20 mg enteric tablet is
pantoprazole
What Pantoloc is and what it is used for
Pantoloc contains the active substance pantoprazole. Pantoloc is a “selective proton pump inhibitor” that reduces the amount of acid formed in your stomach. It is used to treat acid-related diseases of the stomach and intestines.
Pantoloc is used to treat adults and children over 12 years of age:
- treatment of symptoms (eg heartburn, acid reflux, pain when swallowing) associated with diseases of the esophagus caused by reflux of acid from the stomach
- long-term treatment and preventive treatment of reflux esophagitis (esophageal inflammation accompanied by acid reflux).
Pantoloc is used to treat adults:
- preventive treatment of ulcers in the duodenum and in the stomach caused by non-steroidal anti-inflammatory drugs (so-called NSAIDs such as ibuprofen ) in at-risk patients who need this type of drug continuously.
What you need to know before taking Pantoloc
Do not take Pantoloc
- if you are allergic to pantoprazole or any of the other ingredients of this medicine (listed in section 6)
- if you are allergic to other medicines that contain proton pump inhibitors.
Warnings and cautions
Talk to your doctor, pharmacist, or nurse before taking Pantoloc
- if you have severe liver problems. Tell your doctor if you have ever had problems with your liver before. Your doctor will then check your liver enzymes more often, especially if you are taking Pantoloc as a long-term treatment. If liver enzymes increase, treatment should be discontinued.
- if you need to take so-called NSAIDs (for example for inflammation and pain) regularly and receive Pantoloc because you have an increased risk of gastrointestinal complications. Any increased risk will be investigated about your personal risk factors such as your age (over 65 years), previous ulcers in the stomach or duodenum, or bleeding in the stomach or intestines.
- if you have a reduced ability to store vitamin B12 in your body or risk factors for reduced vitamin B12 and receive pantoprazole as a long-term treatment. As with any acid-lowering drug, pantoprazole may lead to reduced absorption of vitamin B12.
- if you are taking HIV protease inhibitors at the same time as pantoprazole, e.g. atazanavir (for the treatment of HIV infection ), you should talk to your doctor for special advice.
- use of proton pump inhibitors such as Pantoloc and especially if you use Pantoloc for more than a year may increase the risk of having a hip, wrist, or vertebral fracture (bone fracture). Tell your doctor if you have osteoporosis or if your doctor has told you that you are at risk for osteoporosis (eg if you are taking medicines called steroids)
- if you use Pantoloc for more than three months, your blood manganese levels may drop. Low levels of magnesium can manifest as fatigue, involuntary muscle movements, confusion, cramps, dizziness, rapid heartbeat. If you get any of these symptoms, contact your doctor immediately. Low levels of magnesium can also lead to decreased levels of potassium or calcium in the blood. Your doctor may measure the level of magnesium in your blood using regular blood tests.
- if you have ever had a skin reaction after treatment with medicine like Pantoloc that reduces stomach acid.
- If you get a rash, especially in areas exposed to the sun, tell your doctor as soon as possible as you may need to stop taking Pantoloc. Also remember to mention any other side effects, such as joint pain.
- if you are going to have a specific blood test (chromogranin A).
Contact your doctor immediately
if you notice any of the following symptoms. These could be signs of another, more serious, medical condition.
- unjustified weight loss
- vomiting, especially if it happens repeatedly
- bloody vomiting, can look like coffee grounds in the vomit
- bloody stools, which then look black or tar-like
- difficulty swallowing or pain when swallowing
- you look pale and feel weak (which may be due to anemia )
- chest pain
- magnet
- severe and/or persistent diarrhea, as a link has been found between Pantoloc and a small increase in infectious diarrhea.
Your doctor may decide that you need to undergo some tests to rule out serious illness as pantoprazole may also relieve the symptoms of cancer and could delay such a diagnosis. If your symptoms persist despite your treatment, further examinations should be considered.
If you are taking Pantoloc as a long-term treatment (longer than 1 year), your doctor will probably call you for regular check-ups. You should tell your doctor about new and unusual symptoms and illnesses.
Other medicines and Pantoloc
Tell your doctor or pharmacist if you are taking, have recently taken, or might take any other medicines, including medicines obtained without a prescription. This is because Pantoloc can affect the way other medicines work, so tell your doctor if you are taking:
- Medicines such as ketoconazole, itraconazole, and posaconazole (for the treatment of fungal infections) or erlotinib (for the treatment of certain types of cancer) as Pantoloc may cause these and other medicines to not work properly.
