Crossacid
Crosacid: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Krosacid
ATX code: A02BC02
Active ingredient: pantoprazole (Pantoprazole)
Producer: Micro Labs Limited (India)
Description and photo update: 2020-10-08
Prices in pharmacies: from 238 rubles.
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Crosacid - antiulcer drug, proton pump inhibitor; lowers the secretion of the stomach glands.
Release form and composition
The drug is produced in the form of enteric-coated tablets: yellow, biconvex, oval, one side has an inscription in black ink "PT20" for tablets with a dosage of 20 mg or "PT40" for tablets with a dosage of 40 mg, the core - from light yellow to white (14 pcs. in blisters, in a cardboard box 1 or 2 blisters; 100 pcs. in polypropylene cans, in a cardboard box 1 can. Each pack also contains instructions for the use of Crosacid).
1 tablet contains:
- active substance: pantoprazole sodium sesquihydrate - 22.5 or 45 mg, which is equivalent to 20 or 40 mg of pantoprazole, respectively;
- auxiliary components: croscarmellose sodium, mannitol, sodium carbonate, colloidal silicon dioxide, magnesium stearate;
- composition of the enteric shell: copolymer of methacrylic acid and ethyl acrylate (1: 1), macrogol-6000, hypromellose 15,000, titanium dioxide (E171), sodium hydroxide, iron dye yellow oxide (E172), talc;
- composition of black ink: shellac glaze 47.5% in denatured ethanol (methylated alcohol 74 OP), soy lecithin, iron dye black oxide (E172), antifoam (food grade), butanol (removed during production), denatured ethanol (methylated alcohol 74 OP) (removed during production).
Pharmacological properties
Pharmacodynamics
Crosacid is an antiulcer drug. Its active ingredient, pantoprazole, is a proton pump inhibitor. The mechanism of its action is due to the ability of pantoprazole to block the final stage of the secretion of hydrochloric acid, lowering the basal and stimulated secretion, regardless of the nature of the stimulus.
The antisecretory effect occurs within 1 hour, reaching a maximum 2–4 hours after taking the pill. In 72–96 hours after the end of therapy, secretory activity is restored.
Does not affect the motility of the gastrointestinal tract (GIT).
Acceptance of Crosacid in case of duodenal ulcer associated with Helicobacter pylori increases the sensitivity of microorganisms to antibiotics.
Unlike other proton pump inhibitors, pantoprazole is characterized by a higher chemical stability at neutral pH (acidity) and a lower possibility of interaction with the liver oxidase system, which depends on isoenzymes of the cytochrome P 450 system. Due to these qualities, pantoprazole does not interact with many other drugs.
Pharmacokinetics
After taking Crosacid inside, pantoprazole is rapidly absorbed from the gastrointestinal tract. The maximum concentration (C max) in blood plasma after the first dose of 20 mg is achieved on average after 2-2.5 hours and is 0.001-0.0015 mg / ml, at a dose of 40 mg - after 2.5 hours and is 0.002 –0.003 mg / ml. Against the background of repeated administration of pantoprazole, this indicator remains stable. Absolute bioavailability - 77%. Simultaneous food intake does not affect C max and AUC (area under the concentration-time pharmacokinetic curve).
Plasma protein binding - 98%, clearance - 0.1 l / h / kg, volume of distribution - 0.15 l / kg. Pantoprazole is excreted in breast milk.
It is metabolized in the liver with the formation of the main metabolite - desmethylpantoprazole, conjugated with sulfate.
The half-life (T 1/2) of pantoprazole is 1 hour, desmethylpantoprazole - 1.5 hours. It is excreted in the form of metabolites mainly (about 80%) through the kidneys, the rest through the intestines.
It does not accumulate in the body.
In elderly patients, there is a slight increase in AUC and C max, it has no clinical significance.
In patients with impaired renal function, as well as those on hemodialysis, the excretion of pantoprazole does not slow down, so a decrease in its dose is not required.
In liver failure (classes A and B according to the Child-Pugh classification) in the case of using pantoprazole at a dose of 20 mg, T 1/2 can increase to 3-6 hours, at a dose of 40 mg - up to 7-9 hours. In addition, the indicators increase C max and AUC. Compared with healthy patients, when taken in a dose of 20 mg, these indicators increase by 1.3 and 3-5 times, at a dose of 40 mg - by 1.5 and 5-7 times, respectively.
Indications for use
- period of exacerbation of gastric ulcer and / or duodenal ulcer;
- symptoms of gastroesophageal reflux disease of mild severity: sour belching, heartburn, nausea;
- erosive gastritis, including caused by the intake of NSAIDs (non-steroidal anti-inflammatory drugs);
- eradication of Helicobacter pylori - as part of combination therapy with antibacterial agents;
- Zollinger-Ellison syndrome.
