Pantoprazole Canon
Pantoprazole Canon: 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: Pantoprazole Kanon
ATX code: A02BC02
Active ingredient: pantoprazole (Pantoprazole)
Producer: CJSC "Kanonfarma production" (Russia)
Description and photo update: 2019-08-07
Prices in pharmacies: from 200 rubles.
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Pantoprazole Canon is an agent that reduces the secretion of stomach glands.
Release form and composition
The drug is produced in the form of enteric tablets, film-coated: round, convex on both sides, bluish-green or light green film shell; the core in cross section is almost white (in a cardboard box 1, 2, 4 blister contour packs of 7, 10 or 14 tablets, or 1-2 blister contour packs of 28 tablets and instructions for use of Pantoprazole Canon).
Composition of 1 tablet:
- active substance: pantoprazole - 20 or 40 mg (in the form of pantoprazole sodium sesquihydrate, respectively 22.57 or 45.14 mg);
- auxiliary components: povidone K-30, crospovidone, calcium stearate, macrogol (polyethylene glycol), colloidal silicon dioxide, mannitol, heavy magnesium hydroxycarbonate;
- film shell: triethyl citrate, Opadrai transparent [including macrogol (polyethylene glycol), hypromellose (hydroxypropyl methylcellulose)], Acryl-From green [including sodium bicarbonate, sodium lauryl sulfate, colloidal silicon dioxide, titanium dioxide, talc, methacrylic acid and ethyl acrylate copolymer (1: 1), dye indigo carmine, iron oxide yellow, dye brilliant blue].
Pharmacological properties
Pharmacodynamics
The active ingredient of the drug - pantoprazole - is a proton pump inhibitor (H + / K + - ATPase). Blocks the final stage of the release of hydrochloric acid by reducing the basal and stimulated secretion in the parietal cells of the gastric mucosa, regardless of the nature of the stimulus.
The antisecretory effect develops within 1 hour after taking Pantoprazole Canon, reaches a maximum after 2-4 hours. In case of duodenal ulcer associated with Helicobacter pylori bacteria, due to a decrease in gastric secretion, the sensitivity of microorganisms to antibiotics increases.
Pantoprazole Canon does not adversely affect the motility of the gastrointestinal tract (GIT). Secretory activity is normalized within 3-4 days after the end of therapy.
Pantoprazole, unlike other proton pump inhibitors, is characterized by greater chemical stability at neutral pH and a lower potential for interaction with microsomal enzymes of the liver oxidase system, which depends on the cytochrome P 450 system. Therefore, the drug does not interact with many other most commonly used drugs.
Pharmacokinetics
Pantoprazole is rapidly absorbed from the gastrointestinal tract. The maximum plasma concentration (Cmax) is reached as a result of taking the first dose. After taking a dose of 20 mg Cmax is 1-1.5 mcg / ml and is achieved on average after 2-2.5 hours, after taking a dose of 40 mg - 2-3 mcg / ml after 2.5 hours. With repeated use of Pantoprazole Canon Cmax remains constant. The absolute bioavailability is about 77%. Simultaneous food intake does not affect Cmax and AUC (area under the concentration-time curve).
It is characterized by a high bond with plasma proteins - 98%. The clearance is 0.1 l / h / kg, the volume of distribution is 0.15 l / kg.
It is metabolized in the liver. The main metabolite, which is determined in blood, plasma and urine, is desmethylpantoprazole, conjugated with sulfate.
It is excreted mainly through the kidneys (~ 80%) in the form of metabolites, in small quantities through the intestines. The half-life (T 1/2) of pantoprazole is 1 hour, the main metabolite is 1.5 hours.
Pharmacokinetics in special cases:
- age: in elderly patients, there is a slight increase in Cmax and AUC, but this phenomenon has no clinical significance;
- liver function: in patients with cirrhosis of the liver (according to the Child-Pugh classification classified as A and B), T 1/2 of the drug increases up to 3-6 hours after taking a dose of 20 mg and up to 7-9 hours after taking a dose of 40 mg; Cmax increases - 1.3 times after a dose of 20 mg and 1.5 times after a dose of 40 mg, as well as AUC - 3-5 times after a dose of 20 mg and 5-7 times after a dose of 40 mg, compared with healthy volunteers;
- renal function: in patients with functional impairment of renal function (including patients receiving hemodialysis), the excretion of the drug occurs quickly enough, the active substance does not accumulate in the body, therefore, dose adjustment of Pantoprazole Canon is not required.
Indications for use
- exacerbation of gastric ulcer and / or duodenal ulcer;
- erosive gastritis, including those associated with the use of NSAIDs (non-steroidal anti-inflammatory drugs);
- Zollinger-Ellison syndrome;
- mild gastroesophageal reflux disease: symptomatic treatment of disorders such as acid belching, heartburn, nausea;
- eradication of Helicobacter pylori (as part of combination therapy in combination with antibacterial agents).
Contraindications
Absolute:
- severe renal failure [creatinine clearance (CC) <20 ml / min] in patients diagnosed with Helicobacter pylori;
- dyspepsia of neurotic genesis;
- malignant diseases of the gastrointestinal tract;
- age up to 18 years;
- period of breastfeeding;
- concomitant use of atazanavir;
- hypersensitivity to the components of the drug.
