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Pantoprazole user manual

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Composition and pharmacological action

The problem of increased acidity of the stomach is extremely relevant in the XXI century. It seems that a high pH brings only discomfort, however, according to doctors, this condition is extremely dangerous.
Firstly, the increased acidity of gastric juice creates favorable conditions for the development of gastritis. And, as you know, this disease is difficult to treat, and often the inflammatory process becomes chronic.
Secondly, against the background of increased acidity of the stomach, peptic ulcer of the stomach and duodenum often develops. The situation can be complicated if a person becomes infected with Helicobacter pylori. When infected with this microorganism and inflammation of the mucous membrane, it is extremely difficult to cure the ulcer, and sometimes it is necessary to resort to surgical interventions.
Pantoprazole is a powerful proton pump inhibitor that helps to stabilize the functionality of the stomach and prevent the development of peptic ulcer of the stomach and duodenum. The composition of the drug includes the active component of the same name - pantoprazole, as well as excipients that do not have pharmacological activity (sucrose, talc, beckons, etc.).
Pantoprazole:
    After ingestion, it begins to actively accumulate in the tubules of the parietal cells of the stomach. Upon absorption, the active substance of the drug turns into cyclic sulfenamide, which, in turn, selectively interacts with the H + -K + -ATPase. It inhibits the H + -K + -ATPase, thereby disrupting the transfer of hydrogen ions from the parietal cell into the lumen of the stomach. That is, in fact, the active substance of the agent blocks the final stage of hydrophilic secretion of hydrochloric acid. Due to this, the production of hydrochloric acid is reduced in principle, and the pH level in it is stabilized.
    Successfully relieves the main symptoms of stomach diseases. After several days of treatment, the acidity of the stomach decreases, due to which the person disappears in the severity in the abdominal region after eating. Also, the drug helps to eliminate nausea, vomiting, acid burping and other characteristic symptoms of gastritis and ulcers.
    It has antibacterial activity. This is a very important therapeutic effect, since often stomach diseases develop due to the fact that the bacterium Helicobacter pylori penetrates the mucous membrane. The active component of Pantoprazole is able to enhance the antibacterial effect. The medication goes well with broad-spectrum antibiotics. For pathologies that are associated with Helicobacter pylori, Pantoprazole is used in combination with tetracyclines, Metronidazole or Amoxicillin. Also considered a good bunch Clarithromycin + Pantoprazole.
    Accelerates regenerative processes. If the patient has gastric ulcer, then with the use of this proton pump inhibitor, he can accelerate the healing process of the ulcer and prevent its perforation. The use of this PPI has helped many people avoid surgical interventions and internal bleeding.
The therapeutic effect persists for a day from the moment of taking Pantoprazole tablets. After two weeks of therapy, approximately 89% of patients experience complete or partial healing of the ulcer. The relapse rate is not more than 55%, and this is a very good result. As a rule, a stable therapeutic effect can be achieved if the patient takes the drug for 4-8 weeks.
Pantoprazole is fully and rapidly absorbed. The instructions mention that the absolute bioavailability of the drug is 70-80%, and the maximum plasma concentration is reached 2-4 hours after administration. Binding to plasma proteins is almost absolute - about 98%. Metabolization of drugs occurs in the liver, the elimination half-life is from 1.5 to 2 hours.
Studies have shown that the active component of the proton pump inhibitor penetrates weakly through the BBB, but is able to accumulate in breast milk.
    Also, experiments on rats showed that prolonged use of this drug can lead to an increased likelihood of developing hyperplasia of ECL cells and gastric carcinoid, as well as neoplastic processes in the thyroid gland.

Pros

    Lasting effect
    Performance
    Good compatibility with almost all drugs
    Relatively low cost
    Possibility of use during pregnancy and lactation
    Drugs used in pediatrics
    Comprehensive Impact

Cons

    Digestive upsets are possible at first.
    Contraindicated in people with liver disease.
    With prolonged use increases the likelihood of developing cancer of the stomach

Indications

Basically, Pantoprazole is prescribed for peptic ulcer of the stomach and 12 duodenal ulcer. Moreover, the etiology of the development of the disease is absolutely not important. So, this proton pump inhibitor will be effective in cases where the ulcer develops as a result of taking NSAIDs, histamine receptor blockers, secondary gastrointestinal tract pathologies, or unbalanced nutrition.
Moreover, you can use the drug even during an exacerbation of an ulcer. The proton pump inhibitor will reduce the acidity of the stomach, accelerate the regenerative processes in the mucous membrane of the stomach, and also prevent the development of internal bleeding and perforation.
In addition to ulcers, indications may include:
    Gastroesophageal reflux disease (severe and moderate form).
    Zollinger-Ellison Syndrome. This term refers to a tumor of the islet apparatus of the pancreas, in which increases the secretion of gastrin, which activates the secretion of more hydrochloric acid.
    Peptic ulcer, which developed as a result of infection with Helicobacter pylori.
    Gastritis in a chronic form. But Pantoprazole can be prescribed only if the inflammatory process is accompanied by increased acidity of the gastric juice.

