Pantoprazole
When ATH:
A02BC02
Characteristic.
The substituted benzimidazole derivative, white or almost white crystalline powder, water-soluble. Solubility increases with increased pH.
Pharmacological action.
Antiulcer.
Application.
Duodenal ulcer or stomach in the acute phase, incl. associated with taking NSAIDs, or refractory to therapy with histamine H2-receptors; gastroesophageal reflux disease (moderate and severe forms); Zollinger - Ellison; Combined H. pylori eradication therapy in patients with peptic ulcer to reduce the frequency of relapses.
Contraindications.
Hypersensitivity, hepatitis and cirrhosis, accompanied by severe hepatic insufficiency.
Restrictions apply.
Abnormal liver function, childhood (application experience in children under 6 years of absence).
Pregnancy and breast-feeding.
When pregnancy is possible only under strict conditions, when the benefit to the mother outweighs the potential risk to the fetus.
Category actions result in FDA - B. (The study of reproduction in animals revealed no risk of adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not done.)
At the time of treatment should stop breastfeeding.
Side effects.
From the digestive tract: diarrhea; rarely - dry mouth, increased appetite, nausea, belching, vomiting, flatulence, abdominal pain, constipation, increase in transaminases, gastrointestinalʹnaâ cancer (single case).
From the nervous system and sensory organs: headache; rarely fatigue, dizziness, drowsiness, insomnia; in some cases, nervousness, depression, tremor, paresthesia, photophobia, visual impairment, noise in ears.
With the genitourinary system: in a few cases-hematuria, swelling, impotence.
Co the Skin: in a few cases, alopecia, acne, exfoliative dermatitis.
Allergic reactions: rarely - rash, hives, itch, angioedema.
Other: rarely giperglikemia, myalgia; in rare cases, fever, eozinofilija, Hyperlipoproteinemia, hypercholesterolemia.
Cooperation.
May reduce the pH-dependent absorption of ketoconazole and other drugs. Compatible with drugs, metabolized with participation of cytochrome P450 enzyme system: Phenazepamum, diazepam, Digoxin, theophylline, Carbamazepine, diclofenac, naproxen, piroxicam, phenytoin, warfarin, nifedipine, metoprolol, ethanol. It does not affect the effectiveness of hormonal contraceptives.
Overdose.
Symptoms: not disclosed.
Treatment: in cases of suspected overdose recommended that a supportive and symptomatic therapy. Dialysis nyeeffyektivyen.
Dosing and Administration.
Inside. Monotherapy with gastric ulcer and duodenal ulcer, gastroesophageal reflux disease is usually 40 mg / day, perhaps (increasing the dose) to 80 mg / day (especially when эrozyvnыh and yazvennыh forms of reflux esophagitis). Duration of the course with ulcers duodenal ulcer — 14 days (sometimes even before 2 Sun), for stomach ulcers and gastroesophageal reflux disease 4 Sun (in individual cases even before 4 Sun).
Combined antihelikobakternaja eradication therapy in patients with gastric ulcers stomach or duodenal ulcer is on 40 mg 2 once a day (before breakfast and before dinner or during a meal, with liquid without destroying the integrity of the tablets, with some liquid) in combination with amoxicillin (1000 mg 2 once a day) and clarithromycin (500 mg 2 once a day); or metronidazole (500 mg 2 once a day) and clarithromycin (500 mg 2 once a day). Duration eradikatini therapy — 7 days (a maximum of 2 Sun).
Precautions.
Before treatment should be excluded cancers of the esophagus and stomach (symptomatic improvement may delay the correct diagnosis and treatment). The diagnosis of reflux disease should be confirmed by endoscopy. Not recommended for patients with non-ulcer dyspepsia. In older patients and in violation of the kidney do not exceed the dose 40 mg / day. In severe hepatic insufficiency dosing regimen should be adjusted: by 1 Table. every 2nd day, under the control of liver enzymes (if it shows the increasing removal of the drug).
