Medicine Information

Probitor

Name: Probitor
Brand: Probitor
Rating: 4.5 (117 reviews)

Capsule (Gastro-resistant)40 mgProton Pump Inhibitors (PPIs)ATC: A02BC02

Generic Name

Pantoprazole

Manufacturer

Square Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
probitor 40 mg capsule	৳ 10.10	৳ 101.00

Description

Overview of the medicine

Probitor 40 mg Capsule is a proton pump inhibitor (PPI) used to treat conditions caused by excess stomach acid, such as gastroesophageal reflux disease (GERD), erosive esophagitis, stomach ulcers, and Zollinger-Ellison syndrome.

Uses & Indications

Gastroesophageal Reflux Disease (GERD)

Erosive Esophagitis

Duodenal Ulcer

Gastric Ulcer

Zollinger-Ellison Syndrome

Helicobacter pylori eradication (in combination with antibiotics)

Dosage

Adults

For GERD/Erosive Esophagitis: 40 mg once daily for up to 8 weeks. For Duodenal/Gastric Ulcer: 40 mg once daily for 2-4 weeks. For H. pylori eradication: 40 mg twice daily with antibiotics for 7-14 days. For Zollinger-Ellison Syndrome: Initially 80 mg once daily, adjusted based on response.

Elderly

No specific dose adjustment is generally required, but caution is advised in very frail patients.

Renal_impairment

No dose adjustment needed for renal impairment.

How to Take

Take the capsule whole, preferably 30-60 minutes before a meal (e.g., breakfast). Do not chew, crush, or break the capsule. Swallow with water.

Mechanism of Action

Pantoprazole irreversibly blocks the H+/K+-ATPase enzyme system (the proton pump) in the gastric parietal cells. This inhibition prevents the final step in gastric acid secretion, leading to a profound and long-lasting reduction in stomach acid production.

Pharmacokinetics

Onset

Onset of acid suppression within 2.5 hours.

Excretion

Mainly excreted renally (approximately 80%), with the remainder in feces (about 18%).

Half life

Approximately 1 hour (terminal half-life), but acid suppression lasts much longer due to irreversible binding.

Absorption

Rapidly absorbed after oral administration, peak plasma concentrations typically occur within 2-2.5 hours. Bioavailability is about 77%.

Metabolism

Extensively metabolized in the liver by the cytochrome P450 system (primarily CYP2C19 and CYP3A4).

Side Effects

Contraindications

Known hypersensitivity to pantoprazole, any substituted benzimidazoles, or any component of the formulation.
Concomitant use with atazanavir or nelfinavir due to significant reduction in their plasma concentrations.

Drug Interactions

Warfarin

May increase INR and prothrombin time, monitor for bleeding.

Iron Salts

Absorption may be reduced due to increased gastric pH.

Methotrexate

May increase methotrexate levels, especially with high-dose therapy.

Atazanavir/Nelfinavir

Decreases absorption and plasma concentrations, leading to potential loss of therapeutic effect.

Ketoconazole/Itraonazole

Absorption may be reduced 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, drowsiness, nausea, vomiting, abdominal pain, diarrhea, and headache. Treatment is symptomatic and supportive. Pantoprazole is not removed by hemodialysis.

Pregnancy & Lactation

Pregnancy Category C. Use only if the potential benefit justifies the potential risk to the fetus. Small amounts of pantoprazole are excreted in breast milk; caution should be exercised when administered to a nursing mother.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 capsules (1x10 blister)30 capsules (3x10 blister)

Shelf Life

Typically 24-36 months from manufacturing date

Availability

Pharmacies, Hospitals

Approval Status

Approved by regulatory bodies (e.g., FDA, DGDA)

Patent Status

Patent expired for generic pantoprazole

WHO Essential Medicine

Yes

Clinical Trials

Numerous clinical trials have established the efficacy and safety of pantoprazole in various acid-related disorders, demonstrating superior or comparable effects to other PPIs and H2-receptor antagonists in healing rates and symptom control.

Lab Monitoring

No specific routine lab monitoring is generally required. However, for long-term therapy (over 1 year), consider monitoring magnesium levels periodically, as PPIs can cause hypomagnesemia.
Monitor for signs of bone fractures in long-term use.

Doctor Notes

Consider lowest effective dose for shortest duration to reduce risks.
Educate patients on potential long-term risks (e.g., fractures, C. diff, hypomagnesemia) if prolonged use is anticipated.
Review necessity for continued PPI therapy periodically.

Patient Guidelines

Take as directed by your doctor, usually once daily before a meal.
Swallow the capsule whole; do not crush or chew.
Inform your doctor if your symptoms do not improve or worsen.
Do not stop taking the medicine suddenly without consulting your doctor.
Long-term use may increase the risk of bone fractures and magnesium deficiency.

Missed Dose Advice

If a dose is missed, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.

Driving Precautions

Pantoprazole may cause dizziness or visual disturbances in some patients. If affected, avoid driving or operating machinery.

Lifestyle Advice

Avoid trigger foods that worsen acid reflux (e.g., spicy, fatty foods, caffeine, chocolate).
Eat smaller, more frequent meals.
Avoid lying down immediately after eating.
Elevate the head of your bed.
Quit smoking and reduce alcohol consumption.