Panoral
Generic Name
Pantoprazole 40 mg Tablet
Manufacturer
Beximco Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| panoral 40 mg tablet | ৳ 7.00 | ৳ 70.00 |
Description
Overview of the medicine
Panoral 40 mg Tablet is a proton pump inhibitor (PPI) used to reduce the amount of acid produced in the stomach. It treats conditions like heartburn, acid reflux, and ulcers.
Uses & Indications
Dosage
Adults
Usually 20-40 mg once daily, taken before a meal. Dosage and duration depend on the condition being treated.
Elderly
No specific dosage adjustment is generally required for elderly patients.
Renal_impairment
No dosage adjustment is necessary for patients with renal impairment or those on hemodialysis.
How to Take
Take the tablet whole with a glass of water, preferably in the morning before breakfast. Do not crush or chew the tablet.
Mechanism of Action
Pantoprazole works by irreversibly binding to the H+/K+-ATPase (proton pump) in the gastric parietal cells, thereby inhibiting the final step in gastric acid secretion.
Pharmacokinetics
Onset
Within 2.5 hours
Excretion
Mainly excreted renally (approximately 80%) as metabolites, with the remaining 20% excreted in feces.
Half life
Approximately 1 hour (terminal half-life), but the duration of anti-secretory effect is much longer.
Absorption
Rapidly absorbed after oral administration, with peak plasma concentrations occurring 2-2.5 hours post-dose. Bioavailability is approximately 77%.
Metabolism
Extensively metabolized in the liver by the cytochrome P450 (CYP) enzyme system, mainly CYP2C19 and CYP3A4.
Side Effects
Contraindications
- Hypersensitivity to pantoprazole, substituted benzimidazoles, or any component of the formulation.
- Concomitant use with atazanavir or nelfinavir.
Drug Interactions
Clopidogrel
Reduced efficacy of clopidogrel (a blood thinner) due to inhibition of its activation.
Methotrexate
May increase and prolong serum levels of methotrexate, particularly at high doses.
Atazanavir/Nelfinavir
Significant reduction in absorption of these antiretrovirals, leading to reduced efficacy.
Drugs dependent on gastric pH for absorption (e.g., ketoconazole, iron salts)
Reduced absorption due to increased gastric pH.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Experience with pantoprazole overdose is limited. Symptoms may include lethargy, tachycardia, confusion, and blurred vision. Treatment is symptomatic and supportive; pantoprazole is not dialyzable.
Pregnancy & Lactation
Pregnancy Category B. Use only if clearly needed. Pantoprazole is excreted in breast milk; caution should be exercised when administered to a nursing woman. Consult your doctor.
Side Effects
Contraindications
- Hypersensitivity to pantoprazole, substituted benzimidazoles, or any component of the formulation.
- Concomitant use with atazanavir or nelfinavir.
Drug Interactions
Clopidogrel
Reduced efficacy of clopidogrel (a blood thinner) due to inhibition of its activation.
Methotrexate
May increase and prolong serum levels of methotrexate, particularly at high doses.
Atazanavir/Nelfinavir
Significant reduction in absorption of these antiretrovirals, leading to reduced efficacy.
Drugs dependent on gastric pH for absorption (e.g., ketoconazole, iron salts)
Reduced absorption due to increased gastric pH.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Experience with pantoprazole overdose is limited. Symptoms may include lethargy, tachycardia, confusion, and blurred vision. Treatment is symptomatic and supportive; pantoprazole is not dialyzable.
Pregnancy & Lactation
Pregnancy Category B. Use only if clearly needed. Pantoprazole is excreted in breast milk; caution should be exercised when administered to a nursing woman. Consult your doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years from manufacturing date
Availability
Available in pharmacies and hospitals
Approval Status
Approved (Widely)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established the efficacy and safety of pantoprazole in various acid-related disorders.
Lab Monitoring
- For long-term use (over 3 months), periodically monitor serum magnesium levels.
- Assess Vitamin B12 levels in patients on prolonged therapy (over 3 years) due to potential malabsorption.
Doctor Notes
- Consider the lowest effective dose for the shortest duration necessary.
- Monitor for potential long-term adverse effects, especially in elderly patients or those with multiple comorbidities.
- Advise patients on lifestyle modifications to manage acid reflux symptoms.
- Counsel patients regarding potential drug interactions, particularly with clopidogrel and certain antiretrovirals.
Patient Guidelines
- Take exactly as prescribed by your doctor.
- Do not crush, chew, or break the tablet; swallow it whole.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
- Do not stop taking the medicine suddenly without consulting your doctor.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose.
Driving Precautions
Pantoprazole generally does not affect the ability to drive or operate machinery. However, if you experience dizziness or visual disturbances, avoid such activities.
Lifestyle Advice
- Avoid foods and drinks that trigger heartburn or acid reflux (e.g., spicy foods, fatty foods, caffeine, alcohol, carbonated drinks).
- Elevate the head of your bed to help reduce nighttime reflux symptoms.
- Avoid eating large meals close to bedtime.
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