Ozzion (Pantoprazole Sodium Sesquihydrate)

Pantoprazole is a proton pump inhibitor that acts on the gastric acid secretion pathway. It is indicated for several acid‑related conditions:

• Gastro‑oesophageal reflux disease (GERD): provides symptomatic relief and promotes healing of erosive esophagitis.
• Erosive esophagitis: heals mucosal damage caused by chronic acid exposure.
• Peptic ulcer disease: supports ulcer healing and reduces risk of recurrence.
• Zollinger‑Ellison syndrome: controls excessive gastric acid secretion associated with the condition.
• Prevention of NSAID‑induced ulcer complications: lowers the incidence of ulcer formation in patients on long‑term NSAID therapy.

• Pantoprazole sodium sesquihydrate selectively and irreversibly binds to the H+/K+‑ATPase enzyme (the gastric proton pump) on the secretory surface of parietal cells. By inhibiting this final step of acid production, it markedly reduces both basal and stimulated gastric acidity, allowing mucosal healing and symptom control.

Pantoprazole is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Headache: mild to moderate intensity.
• Diarrhoea: usually transient and self‑limiting.
• Nausea: occasional, may improve with continued therapy.
• Abdominal pain: mild discomfort in the upper abdomen.
• Flatulence: increased intestinal gas.
• Constipation: reduced bowel movements.

Serious or Rare Side Effects

• Severe allergic reaction (anaphylaxis): rash, swelling, difficulty breathing.
• Clostridioides difficile infection: persistent watery diarrhoea.
• Low magnesium (hypomagnesemia): muscle cramps, irregular heartbeat.
• Liver enzyme elevation: signs of hepatic dysfunction.
• Bone fracture risk: with long‑term high‑dose use.
• Acute interstitial nephritis: kidney inflammation presenting with fever and rash.

Before initiating therapy, consider the following precautions:

• Assess renal function: dose adjustment may be required in severe impairment.
• Review concomitant medications: potential for drug‑drug interactions.
• Monitor magnesium levels: especially during prolonged treatment.
• Evaluate for Helicobacter pylori infection: eradication may be needed for ulcer healing.
• Use the lowest effective dose: to minimise long‑term adverse effects.
• Store at ambient temperature: keep in original container, protect from moisture and heat.

Pantoprazole can affect the absorption and metabolism of several medicines.

Major Interactions (Avoid)

• Atazanavir (and other protease inhibitors): reduced antiviral efficacy.
• Methotrexate (high‑dose): increased toxicity due to decreased renal clearance.
• Warfarin: potential increase in INR, requiring closer monitoring.

Moderate Interactions (Monitor Closely)

• Clopidogrel: possible reduction in antiplatelet effect.
• Digoxin: may increase serum concentrations.
• Oral contraceptives: slight decrease in hormonal efficacy.
• Iron supplements: reduced absorption; separate dosing by at least 2 hours.