20 mg Tablet: Adults and Adolescents ≥12 years: Mild Reflux Disease and Associated Symptoms (eg. heartburn, acid regurgitation, pain on swallowing): Recommended Oral Dose: One 20 mg tablet per day.
Type and Duration of Treatment: Symptom relief is generally accomplished within 2-4 weeks, and a 4-week treatment period is usually required for healing of associated esophagitis. If this is not sufficient, healing is usually achieved within a further 4 weeks. When symptom relief has been achieved, reoccurring symptoms can be controlled using an on-demand regimen of 20 mg once daily, when required. A switch to continuous therapy may be considered in case satisfactory symptom control cannot be maintained with on-demand treatment.
Long-Term Management and Prevention of Relapse in Reflux Oesophagitis: Long-term Management: Maintenance dose: One 20-mg tablet per day is recommended. Increase to 40 mg Pantoprazole per day if a relapse occurs. For this case, 40 mg Pantoprazole tablet is available. After healing of the relapse, the dosage can be reduced back to 20 mg Pantoprazole.
Type and Duration of Treatment: Long-Term Treatment: A treatment period of 1 year should be exceeded only after careful consideration of the benefit/risk ratio, as drug safety over several years is not sufficiently established.
Adults: Prevention of Gastroduodenal Ulcers Induced by NSAIDs in Patients at Risk with a Need for Continuous NSAID Treatment: Recommended Dose: One 20-mg tablet per day.
Children below 12 years of age: Not recommended for use in children below 12 years of age due to limited data in this age group.
A daily dose of 20-mg Pantoprazole should not be exceeded in patients with severe liver impairment. No dose adjustment is necessary in elderly patients or in those with impaired renal function.
40 mg Tablet: Adults and Adolescents ≥ 12 years: Treatment of Moderate and Severe Reflux Esophagitis: One 40 mg tablet per day. In individual cases, the dose may be doubled (increased to two 40 mg tablet daily) especially when there has been no response to other medicines.
Adults: Eradication of H. pylori in Combination with 2 Appropriate Antibiotics: In cases of duodenal or gastric ulcer in which infection with Helicobacter pylori has been confirmed, the microorganism should be eradicated by combination treatment.
Depending upon the resistance pattern, the following combinations can be recommended: One 40 mg tablet twice daily + amoxicillin 1000 mg twice daily + clarithromycin 500 mg twice daily; one 40 mg tablet twice daily + metronidazole 500 mg twice daily + clarithromycin 500 mg twice daily; one 40 mg tablet twice daily + amoxicillin 1000 mg twice daily + metronidazole 500 mg twice daily.
Duodenal and Gastric Ulcers: One 40 mg tablet daily. In individual cases, the dose may be doubled (increased to two 40 mg tablet daily) especially when there has been no response to other medicines.
Long-Term Management of Zollinger-Ellison Syndrome and Other Pathological Hypersecretory Conditions: The recommended daily dose at the beginning of treatment is 80 mg (two 40 mg tablet). Thereafter, the dosage can be titrated up or down as needed using measurements of gastric acid secretion to guide. Doses >80 mg daily should be divided and given twice daily. A temporary increase in dosage to >160 mg Pantoprazole is possible but should not be applied longer than required for adequate acid control. Treatment duration in Zollinger-Ellison-Syndrome and other pathological hypersecretory conditions is not limited and should be adapted according to clinical needs.
Type and Duration of Treatment: Combination therapy for eradication of Helicobacter pylori infection usually lasts 7 days and can be extended to a maximum of 2 weeks. If after this time, further treatment with Pantoprazole 40 mg is indicated to ensure complete healing of ulcers, dose recommendations for gastric and duodenal ulcers must be observed. In majority of cases, duodenal ulcer heals completely within 2 weeks. If a 2-week treatment period is not sufficient, healing will be achieved in almost all cases within a further 2 weeks. Gastric ulcers and reflux oesophagitis usually require a 4-week course of treatment. If this should be inadequate, healing will be achieved within a further 4 weeks in most cases.
Treatment should not exceed 8 weeks as experience with long-term use is limited.
Treatment duration in Zollinger-Ellison Syndrome and other pathological hypersecretory conditions is not limited and should be adapted according to clinical needs.
Administration: Oral. Should be taken on an empty stomach. Take 1 hr before meals. Swallow whole, do not chew/crush.