Pantin 20/40

Pantoprazole

20 mg: Mild reflux disease & associated symptoms (eg, heartburn, acid regurgitation, pain on swallowing). Long-term management & prevention of relapse in reflux oesophagitis. 40 mg: Moderate & severe reflux oesophagitis.

Mild reflux disease & associated symptoms 20 mg/day w/in 2-4 wk, & a 4-wk treatment period for healing of associated oesophagitis, or further 4 wk if not sufficient. Long-term management & prevention of relapse in reflux oesophagitis Maintenance dose: 20 mg/day, increasing to 40 mg/day if relapse occurs. Reduce to 20 mg/day again after healing from relapse. Moderate & severe reflux oesophagitis 40 mg/day, may be doubled [increase to 2 tab (40 mg) daily] especially when there has been no response to other treatment. Severe liver impairment Reduce dose to 1 tab (40 mg) every other day. Elderly or patient w/ impaired kidney function Max daily dose: 40 mg.

Should be taken on an empty stomach: Take 1 hr before meals. Swallow whole w/ water, do not chew/crush.

Hypersensitivity. Co-administration w/ atazanavir.

Regularly monitor liver enzymes during treatment particularly on long-term use. Discontinue treatment in case of a rise in liver enzymes. Combination therapy. Restrict use in the prevention of NSAID-induced gastroduodenal ulcer in patients who require continued NSAID treatment & have increased risk to develop GI complications. Exclude malignancy in the presence of any alarm symptoms & when gastric ulcer is suspected or present. May reduce vit B₁₂ absorption. Long-term treatment (>1 yr). Slightly increased risk of bacterial GI infections. Symptomatic & asymptomatic severe hypomagnesaemia. Monitor Mg levels prior to initiation of treatment & periodically thereafter, in expected prolonged treatment or in concomitant use w/ digoxin or hypomagnesaemia-causing drugs (eg, diuretics). May increase risk for osteoporosis-related fractures of the hip, wrist, or spine. Co-administration w/ primarily high doses of methotrexate. Exclude malignant esophageal or stomach disease prior to treatment. Investigate if the patient do not respond after 4 wk. Risk of cutaneous lupus erythematosus & SLE. May affect ability to drive or operate machinery. Pregnancy & lactation.

Headache; diarrhoea, constipation, abdominal pain & discomfort, flatulence.

May reduce or increase absorption of drugs whose bioavailability is pH-dependent eg, ketoconazole. Reduced atazanavir bioavailability. Monitor prothrombin time or INR after initiation, termination or during irregular use in concomitant use w/ coumarin anticoagulants (eg, phenprocoumon or warfarin). May elevate & prolong serum levels of methotrexate &/or its metabolite hydroxymethotrexate.

Antacids, Antireflux Agents & Antiulcerants

A02BC02 - pantoprazole ; Belongs to the class of proton pump inhibitors. Used in the treatment of peptic ulcer and gastro-oesophageal reflux disease (GERD).

POM

Exemptions granted for limited sale & supply without prescription (with effect from 1 Jan 2014):
As an oral solid preparation containing not more than 20 mg
Indication: For the relief of heartburn symptoms associated with acid reflux
Maximum daily dose: 20 mg
Maximum supply: 14 days
Minimum age: 18 years