Pantoprazole Eg (Pantoprazole Sodium Sesquihydrate)

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

• Gastro‑oesophageal reflux disease (GERD): reduces reflux symptoms and promotes healing of erosive esophagitis.
• Erosive gastritis and duodenal ulcer disease: supports ulcer healing by maintaining a higher gastric pH.
• Zollinger‑Ellison syndrome: controls gastric hypersecretion associated with gastrin‑producing tumours.
• Prevention of NSAID‑induced gastric ulcers: lowers ulcer risk in patients requiring long‑term non‑steroidal anti‑inflammatory therapy.

• Pantoprazole 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 basal and stimulated gastric acid secretion, allowing the gastric environment to become less acidic and facilitating mucosal healing.

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

Common Side Effects

• Headache: mild to moderate intensity.
• Diarrhoea: usually transient.
• Nausea or abdominal discomfort: may improve with continued use.
• Flatulence: occasional gas buildup.
• Constipation: infrequent but reported.

Serious or Rare Side Effects

• Severe allergic reaction (anaphylaxis): rash, swelling, difficulty breathing.
• Clostridioides difficile‑associated diarrhoea: persistent watery stools.
• Low magnesium levels (hypomagnesemia): muscle cramps, irregular heartbeat.
• Bone fractures: increased risk with long‑term use.
• Liver enzyme elevation: abnormal liver function tests.

When prescribing Pantoprazole Eg, clinicians should consider several safety aspects:

• Assess renal and hepatic function: dose adjustment may be required in severe impairment.
• Review concomitant medications: potential for drug‑drug interactions, especially with drugs needing acidic pH for absorption.
• Monitor long‑term users: watch for magnesium deficiency, bone health, and possible infections.
• Pregnancy and lactation: use only if clearly needed after risk‑benefit evaluation.
• Pediatric use: reserve for approved age groups and indications.
• Store at ambient temperature: keep in original container, protect from moisture and direct sunlight.

Pantoprazole Eg can affect the pharmacokinetics of several co‑administered medicines.

Major Interactions (Avoid)

• Antiretroviral protease inhibitors (e.g., atazanavir, nelfinavir): reduced absorption and efficacy.
• Antifungal agents (e.g., ketoconazole, itraconazole): markedly decreased bioavailability.
• Clopidogrel: diminished antiplatelet effect, increasing cardiovascular risk.

Moderate Interactions (Monitor Closely)

• Warfarin: possible alteration of INR, requiring more frequent monitoring.
• Methotrexate: reduced renal clearance may raise serum levels.
• Digoxin: slight increase in serum concentration.
• Iron salts and certain oral bisphosphonates: decreased absorption; separate dosing by at least 2 hours.