestive tract caused by stress.
• Prophylaxis for acid aspiration syndrome: To prevent stomach acid from entering the lungs during anesthesia.

How to Take Pantoloc (Dosage & Administration)

Pantoloc can be taken orally as a tablet or given intravenously (IV).

Adult Dosing

• Erosive Esophagitis Associated With GERD:
  • Treatment: 40 mg by mouth (PO) once daily for 8-16 weeks.
  • Maintenance: 40 mg PO once daily to maintain healing.
  • Alternatively, IV: 40 mg intravenously (IV) once daily for 7-10 days.
• Short-term Treatment of GERD (when oral therapy isn’t suitable):
  • 40 mg IV infusion over 15 minutes, once daily for 7-10 days. Switch to oral therapy once you’re able to swallow.
• Zollinger-Ellison Syndrome:
  • Oral: 40 mg PO once daily; doses up to 240 mg/day have been given in some patients.
  • IV: 80 mg IV infusion every 8-12 hours for up to 7 days. Switch to oral therapy once you’re able to swallow.
• Peptic Ulcer Disease:
  • Duodenal ulcer: 40 mg PO once daily for 2-4 weeks.
  • Gastric ulcer: 40 mg PO once daily for 4-8 weeks.

Special Considerations:

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

Child Dosing (for Erosive Esophagitis Associated With GERD)

• Under 5 years: The safety and effectiveness of Pantoloc for this age group have not been established.
• 5 years and older:
  • 15 kg to <40 kg: 20 mg PO once daily for up to 8 weeks.
  • 40 kg or greater: 40 mg PO once daily for up to 8 weeks.

How to Administer the Tablet

• 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.

IV Preparation and Administration

• For GERD with a history of erosive esophagitis (15-minute infusion): Reconstitute the vial with 10 mL of Normal Saline (NS). Then, further dilute this solution with 100 mL of D5W, NS, or Lactated Ringer’s (LR) to achieve a final concentration of 0.4 mg/mL.
• For Zollinger-Ellison Syndrome:
  • 15-minute infusion: Reconstitute each vial with 10 mL NS. Combine two vials and dilute with 80 mL of D5W, NS, or LR to a total volume of 100 mL (final 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 an infusion rate of 3 mg/min (7 mL/min) for GERD.
• Do not exceed an infusion rate of 6 mg/min (7 mL/min) for conditions causing pathologic hypersecretion.

Important Considerations

When Not to Use (Contraindications)

Do not use Pantoloc if you are taking:

• Rilpivirine
• Atazanavir
• Nelfinavir

Pantoloc is also not recommended if you are breastfeeding.

Precautions

• Your doctor should rule out gastric malignancy (stomach cancer) before you start taking Pantoloc.
• If you are receiving IV therapy and are prone to zinc deficiency, your doctor might consider zinc supplementation.
• If you are pregnant, discuss this with your doctor before using Pantoloc.

Monitoring Parameters

• Your doctor will monitor your magnesium levels before you start Pantoloc and periodically during prolonged use.

Pregnancy and Lactation

• It is not known if pantoprazole is present in breast milk, so its use is not recommended during lactation.

Potential Drug Interactions

Pantoloc can interact with other medications. Always tell your doctor about all medicines, supplements, and herbal products you are taking.

• Increased Risk:
  • Digoxin: Increased risk of heart-related side effects.
  • Diuretics: Increased risk of low magnesium levels (hypomagnesaemia).
  • Warfarin: May increase INR and prothrombin time, potentially increasing bleeding risk.
  • Methotrexate and Saquinavir: May increase their serum concentrations.
• Decreased Absorption/Bioavailability:
  • Sucralfate: Can delay absorption and decrease bioavailability.
  • Ketoconazole, Itraconazole: Decreased absorption of these antifungal medications.
• Potentially Fatal Interactions:
  • May significantly decrease the serum levels and pharmacological effects of rilpivirine, atazanavir, and nelfinavir. This is why concomitant use is contraindicated.

Possible Side Effects (Adverse Effects)

Most side effects are generally mild to moderate:

• Common (1-10% of patients):
  • 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 potentially serious side effects (frequency not defined) include:

• Angioedema (severe swelling under the skin)
• Atrophic gastritis (chronic inflammation of the stomach lining)
• Anterior ischemic optic neuropathy (a condition affecting vision)
• Hepatocellular damage leading to hepatic failure (severe liver damage)
• Interstitial nephritis (kidney inflammation)
• Pancreatitis (inflammation of the pancreas)
• Pancytopenia (a decrease in all types of blood cells)
• Rhabdomyolysis (breakdown of muscle tissue)
• Risk of anaphylaxis (a severe, life-threatening allergic reaction)
• Stevens-Johnson syndrome (a severe skin reaction)
• Fatal toxic epidermal necrolysis (a very severe, life-threatening skin condition)
• Erythema multiforme (a type of skin rash)

Important Note: This information on Pantoloc Tablet is for general knowledge and should not be used for self-diagnosis, medical advice, or treatment. It is not a substitute for professional medical judgment. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.