Contraindications
Absolute:
- malignant gastrointestinal diseases;
- dyspepsia of neurotic genesis;
- simultaneous use with atazanavir;
- breast-feeding;
- age up to 18 years;
- hypersensitivity to the components of the drug.
In addition, for the eradication of Helicobacter pylori, it is contraindicated to use Crosacid tablets in patients with severe renal dysfunction with creatinine clearance (CC) less than 20 ml / min.
Care should be taken to prescribe Crosacid to patients with an increased risk of developing complications from the gastrointestinal tract and receiving NSAIDs at a dose of 20 mg for a long period as anti-relapse therapy for gastric ulcer and duodenal ulcer, with hepatic failure, during pregnancy, and elderly patients.
Krosacid, instructions for use: method and dosage
Crosacid tablets are taken orally, before meals, swallowing whole (the integrity of the enteric membrane must not be violated), washed down with a small amount of liquid.
With a single dose, it is advisable to take the tablets before breakfast, with a double dose, it is recommended to take the second dose of the antiulcer drug before dinner.
Recommended daily dosage:
- peptic ulcer of the stomach and duodenum, erosive gastritis: 40-80 mg; the duration of treatment for exacerbation of duodenal ulcer - 14 days, exacerbation of gastric ulcer - 28–56 days;
- gastric ulcer and duodenal ulcer (anti-relapse therapy): 20 mg;
- eradication of Helicobacter pylori (as part of combination therapy): 20-40 mg 2 times a day in combination with one of the following combinations: 1000 mg 2 times a day amoxicillin and 500 mg 2 times a day clarithromycin, or 500 mg 2 once a day metronidazole and 500 mg 2 times a day clarithromycin, or 1000 mg 2 times a day amoxicillin and 500 mg 2 times a day metronidazole. The course of combination therapy can last from 7 to 14 days. Then, in order to heal the duodenal ulcer, the drug can be continued as monotherapy for 7–21 days;
- symptoms of gastroesophageal reflux disease of mild severity (nausea, heartburn, sour belching): 20 mg for 2-3 days. If necessary, the reception of Crosacid can be continued for up to 7 days. In the absence of positive dynamics in the elimination of symptoms or worsening of the condition after the first 3 days of therapy, you should consult a specialist. Taking the tablets must be stopped immediately after the symptoms disappear;
- Zollinger-Ellison syndrome: 40-80 mg, with severe liver dysfunction - 40 mg 1 time in 2 days, monitoring blood biochemical parameters. In case of increased activity of liver enzymes, taking the tablets should be discontinued.
For elderly patients, the maximum daily dose of Crosacid is 40 mg, with the exception of the eradication of Helicobacter pylori as part of a combination antimicrobial therapy.
In severe renal impairment (CC less than 20 ml / min) or using hemodialysis, the daily dose of pantoprazole should not exceed 40 mg.
It is not recommended to use Crosacid as a prophylactic agent.
Side effects
- from the nervous system: often (≥ 1% and <10%) - headache; infrequently (≥ 0.1% and <1%) - dizziness; rarely (≥ 0.01% and <0.1%) - dysgeusia;
- from the lymphatic system: rarely - agranulocytosis; very rarely (<0.01%) - thrombocytopenia, pancytopenia, leukopenia;
- on the part of the psyche: infrequently - sleep disturbances; rarely - hallucinations, disorientation, depression, clouding of consciousness (more often in patients predisposed to this);
- from the immune system: very rarely - anaphylactic reactions, including anaphylactic shock;
- on the part of the organ of vision: infrequently - blurred vision;
- from the digestive system: often - pain in the upper abdomen, flatulence, diarrhea, constipation; infrequently - nausea, vomiting; rarely - dry mouth; very rarely - severe damage to the liver parenchyma, jaundice (including with hepatic failure);
- from the skin and subcutaneous tissues: infrequently - itching, rash; very rarely - angioedema, urticaria, photosensitivity, exudative erythema multiforme, malignant exudative erythema (Stevens-Johnson syndrome), Lyell's syndrome;
- from the urinary system: very rarely - interstitial nephritis;
- from the musculoskeletal system: rarely - arthralgia; very rarely - myalgia;
- from the genitals and mammary gland: rarely - gynecomastia;
- from the side of metabolism: rarely - changes in body weight, hyperlipidemia; the frequency has not been established (there is not enough data to assess the frequency of development) - hypomagnesemia, hyponatremia;
- general disorders: infrequently - malaise, increased fatigue, weakness; very rarely - increased body temperature, peripheral edema;
- laboratory disorders: rarely - an increase in the level of bilirubin; very rarely - an increase in the concentration of triglycerides, the activity of aspartate aminotransferase, gamma-glutamyltransferase.
