PNZ

Description

PNZ Tablet: Uses, Dosing, and Important Information

PNZ Tablet, containing Pantoprazole Sodium Sesquihydrate, is a medication primarily used to reduce stomach acid. It’s available in Nepal and manufactured by Cadila Pharmaceuticals Limited.

What is PNZ Tablet Used For?

PNZ Tablet is used to treat a variety of conditions related to excess stomach acid, including:

• Peptic Ulcer Disease: Healing ulcers in the stomach and duodenum.
• H. pylori Infection: As part of a regimen to eradicate this bacteria, which can cause ulcers.
• Gastro-Oesophageal Reflux Disease (GERD): Managing symptoms like heartburn and acid reflux, including erosive esophagitis (inflammation of the esophagus due to acid).
• Zollinger-Ellison Syndrome: A rare condition causing excessive stomach acid production.
• Oesophagitis: Inflammation of the esophagus.
• Acid-Related Dyspepsia: Indigestion caused by stomach acid.
• NSAID-Associated Ulceration: Preventing or treating ulcers caused by non-steroidal anti-inflammatory drugs.
• Ulcers Resistant to H2 Receptor Antagonists: For ulcers that don’t respond to other types of acid-reducing medications.
• Gastrointestinal (GI) Bleeding from Stress: Helping to prevent or treat bleeding in the digestive tract due to stress.
• Prophylaxis for Acid Aspiration Syndrome: Reducing the risk of acid entering the lungs during anesthesia induction.

How to Take PNZ Tablet (Dosing Information)

Important Note: Always follow your doctor’s instructions for PNZ Tablet. The doses below are general guidelines.

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.
  • Alternative (IV): 40 mg intravenously (IV) once daily for 7-10 days, if oral administration isn’t possible.
• Short-Term Treatment of GERD (when oral therapy isn’t possible):
  • 40 mg IV infusion over 15 minutes once daily for 7-10 days. Switch to oral therapy when able to swallow.
• Zollinger-Ellison Syndrome:
  • Oral: 40 mg PO once daily; some patients may require up to 240 mg/day.
  • Intravenous: 80 mg IV infusion every 8-12 hours for up to 7 days. Switch to oral therapy when 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.
• Elderly Patients: No dosage adjustment is typically needed.
• Hepatic Impairment (Liver Problems): Maximum dose is 20 mg/day, or 40 mg on alternate days.

Child Dosing (Erosive Esophagitis Associated with GERD)

• Under 5 years: Safety and effectiveness have not been established.
• 5 years and older:
  • Weight 15 kg to less than 40 kg: 20 mg PO once daily for up to 8 weeks.
  • Weight 40 kg or greater: 40 mg PO once daily for up to 8 weeks.

Renal Impairment (Kidney Problems)

• No dosage adjustment is typically needed.

How to Administer PNZ 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: Can be taken with or without food.

Intravenous (IV) Preparation & Administration

Preparation:

• GERD with Erosive Esophagitis (15-minute infusion): Reconstitute one vial with 10 mL of normal saline (NS), then dilute further with 100 mL of D5W, NS, or Lactated Ringer’s (LR) solution to a final concentration of 0.4 mg/mL.
• Zollinger-Ellison Syndrome (15-minute infusion): Reconstitute each vial with 10 mL of NS. Combine two vials and dilute further with 80 mL of D5W, NS, or LR to a total volume of 100 mL (final concentration 0.8 mg/mL).
• Zollinger-Ellison Syndrome (2-minute injection): Reconstitute one vial with 10 mL of NS to a final concentration of 4 mg/mL.

Administration:

• 15-minute infusion: Infuse no faster than 3 mg/min (7 mL/min) for GERD and no more than 6 mg/min (7 mL/min) for pathologic hypersecretory conditions.

Important Considerations and Warnings

Do Not Take If:

• You are taking medications like rilpivirine, atazanavir, or nelfinavir.
• You are breastfeeding (lactation).

Precautions:

• Your doctor should rule out gastric malignancy (stomach cancer) before you start this medication.
• Consider zinc supplementation if you’re receiving IV therapy and are prone to zinc deficiency.
• Discuss with your doctor if you are pregnant.
• Monitoring: Your magnesium levels should be monitored before starting PNZ and periodically during prolonged use.

Possible Drug Interactions:

PNZ Tablet can interact with other medications, potentially leading to:

• Increased risk of heart problems with digoxin.
• Increased risk of low magnesium levels with diuretics.
• Increased INR and prothrombin time with warfarin (a blood thinner).
• Increased levels of methotrexate and saquinavir in the blood.
• Delayed absorption and decreased effectiveness if taken with sucralfate.
• Decreased absorption of ketoconazole and itraconazole.
• Potentially Fatal: May significantly decrease the effectiveness of rilpivirine, atazanavir, and nelfinavir.

Possible Side Effects:

Common (1-10% of patients):

• Headache (>4%)
• Abdominal pain (4%)
• Diarrhea (4%)
• Pruritus (itching) (4%)
• Rash (4%)
• Chest pain (4%)
• Vomiting (>4%)
• Facial swelling (<4%)
• Generalized swelling (<2%)
• Constipation (<4%)
• Flatulence (<4%)
• Hyperglycemia (high blood sugar) (1%)
• Nausea (1%)
• Photosensitivity (increased sensitivity to light) (<2%)

Less Common (Frequency Not Defined, but serious):

• Angioedema (severe swelling under the skin)
• Atrophic gastritis (inflammation of the stomach lining)
• Anterior ischemic optic neuropathy (eye condition)
• Hepatocellular damage leading to hepatic failure (liver damage leading to liver failure)
• Interstitial nephritis (kidney inflammation)
• Pancreatitis (inflammation of the pancreas)
• Pancytopenia (deficiency of all blood cells)
• Rhabdomyolysis (muscle breakdown)
• Risk of anaphylaxis (severe allergic reaction)
• Stevens-Johnson syndrome (severe skin reaction)
• Fatal toxic epidermal necrolysis (very severe skin reaction)
• Erythema multiforme (skin condition)

How PNZ Tablet Works (Mechanism of Action)

PNZ Tablet is a proton pump inhibitor (PPI). It works by blocking the final step of acid secretion in the stomach. It does this by inhibiting the H+/K+ ATPase enzyme system, also known as the “proton pump,” located in the parietal cells of the stomach lining. This action effectively reduces both the normal (basal) and stimulated production of stomach acid.

Disclaimer: This information about PNZ 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 healthcare professional for any health concerns or before making any decisions related to your health or treatment.