Pantoprazole Canon should be used with caution in patients with hepatic impairment, the elderly, and pregnant women. Precautions are required for patients with an increased risk of gastrointestinal complications and long-term use of NSAIDs as anti-relapse treatment for gastric / duodenal ulcer at a dose of 20 mg.
Pantoprazole Canon, instructions for use: method and dosage
Pantoprazole Canon is indicated for oral administration, before meals (preferably before the first meal). The tablets should not be broken or chewed, but should be swallowed whole with sufficient water.
For the eradication of Helicobacter pylori, Pantoprazole Canon is used as part of a combination therapy. Possible therapeutic regimens:
- 20-40 mg of pantoprazole 2 times / day + 500 mg of clarithromycin 2 times / day + 1000 mg of amoxicillin 2 times a day for 7-14 days;
- 20-40 mg of pantoprazole 2 times / day + 500 mg of clarithromycin 2 times / day + 500 mg of metronidazole 2 times a day for 7-14 days;
- 20-40 mg of pantoprazole 2 times / day + 500 mg of metronidazole 2 times + 1000 mg of amoxicillin 2 times a day for 7-14 days.
In order to heal the ulcer, the administration of Pantoprazole Canon can be extended even after the end of the combined treatment. In case of duodenal ulcer, prolonged use of the drug from 1 to 3 weeks may be recommended.
Recommended dosage regimens for Pantoprazole Canon for other indications:
- erosive gastritis, peptic ulcer: 40-80 mg per day. In case of exacerbation of gastric ulcer, the course of treatment is 4–8 weeks, duodenal ulcer - 2 weeks. As anti-relapse therapy, 20 mg per day is prescribed;
- Zollinger-Ellison syndrome: 40-80 mg per day;
- symptomatic therapy of mild gastroesophageal reflux disease: 20 mg per day. The duration of treatment is determined by the time of disappearance of disorders from the gastrointestinal tract. The minimum duration of admission is 2-3 days, for complete relief of negative symptoms it may be necessary to increase the course up to 7 days. If the condition worsens during the first 3 days, you should consult your doctor.
Patients with Zollinger-Ellison syndrome and impaired liver function Pantoprazole Canon is prescribed 40 mg every 2 days. Treatment is carried out under close monitoring of blood biochemical parameters. In case of increased activity of liver enzymes, treatment is stopped.
For patients with CC <20 ml / min and patients receiving hemodialysis, the drug can be used in a daily dose of not more than 40 mg. It is not recommended to take Pantoprazole Canon for prophylaxis. It is forbidden to carry out eradication therapy of Helicobacter pylori.
There are no special instructions for dosing the drug for elderly patients. However, it is recommended not to exceed the dose of 40 mg per day, except for the eradication of Helicobacter pylori - in this case, pantoprazole is allowed to be taken at 40 mg 2 times a day.
Side effects
- from the nervous system: often (from ≥ 1/100 to <1/10 appointments) - headache; infrequently (from ≥ 1/1000 to <1/100) - dizziness; rarely (from ≥ 1/10000 to <1/1000) - dysgeusia;
- from the liver and biliary tract: very rarely (<1/10000 appointments) - severe damage to the liver parenchyma, leading to jaundice, sometimes with liver failure;
- from the gastrointestinal tract: often - flatulence, diarrhea, pain in the upper abdomen, constipation; infrequently - nausea, vomiting; rarely - dry mouth;
- from the immune system: very rarely - anaphylactic reactions, including anaphylactic shock;
- from the side of metabolism: rarely - hyperlipidemia, changes in body weight; frequency unknown - hypomagnesemia, hyponatremia;
- from the musculoskeletal and connective tissue: rarely - arthralgia; very rarely - myalgia;
- from the urinary system: very rarely - interstitial nephritis;
- from the genitals and mammary gland: rarely - gynecomastia;
- on the part of the blood and lymphatic system: rarely - agranulocytosis; very rarely - pancytopenia, thrombocytopenia, leukopenia;
- from the skin and subcutaneous tissues: infrequently - itching, skin rash; very rarely - photosensitization, urticaria, Lyell's syndrome, angioedema, exudative erythema multiforme, malignant exudative erythema (Stevens-Johnson syndrome);
- on the part of the organ of vision: infrequently - impaired visual perception (blurred vision);
- on the part of the psyche: infrequently - sleep disturbances; rarely - clouding of consciousness, hallucinations, depression, disorientation (development in predisposed patients or aggravation in patients in whom similar disorders were observed earlier);
- laboratory and instrumental data: rarely - an increase in the level of bilirubin; very rarely - an increase in the content of triglycerides, an increase in the activity of liver enzymes (aspartate aminotransaminase, gamma-glutamyl transferase);
- others: infrequently - malaise, weakness, fatigue; very rarely - an increase in body temperature, peripheral edema.
Overdose
Overdose episodes have not been noted to date. In studies, the drug administered intravenously in doses of more than 240 mg for 2 minutes was well tolerated.