- Warfarin and phenprocoumon which affect the thickness of the blood. You may need additional controls.
- Medicines for the treatment of HIV infection such as atazanavir.
- Methotrexate (for the treatment of rheumatism, psoriasis, and cancer). If you are taking methotrexate, your doctor may temporarily stop your treatment with Pantoloc as pantoprazole may increase methotrexate levels in your blood.
- Fluvoxamine (for the treatment of depression and other psychiatric disorders). If you are taking fluvoxamine, your doctor may reduce the dose one.
- Rifampicin (for the treatment of infections ).
- St. John’s wort ( Hypericum perforatum) (for the treatment of mild depression).
Children and young people
Pantoloc is not recommended for use in children below 12 years of age due to a lack of data for this age group.
Pregnancy, breastfeeding, and fertility
There are no data on the use of pantoprazole in pregnant women. Excretion in breast milk has been reported. If you are pregnant or breastfeeding or think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
You should only use this medicine if your doctor thinks that the benefits to you outweigh the risks to the fetus or baby.
Driving and using machines
Pantoloc has no or negligible effect on the ability to drive and use machines.
You are responsible for assessing whether you are fit to drive a motor vehicle or perform work that requires sharpened attention. One of the factors that can affect your ability in these respects is the use of drugs due to their effects and/or side effects. Descriptions of these effects and side effects can be found in other sections. Read all the information in this leaflet for guidance. If you are not sure, talk to your doctor or pharmacist.
If you experience side effects such as dizziness and visual disturbances, do not drive or use machines.
Pantoloc contains sodium
This medicine contains less than 1 mmol (23 mg) sodium per tablet, ie essentially ‘sodium-free’.
How to take Pantoloc
Always take this medicine exactly as your doctor or pharmacist has told you. Ask your doctor or pharmacist if you are unsure.
How to take Pantoloc
Take the medicine one hour before a meal without chewing or crushing the tablet. Swallow the tablet whole with a little water.
The recommended dose is:
Adults and adolescents over 12 years
For the treatment of symptoms (eg heartburn, acid reflux, and pain when swallowing) in connection with esophageal problems caused by reflux of acid from the stomach :
The usual dose is one tablet daily. This dose usually provides relief within 2-4 weeks – sometimes an additional 4 weeks of treatment is needed. Your doctor will tell you how long to take the medicine. Thereafter, recurrent symptoms can be controlled by taking one tablet daily as needed.
For long-term treatment and to prevent recurrence of reflux oesophagitis: The
the usual dose is one tablet a day.
If the disease returns, your doctor may double the dose and you can use Pantoloc 40 mg tablets instead, one tablet daily. After healing, you can reduce the dose one to one tablet of 20 mg per day.
Adults
To prevent duodenal ulcers in patients who need NSAIDs regularly: The
the usual dose is one tablet a day.
Patients with hepatic impairment
If you have severe liver problems, do not take more than one 20 mg tablet per day.
Children and young people
These tablets are not recommended for children under 12 years.
If you take more Pantoloc than you should
If you have ingested too much medicine or if e.g. If a child has ingested the medicine by mistake, contact a doctor or hospital for risk assessment and advice.
There are no known symptoms of overdose.
If you forget to take Pantoloc
Do not take a double dose to make up for a forgotten dose. Take the next dose as usual.
If you stop taking Pantoloc
Do not stop taking these tablets without first talking to a doctor or pharmacist.
If you have any further questions on the use of this product, ask your doctor, pharmacist, or nurse.
POSSIBLE SIDE EFFECTS
Like all medicines, Pantoloc can cause side effects, although not everybody gets them.
If you get any of the following side effects, stop taking the tablets and tell your doctor immediately or contact the emergency department at the nearest hospital:
- Severe allergic reaction (rare: may affect up to 1 in 1,000 people):
swelling of the tongue and/or throat, difficulty swallowing, hives, difficulty breathing, allergic facial swelling (Quincke’s edema/angioedema), severe dizziness with very rapid heartbeat, and heavy sweating. - Severe skin reactions (reported: occurs in an unknown number of users ): You may notice one or more of the following symptoms: blistering of the skin and rapid deterioration of your general condition, superficial sores (with light bleeding) in the eyes, nose, mouth/lips or genitals, or sensitive skin/rash especially on skin areas exposed to light / the sun. You may also have joint pain or flu-like symptoms, fever, swollen glands (eg in the armpits), and blood tests may show changes in certain white blood cells or liver enzymes ( Stevens-Johnson syndrome, Lyell’s syndrome, multiforme erythema, subacute cutaneous lupus erythematosus, drug reaction with eosinophilia and systemic symptoms (DRESS), photosensitivity).
