PANTORC ® Pantoprazole

PANTORC ® is a Pantoprazole based drug.

THERAPEUTIC GROUP: Antireflux - Antiulcer - Inhibitors of the acid pump

IndicationsAction mechanismStudies and clinical effectiveness Usage and dosage instructionsWarnings Pregnancy and lactationInteractionsContraindicationsUndesirable effects

Indications PANTORC ® Pantoprazole

PANTORC ® is used both as a preventive pharmacological treatment of gastric and duodenal ulcers induced by prolonged use of non-steroidal anti-inflammatory drugs, and as a therapeutic treatment of the symptoms associated with gastro-oesophageal reflux.

Mechanism of action PANTORC ® Pantoprazole

Pantoprazole contained in PANTORC ® represents an active ingredient belonging to the pharmacological category of proton pump inhibitors, with advantageous pharmacokinetic characteristics compared to the more common omeprazole.

In fact, once taken orally, pantoprazole is rapidly absorbed at the duodenal level, reaching its maximum plasma concentration in just 2 hours, with a bioavailability of around 77% of the total dose taken, therefore significantly higher than the 30 % of omeprazole.

From the pharmacodynamic point of view, on the other hand, the mechanism of action of this active principle remains almost unchanged, being able to act selectively on the H + / K + ATPase pump, expressed by the parietal cells of the stomach, thus inhibiting both basal and hormone-induced acid secretion like gastrin or histamine.

It is therefore evident that its prolonged use of this drug will be accompanied by a significant increase in gastrin blood concentrations, fortunately without clinically evident repercussions.

After its action, after a very rapid half-life, the drug is mostly eliminated through the renal route.

Studies carried out and clinical efficacy

1. PANTOPRAZOLE AND ESOPHAGEAL GASTRO REFLUX DISEASE

Pantoprazole treatment has proven to be particularly effective in treating the symptoms associated with gastro-oesophageal reflux, resulting in the reduction of cases of heartburn, acid secretion, abdominal pain and dyspepsia without particular side effects in just one week of treatment.

2. PANTOPRAZOLE AND GASTROINTESTINAL HEMORRHAGES

Patients with acute coronary syndrome have a high risk of developing bleeding from the gastro-intestinal tract. In these patients the administration of 40 mg of pantoprazole per day for 7 days, has proved to be useful in significantly reducing the incidence of this adverse reaction, without any particular side effects.

3. CROSS REACTIVITY BETWEEN PROBON PUMP INHIBITORS

Cross-reactivity between different proton pump inhibitors was ascertained in this clinical case, in which a 60-year-old man experienced neutropenia both after taking omeprazole and pantoprazole after about 1 year. These data are important to underline the presence of cross reactivity between different proton pump inhibitors.

Method of use and dosage

PANTORC ® pantoprazole 20-40 mg gastro-resistant tablets:

both in the treatment of symptoms associated with gastro-oesophageal reflux, and in the prevention of ulcers and esophagitis, the effective daily dose is 20 mg taken preferably in the morning with a glass of water.

In general the remission of the symptomatology is observed in 2-4 weeks of treatment, at the end of which, one-time use could be used following the reappearance of symptoms.

Variations in the dosage could be foreseen in particular categories of patients at risk, and always under strict instructions from your doctor.

Warnings PANTORC ® Pantoprazole

Before taking PANTORC ® the doctor should make a careful clinical evaluation of the patient, able to exclude the malignant origin of the pathologies of the gastrointestinal tract, so that the therapeutic action of the medicine, able to mask some particularly important symptoms, do not delay its diagnosis.

The reduction of the acid content of the stomach, very important following the prolonged intake of pantoprazole, could determine a reduction in the absorption of vitamin B12, with the appearance of the related symptomatology.

PANTORC ® should be administered with particular care in patients with impaired renal and hepatic function.

PREGNANCY AND BREASTFEEDING

The studies currently present in the literature, statically little significant, do not allow to totally characterize the safety profile of pantoprazole, when taken during pregnancy.

Therefore the use of PANTORC ® during the period of pregnancy and the subsequent period of breastfeeding is not recommended.

Interactions

As is known, pantoprazole is metabolized by the cytochrome p450 system, also involved in the metabolism of high active ingredients such as carbamazepine, caffeine, diazepam, diclofenac, digoxin, ethanol, glibenclamide, metoprolol, naproxen, nifedipine, phenytoin, piroxicam, theophylline and oral contraceptives .

In light of these data, possible interactions could alter the normal pharmacokinetic properties of the above compounds, with particular importance for anticoagulants, for which a continuous monitoring of prothrombin time would be necessary.

Furthermore, the concomitant intake of atazanavir and pantoprazole could lead to a significant reduction in the absorption of atazanavir, which is achieved thanks to the acidic contents of the stomach.

Contraindications PANTORC ® Pantoprazole

PANTORC ® is contraindicated in patients with known hypersensitivity to the active substance or one of its excipients. Given the possibility of cross reactivity it would be good to avoid taking the medicine even in case of hypersensitivity to compounds similar to pantoprazole.

Undesirable effects - Side effects

Clinical experimentation and post-marketing monitoring have highlighted some particularly frequent side effects, such as headache, drowsiness and dizziness, abdominal pain, nausea, vomiting, diarrhea, constipation and flatulence, following the intake of PANTORC ®

Cases of hepatic, renal, hematologic and cutaneous damage were more rare and rapidly disappeared once therapy was suspended.