Overdose
Symptoms of an overdose of Crosacid have not been established.
Treatment: the appointment of symptomatic therapy in case of development of clinical manifestations of an overdose. Hemodialysis is ineffective.
special instructions
The activity of liver enzymes in the blood plasma should be regularly monitored, in case of their increase, Krosacid should be stopped.
In order to exclude malignant diseases of the stomach and esophagus, endoscopic control is required before and after the use of Crosacid.
A decrease in the pH of the stomach contributes to an increase in the number of bacteria in the stomach and the development of infectious diseases of the gastrointestinal tract caused by Salmonella spp. (speciales) Campylobacter spp.
It should be borne in mind that Crosacid reduces the absorption of vitamin B 12, especially if it is necessary to use a long course of therapy in patients with low body weight.
If treatment within 4 weeks did not lead to the desired effect, additional examination of the patient is required.
Influence on the ability to drive vehicles and complex mechanisms
The use of Crosacid can cause dizziness in patients, therefore, during the period of treatment, care is required when performing potentially hazardous activities that require concentration of attention and high speed of psychomotor reactions, including driving and complex mechanisms.
Application during pregnancy and lactation
The use of Crosacid during lactation is contraindicated, therefore, when prescribing the drug, it is recommended to stop breastfeeding.
With caution, only after a careful assessment of the ratio of the expected clinical effect for the mother and the potential risk to the fetus, the use of pantoprazole during pregnancy is indicated.
Pediatric use
The use of Crosacid tablets for the treatment of children under the age of 18 is contraindicated due to the lack of information on the safety and effectiveness of its use in pediatrics.
With impaired renal function
The use of Crosacid is contraindicated for the eradication of Helicobacter pylori in patients with severe renal dysfunction (CC less than 20 ml / min).
For other indications, the maximum daily dose of pantoprazole for impaired renal function with CC less than 20 ml / min or using hemodialysis should not exceed 40 mg.
For violations of liver function
It is recommended to take Krosacid with caution in liver failure.
Regular monitoring of the activity of liver enzymes in blood plasma is required, especially with prolonged use of the drug in patients with severe hepatic insufficiency.
Use in the elderly
Care should be taken to prescribe Crosacid to patients over the age of 65 years with a history of gastric ulcer or duodenal ulcer, bleeding from the upper gastrointestinal tract.
The maximum daily dose in elderly patients should be no more than 40 mg, except in cases of Helicobacter pylori eradication as part of a combination antimicrobial therapy.
Drug interactions
- ketoconazole, atazanavir, iron salts, ritonavir: it should be borne in mind that the absorption of the listed and other drugs, the bioavailability of which depends on the acidity of the gastric juice, may decrease;
- warfarin: concomitant therapy with warfarin can cause an increase in the international normalized ratio, therefore, this indicator should be monitored;
- digoxin and other cardiac glycosides, beta-blockers (metoprolol), slow calcium channel blockers (including nifedipine), oral contraceptives, NSAIDs (naproxen, piroxicam, diclofenac, phenazone), levothyroxine sodium, glibenclamide, cyclospinamide, diazepamol, theophylline, caffeine, ethanol: the combination with each of these drugs does not cause drug interactions with pantoprazole.
Analogs
Crosacid analogs are Pantaz, Controloc, Pantoprazole, Pantoprazole Canon, Pantoprazole-VERTEX, Pantoprazole-Teva, Pantoprazole-Akrikhin, Peptazol, Panum, Pizhenum-sanovel, Sanpraz, Puloref, Lansoprazol, Omezmeprazol, Razprazo Esomeprazole, Dexilant, etc.
Terms and conditions of storage
Keep out of the reach of children.
Store at temperatures up to 25 ° C, protected from moisture and light.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Crosacid
The few reviews about Crosacid are positive. Patients taking the drug to eliminate the symptoms of gastroesophageal reflux disease indicate its effectiveness, rapid action and good tolerance.
Price for Crosacid in pharmacies
The price of Krosacid for a package containing 28 tablets with a dosage of 20 mg can be from 295 rubles, with a dosage of 40 mg - from 368 rubles.
Crosacid: prices in online pharmacies
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Drug name Price Pharmacy |
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Krosacid 20 mg enteric-coated tablets 28 pcs. 238 r Buy |
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Krosacid 40 mg enteric-coated tablets 28 pcs. 368 RUB Buy |
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
