Proton pump inhibitor (H + / K + - ATPase) in the parietal cells of the stomach. It inhibits the secretion of hydrochloric acid, both basic and stimulated (regardless of the stimulating factor of this secretion). It reduces the acidity of the stomach contents and thus increases the gastrin secretion to an extent proportional to the decrease in acidity. Pantoprazole quickly absorbs from the gastrointestinal tract, reaching Cmax in 2-2.5 hours. Bioavailability is about 77%; binding to plasma proteins - 98%. It is metabolized in the liver. The metabolites of pantoprazole are mainly excreted via the kidneys (approximately 80%); the rest is excreted with faeces. T0,5 in the final phase of elimination is about 1 hour.
Contraindications:
Hypersensitivity to pantoprazole or other ingredients of the preparation. Co-administration with atazanavir.
Precautions:
Patients should be advised to report the following cases: weight loss not caused by deliberate weight loss, anemia, gastrointestinal bleeding, dysphagia, persistent or bloody vomiting (treatment with pantoprazole may relieve symptoms of severe disease and delay its diagnosis, in which case the tumor should be excluded diseases); history of gastric ulcer or gastrointestinal surgery; treatment of dyspepsia or heartburn symptoms that have lasted for more than 4 weeks; jaundice, liver dysfunction or disease; other severe diseases affecting general well-being; onset of new symptoms or change in the nature of previously observed symptoms in patients> 55 years. Patients with long-term recurrent symptoms of indigestion or heartburn should undergo regular medical check-ups. Caution should be exercised before using the medicine in patients who are to undergo endoscopy or a urease test. The drug is not intended to immediately remove symptoms; regression of symptoms may be felt after about the age of pantoprazole; in order to achieve complete resolution of heartburn, it may be necessary to use pantoprazole for 7 days. Pantoprazole should not be used prophylactically. Treatment with the preparation may slightly increase the risk of gastrointestinal infections with bacteria such asSalmonella spp. andCampylobacter spp. Use in children and adolescents <18 years is not recommended. Due to the sorbitol content, do not use in patients with rare hereditary fructose intolerance.
Pregnancy and lactation:
Do not use during pregnancy unless clearly necessary. Pantoprazole is excreted in human milk. Therefore, the decision whether to continue / stop breastfeeding or to continue / stop the use of pantoprazole should be taken taking into account the benefits for the child resulting from breastfeeding and the benefits for a woman resulting from treatment with pantoprazole.
Side effects:
Uncommon: headache, dizziness, diarrhea, nausea, vomiting, abdominal fullness and bloating, constipation, dry mouth, epigastric pain and discomfort, skin rash, erythema, skin eruptions, pruritus, weakness, fatigue, bad mood, increased activity of liver enzymes (aminotransferases, γ-GT), sleep disorders. Rarely: agranulocytosis, dysgeusia, blurred vision, urticaria, angioneurotic edema, joint pain, muscle pain, hyperlipidemia and increased lipids (triglycerides, cholesterol), change in body weight, elevated body temperature, peripheral edema, hypersensitivity reactions (in including anaphylactic reactions and anaphylactic shock), increased bilirubin, depression and mental deterioration, gynecomastia. Very rare: thrombocytopenia, leukopenia, pancytopenia, confusion and mental deterioration.Not known: interstitial nephritis, Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme, photosensitivity, hyponatraemia, hypomagnesaemia, liver cell damage, jaundice, hepatic cell failure, hallucinations, confusion (especially susceptible patients, as well as worsening similar symptoms in case of their previous occurrence).
Dosage:
Orally. Adults: 1 tabl. once a day. In order to achieve relief of symptoms, it may be necessary to use the medicine for the Next 2-3 days. After complete relief of symptoms, treatment should be discontinued. The drug should not be used for more than 4 weeks, inform the patient about the need to report if the symptoms do not subside within 2 weeks of treatment. Elderly patients with renal or hepatic impairment do not need to modify their dosage. The tablets should not be chewed or chewed; take before a meal swallowing whole and washed down with water.
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