In the event of any clinical manifestations against the background of an overdose of Pantoprazole Canon, symptomatic and supportive treatment is recommended. Hemodialysis is ineffective.
special instructions
Before the appointment of Pantoprazole Canon and after its cancellation, it is strongly recommended to conduct an endoscopic examination in order to exclude the presence of malignant diseases of the esophagus and stomach, since against the background of taking the drug, symptoms can be masked, which complicates and delays timely and correct diagnosis.
Long-term treatment requires regular medical supervision.
Due to a decrease in the acidity of gastric juice, the number of bacteria in the stomach increases, which is fraught with the development of infectious diseases of the gastrointestinal tract caused by Campylobacter spp. and Salmonella spp.
Pantoprazole Canon helps to reduce the absorption of vitamin B 12, which should be taken into account during long-term treatment with the drug in patients with an increased risk of decreased absorption of cyanocobalamin in persons with low body weight. If there is no therapeutic effect within 4 weeks of regular intake of the drug, an additional examination is required.
Influence on the ability to drive vehicles and complex mechanisms
In some patients, Pantoprazole Canon causes dizziness. This should be taken into account by vehicle drivers and persons performing potentially dangerous work requiring speed of reaction and concentration.
Application during pregnancy and lactation
Pantoprazole Canon is approved for use during pregnancy if the expected benefit to the mother, according to the doctor, is higher than the possible risks to the fetus.
The active substance of the drug penetrates into breast milk, therefore, feeding should be stopped for the period of treatment.
Pediatric use
Pantoprazole Canon is not used to treat children and adolescents under 18 years of age.
With impaired renal function
For the purpose of eradication of Helicobacter pylori, it is contraindicated to prescribe Pantoprazole Canon to patients with severe renal impairment (CC <20 ml / min) and patients on hemodialysis.
For violations of liver function
In patients with functional impairment of the liver, Pantoprazole Canon should be used with caution. During treatment, especially long-term, you should regularly check the activity of liver enzymes in plasma. In case of increased activity, the drug should be canceled.
Use in the elderly
Pantoprazole Canon should be used with caution in elderly people (over 65 years of age) with a history of bleeding from the upper gastrointestinal tract, gastric ulcer or duodenal ulcer.
There are no special instructions for dosing the drug for elderly patients. However, it is recommended not to exceed the daily dose of 40 mg, except for the eradication of Helicobacter pylori - in this case, pantoprazole is allowed to be taken at 40 mg 2 times a day.
Drug interactions
Pantoprazole Canon is able to reduce the absorption of drugs, the bioavailability of which depends on the pH of the stomach environment, for example, ketoconazole, atazanavir, iron salts, ritonavir.
When used simultaneously with warfarin, the drug can increase the INR (International Normalized Ratio), so this indicator should be carefully monitored.
There is no data on the possible relationship of pantoprazole with antacids.
Unlike other proton pump inhibitors, pantoprazole does not interact with the following drugs: oral contraceptives, diazepam, amoxicillin, clarithromycin, NSAIDs (naproxen, phenazone, diclofenac, piroxicam), levothyroxine sodium, glibenclamide, tacosprolin phenytoin, slow calcium channel blockers (nifedipine), cardiac glycosides (digoxin), beta-blockers (metoprolol), theophylline, caffeine, ethanol.
Analogs
Analogues of Pantoprazole Canon are Lanzap, Lancid, Epicur, Gastrozole, Omez, Omizak, Promez, Otsid, Helicid, Controloc, Sanpraz, Nolpaza, Bereta, Pariet, Ulblok, Rabelok, Nexium, Pemozar, Emesol, Esomeprazole, Zulbex, Pelicidex Omezol and many others.
Terms and conditions of storage
Expiration date: 2 years.
Storage conditions: temperature - up to 25 ° С, protected from light and dry place out of reach of children.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Pantoprazole Canon
Patients leave mostly positive reviews about Canon Pantoprazole. The drug quickly eliminates such unpleasant disorders of the digestive system as heartburn, belching and nausea. Helps with exacerbations of gastric ulcer and 12 duodenal ulcer. Additional advantages include the small size of the tablets, which makes it easier to take, good tolerance and relatively low cost.
Side effects include headache, diarrhea / constipation, and abdominal pain.
Price for Pantoprazole Canon in pharmacies
Depending on the region of sale and the pharmacy network, the prices for Pantoprazole Canon (for a pack of 28 film-coated tablets) can be approximately: 20 mg dosage - 198–270 rubles, 40 mg dosage - 278–395 rubles.
Pantoprazole Canon: prices in online pharmacies
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Drug name Price Pharmacy |
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Pantoprazole Canon 20 mg enteric coated tablets 28 pcs. RUB 200 Buy |
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Pantoprazole Canon tablets p.o. enteric solution. 20mg 28 pcs. 210 RUB Buy |
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Pantoprazole Canon 40 mg enteric-coated tablets 28 pcs. 263 r Buy |
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Pantoprazole Canon tablets p.o. enteric solution. 40mg 28 Pcs. 273 r Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, 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!
