Pantobex 40 mg is indicated in conditions where suppression of gastric acid secretion is therapeutically beneficial, including:

• Gastric and duodenal ulcer disorders

• Gastroesophageal reflux disease (GERD)

• Ulcers associated with non-steroidal anti-inflammatory drugs (NSAIDs)

• Helicobacter pylori eradication (in combination with appropriate antibiotics)

• Zollinger–Ellison syndrome and other pathological hypersecretory conditions

  রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Therapeutic Class

Proton Pump Inhibitor (PPI)

Pharmacology

Pantobex 40 mg contains pantoprazole, a proton pump inhibitor that suppresses gastric acid secretion by irreversibly binding to the H⁺/K⁺-ATPase enzyme system located on the gastric parietal cells. This inhibits the final step of acid production, resulting in prolonged suppression of both basal and stimulated gastric acid secretion for more than 24 hours, regardless of the initiating stimulus.

Dosage & Administration

Oral Administration

• Benign gastric ulcer:
  40 mg once daily in the morning for 4 weeks; may be continued for another 4 weeks if healing is incomplete.

• Gastroesophageal reflux disease (GERD):
  20–40 mg once daily for 4 weeks; may be continued for another 4 weeks if required. Maintenance dose is 20 mg daily, which may be increased to 40 mg if necessary.

• Duodenal ulcer:
  40 mg once daily for 2 weeks; may be continued for another 2 weeks if not fully healed.

• Duodenal ulcer with H. pylori infection:
  Pantobex 40 mg twice daily in combination with:

  • Amoxicillin 1 g + Clarithromycin 500 mg, both twice daily for 7 days, or

  • Clarithromycin 250 mg + Metronidazole 400 mg, both twice daily for 7 days.

• NSAID-associated ulcer prophylaxis:
  20 mg once daily in patients requiring long-term NSAID therapy.

• Zollinger–Ellison syndrome:
  Initial dose 80 mg once daily, adjusted according to clinical response (elderly patients: maximum 40 mg daily). Doses exceeding 80 mg should be divided into two doses.

Intravenous Administration

• Duodenal or gastric ulcer:
  40 mg once daily for 7–10 days.

• GERD with erosive esophagitis history:
  40 mg once daily for 7–10 days.

• Prevention of rebleeding in peptic ulcer:
  80 mg IV bolus followed by continuous infusion of 8 mg/hour for 72 hours.

• Prophylaxis of acid aspiration:
  80 mg IV every 12 hours for 24 hours, followed by 40 mg every 12 hours.

• Zollinger–Ellison syndrome:
  80 mg IV every 12 hours; may be increased to every 8 hours based on acid output.

Drug Interactions

Clinical studies have shown no significant drug interactions with Pantobex 40 mg.

Contraindications

Pantobex 40 mg is contraindicated in patients with known hypersensitivity to pantoprazole or any component of the formulation.

Side Effects

Pantobex 40 mg is generally well tolerated. Common adverse effects include:

• Headache

• Diarrhea

Rare side effects include abdominal pain, flatulence, rash, insomnia, and hyperglycemia.

Pregnancy & Lactation

Pantobex 40 mg is classified as Pregnancy Category B by the US FDA. However, adequate and well-controlled studies in pregnant women are lacking. It should be used during pregnancy only if clearly necessary. Pantoprazole is excreted in human breast milk; therefore, a decision should be made to discontinue breastfeeding or discontinue the drug, considering the benefit to the mother.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Precautions & Warnings

• Tablets should not be split, chewed, or crushed.

• Long-term use may result in vitamin B12 (cyanocobalamin) malabsorption.

• Prolonged therapy may increase the risk of osteoporosis-related fractures.

Overdose Effects

No specific symptoms of overdose have been reported. Pantobex 40 mg is highly protein-bound and not readily dialyzable. Treatment should be symptomatic and supportive.

Storage Conditions

Store in a dry place, away from heat and light. Keep out of reach of children.

Reconstitution & IV Use Instructions

IV Injection

Reconstitute Pantobex 40 mg lyophilized powder with 10 ml of 0.9% sodium chloride injection. Administer intravenously over 2–5 minutes. Use freshly prepared solution; it may be stored for up to 4 hours at room temperature (≤30°C).

IV Infusion

Reconstitute with 10 ml of 0.9% sodium chloride injection, then dilute to 100 ml using 0.9% sodium chloride, 5% dextrose, or lactated Ringer’s solution. Infuse over approximately 15 minutes. The admixed solution should be used within 24 hours of initial reconstitution.