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PANOM
Generic Name   Pantoprazole            
Therapeutic class  Gastrointestinal Agent
Pharmacological Class Proton Pump Inhibitor
Composition  Each tablet contains Pantoprazole sodium 40 mg.

(As delayed-release tablets)

Pregnancy category ‘B’
Presentation Available in the pack size as 10 tablets X 20 strips

What is Panom?     

Panom, available as 40 mg tablets, contains Pantoprazole, which blocks the production of acid by the stomach and hence treats conditions that are caused by hyperproduction of stomach acid.

In what conditions Panom can be used?

 

 Panom can also be used in quadruple regimens for the treatment of H. pylori infections along with other antibiotics.

How does Panom work?                    

Panom acts to decrease gastric acid secretion, which reduces stomach acidity. Panom administration leads to long-lasting inhibition of gastric acid secretion.

How to take Panom?

Panom tablets should be administered orally and the whole tablet has to be swallowed with water (Crushing or chewing the tablet should be strictly avoided.)

                                  

The recommended dosage regimen is;

  • GERD: 40 mg orally once a day 8 weeks
  • Gastric (Stomach) Ulcer: 40 mg orally once a day for 4-8 weeks
  • Duodenal (Intestinal) Ulcer: 40 mg orally once a day for 12 weeks
  • Zollinger Ellison Syndrome: 40 mg twice daily, to a maximum of 240 mg per day.

                                  

Panom, being delayed-release tablets, can be taken either with or without food. Better efficacy can be achieved if taken 30 minutes before meal. Take Panom at around the same time(s) every day. 

Take Panom exactly as directed. Do not take more or less of it or take it more often or for a longer period of time than prescribed by your doctor.

                                       

What to do if a dose is missed?

If you forget to take a dose, take it as soon as you remember. If you don’t remember until it’s nearly time for the next dose, skip the missed dose. Never take two doses at the same time. Never take an extra dose to make up for a forgotten one.

If you often forget doses, it setting an alarm might be helpful to remind you.

                                                        

What do you need to know before you take Panom?

  • Tell your doctor and pharmacist if you are allergic to any component of the formulation.
  • Tell your doctor if you have ever had:
  • low levels of magnesium in your blood;
  • lupus; or
  • Osteoporosis or low bone mineral density.

 

Do not hesitate to provide information to your healthcare provider about the underlying health conditions that you have and also about other medicines that you are currently taking.

 

Warnings and Precautions:

  • Ask your doctor for the precautions you need to take while using Panom if you are due to have an endoscopy
  • Talk to your healthcare provider if you have liver problems so as to take the necessary precautions.
  • If you have diarrhea that is watery or bloody, call your doctor.Do not use anti-diarrhea medicine unless your doctor tells you to.
  • Long-term and improper use of Panom can lead to an increased risk of certain side effects and complications.

            

 Can Panom be taken during pregnancy?

As a precautionary measure, Panom is not recommended during pregnancy. However, you may consult with your healthcare provider in case of unavoidable use.

 

Can lactating mothers consume Panom?

Use of Panom during breastfeeding is not recommended.

Is Panom safe for use in Children?

Panom is not approved for use by anyone younger than 5 years old.

Possible Side effects:                          

The more common side effects that can occur with pantoprazole include headache, diarrhea, stomach pain, nausea or vomiting, gas, dizziness and joint pain.

Tell your doctor right away if you have any serious side effects, including: symptoms of a low magnesium blood level (such as unusually fast/slow/irregular heartbeat, persistent muscle spasmsseizures), signs of lupus (such as rash on nose and cheeks, new or worsening joint pain).

Pharmacodynamics:

Pantoprazole is a prodrug; in the acid environment of the parietal cells, it inhibits the H+, KATPase of the coating gastric cells and gastric acid secretion is suppressed.

 Pantoprazole exerts its stomach acid-suppressing effects by preventing the final step in gastric acid production by covalently binding to sulfhydryl groups of cysteines found on the (H+, K+)-ATPase enzyme at the secretory surface of gastric parietal cell. This effect leads to inhibition of both basal and stimulated gastric acid secretion, irrespective of the stimulus. As the binding of pantoprazole to the (H+, K+)-ATPase enzyme is irreversible and new enzyme needs to be expressed in order to resume acid secretion, pantoprazole’s duration of antisecretory effect persists longer than 24 hours.

Pharmacokinetics:

Absorption: Absolute bioavailability is approximately 77%.

                                                                                                 

Volume of distribution: The apparent volume of distribution of pantoprazole is approximately 11.0-23.6 L, distributing mainly in the extracellular fluid.

 

Protein binding: Approximately 98%

                                                                                                         

Metabolism: Hepatic                  

 

Route of elimination: 80% of the dose is excreted as metabolites in urine; the remainder is found in feces and originates from biliary secretion.

 

Half-life: The half life of elimination is about 1 hour.

                     

Drug Interactions:

  • Pantoprazole may reduce the absorption of certain drugs that may be affected by stomach acidity.
  • Pantoprazole may also increase the action of warfarin increasing the risk of bleeding.
  • False positive urine screening tests for tetrahydrocannabinol (THC) may occur in patients receiving PPIs including Pantoprazole. An alternative confirmatory method should be considered to verify positive results.
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