Mode of action
Irreversibly inactivate the hydrogen/potassium ATPase enzyme system (proton pump), suppressing both stimulated
and basal acid secretion. When PPIs are stopped, acid secretion is restored by synthesis of new hydrogen/potassium
ATPase.
Indications
Marketed: Peptic ulcer disease (PUD); Gastro-oesophageal reflux disease (GORD); Zollinger–Ellison syndrome;
H. pylori eradication as part of effective eradication regimen; Treatment and prevention of peptic ulcer and erosion
associated with NSAIDs.
Accepted: Scleroderma oesophagus; In selected patients for stress ulcer prophylaxis; acute upper GI bleeding;
Prevention of acid aspiration.
Specific considerations
Same as esomeprazole
Adverse effects
PPIs are generally well tolerated.
Common: headache, nausea, diarrhoea, abdominal pain, fatigue, dizziness.
Infrequent: dry mouth, increased sweating , rash, itch, flatulence, constipation, decreased absorption of
cyanocobalamin (vitamin B12) may occur with long term use
Rare: gynaecomastia, myalgia, interstitial nephritis, raised liver enzymes, hepatitis, jaundice, thrombocytopenia,
leucopenia, erythema multiforme, Stevens–Johnson syndrome, toxic epidermal necrolysis, hypersensitivity reactions.
Dosage
PUD: Initially, oral/IV 40 mg once daily for 4–8 weeks; change from IV to oral treatment as soon as possible.
GORD: Initially, oral 40 mg once or twice daily; IV 20–40 mg daily (change to oral treatment as soon as possible).
Maintenance, reduce to minimum required.
Prevention of NSAID-associated dyspepsia, PUD or erosion: Oral, 20 mg once daily.
Zollinger–Ellison syndrome: Adjust dose according to gastric acid output. Usually 80–120 mg oral twice daily or
80 mg 3 times daily.
H. pylori eradication:
Oral, 40 mg twice daily for 1 week, with 2 antibiotics.
Patient counselling
Swallow tablet whole; do not crush or chew.
Tell your doctor if you develop symptoms such as black stools or coffee-coloured vomit.
Products
PANTOPRAZOLE TABS 40 MG (CONTROLOC®, PANTODAR®, PANTOLOC®, PANTOVER®,
PROTON®, RAZON®)