- Other serious conditions (reported in an unknown number of users):
yellowing of the skin or whites of the eyes (severe damage to liver cells, jaundice) or fever, rash, and enlarged kidneys sometimes with pain associated with urinary incontinence and lower back pain (severe nephritis). This can lead to kidney failure.
Other side effects are:
- Common (may affect up to 1 in 10 people): Benign polyps are in the stomach.
- Uncommon (may affect up to 1 in 100 people):
Headache, dizziness, diarrhea, nausea, vomiting, flatulence, constipation, dry mouth, pain and discomfort in the stomach, rash, hives, rash, itching, feeling of weakness, lethargy, or general malaise, difficulty sleeping, hip, wrist, or vertebral fracture (bone fracture). - Rare(may affect up to 1 in 1,000 people):
Altered or lack of taste experience, visual disturbances ex. blurred vision, hives, joint pain, muscle aches, weight changes, increased body temperature, high fever, swelling of the arms and legs (peripheral edema ), allergic reactions, depression, enlarged breasts in men. - Very rare (may affect up to 1 in 10,000 people):
Disorientation. - Has been reported (occurs in an unknown number of users):
Hallucinations, confusion (especially in patients who have previously had such symptoms); feeling of numbness, tingling, burning sensation, or loss of feeling; skin rash, possibly with pain in the joints, inflammation of the colon, which gives rise to persistent watery diarrhea.
Side effects identified by blood tests:
- Uncommon (may affect up to 1 in 100 people):
an increase in liver enzymes - Rare (may affect up to 1 in 1,000 people):
an increase in bilirubin, higher levels of blood fats, high fever associated with a sharp decrease in granulocytes (a type of white blood cell ) in the blood - Very rare (may affect up to 1 in 10,000 people):
a decrease in the number of platelets which can lead to you bleeding more or more easily getting bruises, a decrease in the number of white blood cells which can lead to more infection, while an abnormal reduction of the number of red and white blood cells and platelets. - Has been reported (occurs in an unknown number of users): decreased amount of sodium, magnesium, calcium, or potassium in the blood (see section 2).
How to store Pantoloc
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the carton and the jar after EXP. The expiration date is the last day of the specified month.
Can: The tablets should be used within 120 days after the can is first opened.
No special storage instructions.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.
Contents of the pack and other information
Content declaration
- The active substance is pantoprazole. One tablet contains 20 mg pantoprazole (as sodium sesquihydrate).
- The other ingredients are
Tablet core: sodium carbonate (anhydrous), mannitol, crospovidone, povidone K90, calcium stearate Coating: hypromellose, povidone
K25, titanium dioxide (E171), yellow iron oxide (E172), propylene glycol, methacrylic acid 1-ethyl, ethyl polysorbate 80, sodium lauryl sulfate, triethyl citrate Ink: shellac, red, black, and yellow iron oxide (E172), concentrated ammonia solution
What the medicine looks like and the contents of the pack
A yellow, oval, biconvex enteric tablet marked “P 20” on one side.
Packaging: cans (HDPE container with LDPE screw cap) and blisters (aluminum/aluminum blisters) without cardboard reinforcement or with cardboard reinforcement (“blister wallet”).
Pantoloc is available in the following pack sizes:
Packs of 7, 10, 14, 15, 24, 28, 30, 48, 49, 56, 60, 84, 90, 98, 98 (2×49), 100, 112, 168 enteric tablets .
Hospital packs with 50, 56, 84, 90, 112, 140, 50 (50×1), 140 (10×14 or 5×28), 150 (10×15), 280 (20×14 or 10×28), 500, 700 (5×140) enteric tablets .
Not all pack sizes may be marketed.
Marketing Authorisation Holder
Takeda Pharma AB
Box 30143
104 25 Stockholm
tel: 08-731 28 00
email: infosweden@takeda.com
Manufacturer
Takeda GmbH
Production Site Oranienburg
Lehnitzstrasse 70-98
16515 Oranienburg
Germany