
P – 40
Form: Tablet
Strength: 40mg
Generic Name: Pantoprazole Sodium Sesquihydrate
Company: Asiatic Laboratories Ltd.
MRP:৳ 6.0 (Tablet)
Is Antibiotic: No
Indications
P – 40 is used to reduce stomach acid in the treatment of conditions like peptic ulcers, acid reflux, ulcers caused by NSAIDs, and to help remove Helicobacter pylori bacteria when combined with antibiotics. P – 40 is also used to treat Zollinger-Ellison Syndrome.
Pharmacology
P – 40 is a proton pump inhibitor that works by blocking the final step in acid production in the stomach. P – 40 binds to an enzyme system in the stomach lining, reducing both normal and stimulated stomach acid production for over 24 hours.
Dosage & Administration
Oral:
For benign gastric ulcers: Take 40 mg daily in the morning for 4 weeks. If not fully healed, continue for another 4 weeks.
For gastroesophageal reflux disease: Take 20-40 mg daily in the morning for 4 weeks. If not fully healed, continue for another 4 weeks. Maintenance dose: 20 mg daily, which may be increased to 40 mg daily.
For duodenal ulcers: Take 40 mg daily in the morning for 2 weeks. If not fully healed, continue for another 2 weeks.
For duodenal ulcers with Helicobacter pylori: Take 40 mg twice a day with Amoxycillin 1 g and Clarithromycin 500 mg, or Clarithromycin 250 mg and Metronidazole 400 mg, both twice daily for one week.
For prevention of NSAID-induced ulcers: Take 20 mg daily for those on long-term NSAID treatment.
For Zollinger-Ellison Syndrome: Start with 80 mg once daily, adjust based on response (elderly max 40 mg daily). Doses above 80 mg should be divided into two doses.
IV Injection:
For duodenal and gastric ulcers: 40 mg once daily for 7-10 days.
For gastroesophageal reflux disease with erosive esophagitis: 40 mg once daily for 7-10 days.
For preventing rebleeding in peptic ulcers: 80 mg IV, followed by 8 mg/hour infusion for 72 hours.
For acid aspiration prevention: 80 mg IV every 12 hours for 24 hours, followed by 40 mg every 12 hours.
For long-term management of Zollinger-Ellison Syndrome: 80 mg IV every 12 hours, may increase to 80 mg every 8 hours if needed.
Interaction
No significant drug interactions have been reported in clinical studies.
Contraindications
P – 40 is contraindicated in patients who are allergic to any of its components.
Side Effects
P – 40 is generally well tolerated. Common side effects include headache and diarrhea. Rare side effects may include abdominal pain, bloating, rash, insomnia, and high blood sugar.
Pregnancy & Lactation
P – 40 is classified as a Category B drug by the US FDA for pregnancy. However, there are no well-controlled studies in pregnant women. P – 40 should be used during pregnancy only if necessary. P – 40 is excreted in human milk, so a decision should be made whether to discontinue nursing or the drug based on the benefit to the mother.
Precautions & Warnings
Patients should avoid splitting, chewing, or crushing the tablet. Long-term use may cause a decrease in vitamin B12 absorption and increase the risk of bone-related disorders.
Overdose Effects
There are no known symptoms of overdose. Since P – 40 is highly protein-bound, P – 40 is not easily removed by dialysis. Supportive treatment is recommended in case of overdose.
Therapeutic Class
Proton Pump Inhibitor
Storage Conditions
Store in a dry place, away from light and heat. Keep out of the reach of children.
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