Pantoprazol, Pakningsstørrelser > 28 Stk. Stada (Pantoprazole Sodium Sesquihydrate)

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

• Gastro‑esophageal reflux disease (GERD): provides relief of heartburn and promotes healing of erosive esophagitis.
• Peptic ulcer disease: supports ulcer healing and reduces risk of recurrence.
• Zollinger‑Ellison syndrome: controls excessive gastric acid production associated with this rare neuroendocrine tumor.
• Maintenance therapy after healed erosive esophagitis: helps prevent relapse of symptoms.
• Prevention of NSAID‑induced gastric ulcers: reduces the risk of ulcer formation in patients requiring long‑term NSAID 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 secretion, it markedly lowers gastric acidity, allowing mucosal healing and symptom relief in acid‑related disorders.

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

Common Side Effects

• Headache: mild to moderate intensity.
• Diarrhea: watery stools, usually transient.
• Abdominal pain: cramping or discomfort.
• Nausea: occasional feeling of queasiness.
• Flatulence: increased intestinal gas.
• Constipation: reduced bowel movements.

Serious or Rare Side Effects

• Acute interstitial nephritis: inflammation of the kidneys.
• Severe allergic reaction: rash, itching, swelling, or difficulty breathing.
• Clostridioides difficile infection: severe diarrhea linked to gut flora disruption.
• Osteoporosis‑related fractures: increased risk with long‑term use.
• Hypomagnesemia: low magnesium levels, potentially causing muscle cramps or arrhythmias.

Before initiating pantoprazole therapy, consider the following safety measures:

• Assess renal function: dose adjustment may be needed in severe impairment.
• Review liver status: monitor for rare hepatic effects.
• Evaluate need for long‑term use: limit duration to the shortest effective period.
• Monitor electrolytes: especially magnesium during prolonged therapy.
• Caution in pregnancy: use only if clearly needed after risk‑benefit assessment.
• Store at ambient temperature: keep below 25°C, retain original packaging, protect from moisture.

Pantoprazole may 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 activity, increasing cardiovascular risk.

Moderate Interactions (Monitor Closely)

• Warfarin: potential alteration of INR, requiring more frequent monitoring.
• Methotrexate (high dose): possible increased serum concentrations.
• Digoxin: slight increase in serum levels, monitor for toxicity.