Pregnancy and lactation: experience with pantoprazole in pregnant women is limited. During pregnancy and lactation should only be used if the positive effects to the mother justifies trenbolone enanthate for sale the potential risk to the fetus and child. Data on the allocation of pantoprazole in breast milk does not.
Dosing and Administration
Inside, the tablet should not be chewed or crush. The tablet is swallowed whole with a little liquid before a meal, usually before breakfast. If taken twice a second dose is recommended to take before dinner.GERD, including erozivpo-ulcerative reflux esophagitis, and associated symptoms of heartburn, regurgitation of acid, pain on swallowing.
Erosive-ulcerative lesions of gastric and duodenal ulcers associated with NSAID :
The recommended dosage of 40-80 mg / day (1-2 tablets Nolpazy 40 mg). The course of treatment – 4-8 weeks. For the prevention of erosive lesions on the background of long-term use of NSAIDs – 20 mg.Peptic ulcer and duodenal ulcers, treatment and prevention: Assign to 40-80 mg / day. The course of treatment during exacerbation of duodenal ulcer is usually 2 weeks, gastric ulcer – 4-8 weeks. If necessary, increase the duration of therapy. Eradication of Helicobacter pylori (in combination with antibiotics): Recommended dose: 1 tablet Nolpazy (40 mg) 2 times a day in combination with two antibiotics, usually a course of H. pylori therapy is 7-14 days. Syndrome Zollinger – Ellison and other pathological conditions related to increased gastric secretion: The recommended starting dose of pantoprazole prolonged therapy: 80 mg (2 tablets Nolpaza 40 mg) per day divided into 2 doses. Subsequently, the daily dose can be titrated according to the starting level of gastric secretion. May temporarily increase to a daily dose of 160 mg of pantoprazole in order to adequately control gastric secretion. Duration of therapy is chosen individually. In patients with severely impaired hepatic function dose pantoprazole should not exceed 40 mg per day is recommended to regularly monitor the activity of “liver” enzymes, especially during long-term treatment of pantoprazole. By increasing the activity of “liver” enzymes is recommended to repeal the drug. In the elderly and patients with kidney disease the maximum daily dose of pantoprazole – 40 mg. In trenbolone enanthate for sale elderly persons receiving eradication therapy of Helicobacter pylori, the duration of therapy is usually not more than 7 days.
are presented side-effects according to WHO classification: From the side of hematopoiesis : rarely – leukopenia, thrombocytopenia From the digestive system: often – abdominal pain, diarrhea, constipation, flatulence, rarely – nausea, vomiting; rarely – dry mouth; very rarely – increased activity of “liver” transaminases and gamma-glutamintransferaza (GGT), severe liver damage resulting in jaundice with liver failure or not. On the part of the immune system : very rarely – anaphylactic reactions, including anaphylactic shock.
Symptoms in humans overdose are not known. Treatment: the specific antidote does not exist. In the case of drug overdose, is usually accompanied by symptoms of intoxication, use detoxification activities. Treatment is symptomatic.
The interaction with other drugs Nolpaza reduces the absorption of drugs, bioavailability which is dependent on the pH of the stomach environment, and suction at acidic pH (e.g., ketoconazole ).Pantoprazole is metabolized in the liver by the enzyme cytochrome P450 system. We can not exclude pantoprazole interactions with drugs that are metabolized by the same system. However, in clinical studies there was no significant interactions with digoxin, diazepam, diclofenac, ethanol, fepitoinom, glibenclamide, carbamazepine, caffeine, metoprolol, naproxen, nifedipine, piroxicam, theophylline and oral contraceptives. Although the simultaneous use of warfarin in clinical pharmacokinetic studies found no significant interactions were several individual to change the international normalized ratio messages (MHO). In patients receiving coumarin anticoagulants , at the same time with pantoprazole, should regularly monitor the prothrombin time or MHO. When concomitantly with pantoprazole aptatsidami any drug interactions have been reported.
Before therapy is necessary to exclude the presence of malignant neoplasms (endoscopic control, if necessary, a biopsy – especially gastric ulcer), as treatment, masking symptoms, may delay correct diagnosis. If after 4 weeks of therapy, the patient is no pantoprazole desired therapeutic effect, it should be retested. As with other proton pump inhibitors, pantoprazole may reduce the absorption of cyanocobalamin (vitamin B 12 ) trenbolone enanthate for sale on the background of hypo- and achlorhydria. This should be taken into account especially during prolonged treatment and in patients with risk factors for vitamin A deficiency in 12 .
Conducting long-term therapy, especially for more than 1 year, require regular monitoring of the patient.