Mode of application

Pantoprazole is recommended before meals. Eating, in principle, does not significantly affect the absorption and effect of the drug, but fasting is still recommended by the manufacturer.
Tablets are strictly forbidden to chew or dissolve, they must be swallowed whole, and washed down with plenty of water. The dosage regimen will entirely depend on the specific indications, the severity of the disease, and the individual characteristics of the patient.
Average dosages:
    In the treatment of moderate reflux disease, it is recommended to start treatment with 20 mg per day. Over time, you can increase the dose to 30-40 mg. The duration of treatment is at least 2-4 weeks. Some patients may be recommended even a lifelong admission.
    If a person has been diagnosed with a neglected form of reflux disease, then he is recommended to drink 40 mg per day. As soon as the pathology passes into the stage of persistent remission, the dose can be halved. The duration of the course is selected individually.
    With peptic ulcer of the stomach and duodenum, gastritis, Zollinger-Elisson syndrome, it is recommended to drink 40 mg per day on an empty stomach. In exceptional cases, the dose is raised to 60-80 mg. The course lasts until the pathology passes into a stable remission. Some patients are advised to continue taking 20 mg / day even after stopping the main symptoms.

Contraindications

Let us consider in more detail in which cases the drug is contraindicated. Firstly, the proton pump inhibitor is strictly forbidden to take to people who have hypersensitivity to the active or auxiliary components.
In pediatrics, the drug is used. The proton pump blocker is prescribed for children from the age of 6 years. During pregnancy, taking tablets can only be done if absolutely necessary, and the doctor must necessarily compare the risks for the baby and the benefits for the mother.
During lactation, you can drink Pantoprazole tablets only if the mother stops breastfeeding for the period of therapy, since the active substance of the drug is able to penetrate into breast milk.
Other contraindications:
    Hepatitis in the acute stage. Moreover, the etiology of hepatitis is unimportant. It is forbidden to take with viral, and with autoimmune, and with alcoholic hepatitis.
    Cardiac cirrhosis of the liver.
    Acute or decompensated liver failure.
    Cirrhosis of the liver.

Side effects

Pantoprazole is well tolerated by patients, in principle. Side effects are rare. In general, adverse reactions are observed in patients who take increased dosages, and in those whose course of therapy lasts more than 4-6 weeks.
If the patient has an increased sensitivity to the main or auxiliary components of the drug, then taking the tablets may cause allergic reactions. Swelling, itching, redness of the skin, Quincke's edema, and even anaphylactic shock occur.
In addition to allergic reactions, the following are possible:
    Violations of the digestive system. The instructions mention that drugs can cause dry mouth, nausea, increased appetite, belching, flatulence, vomiting, abdominal pain, constipation. An increase in the activity of hepatic transaminases is not excluded. Also, isolated cases were recorded when gastrointestinal carcinoma developed against the background of taking a proton pump inhibitor.
    Failures in the central nervous system and sensory organs. Headaches, asthenic syndrome, dizziness, drowsiness, insomnia are possible. Some patients experienced depressive states, tremors, visual and auditory disturbances, muscle cramps.
    Hematuria, swelling of the extremities.
    Potency reduction in men.
    Increased blood sugar.
    Hypercholesterolemia, eosinophilia, hyperlipoproteinemia.
    Myalgia.
    Fever.

Drug Interactions and Special Instructions

Pantoprazole goes well with many drugs. However, in the section "drug interaction" there is a mention that the proton pump inhibitor is able to reduce the ph-dependent absorption of ketoconazole and some other drugs.
But Pantoprazole goes well with medications that are metabolized with the participation of the cytochrome P450 enzyme system, as well as with antibiotics and antacids. It should also be taken into account that the proton pump blocker does not affect the effectiveness of hormonal contraceptives, which is a huge plus.
Special instructions:
    During the period of taking drugs, it is recommended to follow the prescribed diet.
    It is highly undesirable to take alcohol during therapy.
    Before starting taking the tablets, the presence of malignant tumors in the esophagus should be excluded.
    Elderly people and patients who have impaired renal function are not recommended to take more than 40 mg per day.
    If there is a malfunction in the liver, then during therapy should carefully monitor the activity of transaminases and the function of the hepatobiliary system as a whole.

Reviews on the drug Pantoprazole

People who took Pantoprazole respond differently about this drug. For some, the medicine really helped stabilize the digestive tract, speed up the healing of ulcers and normalize the acidity of the stomach.
Others complain that the medication is completely ineffective, and digestive upsets occurred during its use. Most often, patients complain of dry mouth, increased appetite and constipation.
Doctors are positive about this proton pump inhibitor. According to them, Pantoprazole is one of the best drugs in its class, and in its effectiveness it is not inferior to expensive analogues.
     And the ineffectiveness of drugs in some cases is due to the incorrect selection of the dosage regimen and the fact that sometimes patients seek medical help too late.

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