PANSEC DR TABLETS 40MG

Indications

• Gastroesophageal reflux disease (GERD)
• Erosive esophagitis due to gastroesophageal reflux disease
• Peptic ulcers
• Zollinger-Ellison syndrome
• Prevention of gastric ulcers in patients requiring continuous NSAID treatment

Dosage

Children: Refer to the BNF for Children for specific dosage recommendations.

Adults: Refer to the BNF for specific dosage recommendations.

Mechanism of action

Pantoprazole exerts its therapeutic effects by irreversibly binding to the H+/K+ ATPase enzyme, which is the final step in gastric acid production. This binding inhibits the secretion of hydrogen ions into the gastric lumen, thereby reducing gastric acidity. The action of pantoprazole leads to increased gastric pH, allowing for healing of erosive esophagitis and ulcers.

Pharmacodynamics

The pharmacodynamic effects of pantoprazole include the suppression of gastric acid secretion, which not only alleviates symptoms associated with acid-related disorders but also promotes the healing of gastric and duodenal ulcers. The onset of action typically occurs within 1 to 2 hours, and the duration of effect can last up to 24 hours, making it suitable for once-daily dosing in most cases.

Pharmacokinetics

Pantoprazole is well-absorbed after oral administration, with peak plasma concentrations occurring within 2 to 4 hours. It is extensively metabolized in the liver through CYP2C19 and CYP3A4 pathways, resulting in various metabolites. The elimination half-life is approximately 1 hour, but the effects on acid secretion can last much longer due to the irreversible nature of its action. It is primarily excreted through the urine, with only a small percentage eliminated unchanged.

Contra-indications

• Hypersensitivity to pantoprazole or any of the excipients
• Severe hepatic impairment

Adverse effects

• Headache
• Diarrhea
• Nausea
• Vomiting
• Abdominal pain
• Flatulence
• Dizziness
• Fatigue
• Rash
• Risk of Clostridium difficile infection in the colon

Interactions

• May reduce the absorption of drugs that require an acidic gastric pH
• Potential interaction with warfarin, increasing the risk of bleeding
• May affect the metabolism of certain drugs via CYP2C19

Precautions

• Use with caution in patients with liver disease
• Monitor for signs of gastrointestinal malignancy
• Long-term use may lead to vitamin B12 deficiency

Pregnancy

Pantoprazole should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Limited data available.

Breast-feeding

Pantoprazole is excreted in breast milk. Caution should be exercised when administering to nursing mothers.

Storage

Store at room temperature, away from moisture and heat. Keep out of reach of children.

Formulations

• Tablets
• Injectable form

Dosage

Children: Refer to specific drug guidelines as the dosing will depend on the active pharmaceutical ingredient associated with the sesquihydrate form.

Adults: Refer to specific drug guidelines as the dosing will depend on the active pharmaceutical ingredient associated with the sesquihydrate form.

Mechanism of action

The mechanism of action of sesquihydrates is largely dependent on the specific active pharmaceutical ingredient they are associated with. Generally, hydration can influence the dissolution and release rates of the active drug in the gastrointestinal tract, enhancing its absorption and therapeutic efficacy. The presence of water molecules in the structure can also stabilize the drug, preventing degradation and improving shelf-life.

Pharmacodynamics

Pharmacodynamics of sesquihydrates varies with the specific properties of the compound. Generally, the hydration state can affect the drug's interaction with biological targets, its efficacy, and potency. Hydrated forms may exhibit different binding affinities or pharmacological effects compared to their anhydrous counterparts, leading to variations in therapeutic outcomes. The hydration levels can also influence the pharmacological profile, such as the onset and duration of action.

Pharmacokinetics

Sesquihydrate compounds can exhibit altered pharmacokinetic parameters due to their water content. The absorption rate may be modified as hydration can enhance solubility, allowing for faster dissolution and absorption in the gastrointestinal tract. Distribution can also be influenced by the molecular weight and solubility characteristics of the hydrated form. Metabolism and excretion depend on the specific drug's pathways and can be affected by the hydration state, potentially altering half-life and clearance rates.

Pregnancy

Safety during pregnancy has not been established. Use with caution and only if the benefits outweigh the risks.

Breast-feeding

It is not known whether sesquihydrate is excreted in human milk. Caution is advised when administered to breastfeeding women.

Storage

Store in a cool, dry place away from light. Ensure the container is tightly closed.