PANTUL 40 mg. 14 capsules

WHAT PANTUL 40 MG AND WHAT IT IS USED
Pantul 40 mg of selective inhibitor of the proton pump product that reduces the amount of acid formed in the stomach. Used for treatment-related effects of hydrochloric acid conditions of the stomach and intestines.

Pantul 40 mg is used for the treatment of:
Adults and adolescents over 12 years:
Reflux esophagitis. An inflammation of your esophagus (the tube that connects your throat to your stomach) accompanied by regurgitation of gastric acid.
Adults:
Treatment of infections caused by the bacteria Helicobacter pylori in patients with duodenal ulcers and stomach in combination with two antibiotics (eradication therapy). The objective is the removal of bacteria, thereby reducing the likelihood of recurrence of ulcers;
Ulcers of the stomach and duodenum;
Syndrome Zollinger-Ellison, and other disorders associated with hypersecretion of hydrochloric acid in the stomach.

2. BEFORE YOU TAKE PANTUL 40 MG
Do not take Pantul 40 mg:
if you are allergic (hypersensitive) to pantoprazole, soya lecithin or any of the other ingredients of Pantul 40 mg;
if you are allergic to medicines containing other proton pump inhibitors.
Take special care with Pantul 40 mg:
If you have severe liver problems. Please tell your doctor if you have or have had liver problems. He will explore common values of your liver enzymes, especially during prolonged treatment with Pantul 40 mg. Upon elevation of liver enzymes the treatment should be discontinued;
If you have lost your body weight or the presence of risk factors for vitamin B12 deficiency and conduct long-term treatment with pantoprazole. Pantoprazole and other antacids may result in a reduced absorption of vitamin B12;
If you are taking a medicine containing atazanavir (for the treatment of HIV infection) at the same time as pantoprazole, ask your doctor for specific advice;
Taking proton pump inhibitors such as Pantul 40 mg, especially if the intake is more than one year may increase the risk of fractures of the hip, wrist or spine. Tell your doctor if you have osteoporosis or if you are taking corticosteroids, which can increase the risk of osteoporosis.
Tell your doctor if you notice any of the following symptoms:
unintentional weight loss;
repeated vomiting blood;
difficulty swallowing;
vomiting blood;
if you are pale and feel weak (anemia);
notice blood in the stool;
in severe and / or persistent diarrhea, as taking Pantul 40 mg was associated with a marginal increase of cases of infectious diarrhea.
Your doctor may perform additional tests to rule out malignant disease because pantoprazole may alleviate symptoms of malignancy and thus delay its diagnosis. If the symptoms persist despite treatment must be considered to perform additional studies.
If you are taking 40 mg of Pantul long time (more than 1 year) your doctor will probably monitor your condition regularly. You should inform your doctor of any exceptional symptoms and circumstances.

Taking other medicines
Pantul 40 mg may influence the effectiveness of other medicines, so tell your doctor if you take:
Drugs such as ketoconazole, itraconazole or posaconazole (used to treat fungal infections) or erlotinib (used in certain types of cancer), as 40 mg Pantul may prevent adequate effect of these and other drugs;
Warfarin and phenprocoumon, which affect coagulation or blood thinning. You may need additional testing;
Atazanavir (used to treat HIV infection).
Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription.

Pregnancy and lactation
There are no adequate data from the use of pantoprazole in pregnant women. Reportedly broadcast into breast milk. If you are pregnant or think you are pregnant or breast-feeding should not use this medicine if your doctor believes that the benefit to you of treatment outweighs the potential risk to the fetus or baby.
Ask your doctor or pharmacist before taking any medicine.

Driving and using machines
If you notice side effects such as dizziness or visual disturbances, you should not drive or operate machinery.

Important information about some of the ingredients of 40 mg of Pantul
This medicinal product contains maltitol. If your doctor has told you that you have an intolerance to some sugars, contact your doctor before you start taking this medicine.
Pantul 40 mg contains soya lecithin. If you are allergic to peanut or soya, do not take this product.

3. HOW TO TAKE PANTUL 40 MG
Always take Pantul 40 mg exactly as your doctor tells you. If you're not sure, ask your doctor or pharmacist.

When and how should you take 40 mg of Pantul
Take the tablets 1 hour before a meal without chewing or crush and swallow them whole with water.
In the event that there is no prescription from your doctor, the usual dose is:
Adults and adolescents 12 years and more:
For the treatment of reflux esophagitis:
The usual dose is one tablet daily. Your doctor may tell you to increase the dose to 2 tablets daily. Usually, the period for the treatment of reflux oesophagitis is between 4 and 8 weeks. Your doctor will tell you how long to take the drug.
Mature
For the treatment of infection caused by the bacteria Helicobacter pylori in patients with duodenal ulcers and stomach in combination with two antibiotics (eradication treatment):
One tablet twice a day in combination with two antibiotics amoxicillin, clarithromycin and metronidazole (or tinidazole) taken twice daily with pantoprazole tablet. Take the first pantoprazole tablet 1 hour before breakfast and the second 1 hour before dinner. Follow your doctor's instructions and read the leaflets of these antibiotics. Typical treatment period is from one to two weeks.
For the treatment of ulcers of the stomach and duodenum
The usual dose is one tablet daily. After consulting your doctor, the dose may be doubled. Your doctor will tell you how long to take the drug. The typical period for the treatment of ulcers of the stomach is between 4 and 8 weeks. The typical period for the treatment of duodenal ulcers is between 2 and 4 weeks.

For the treatment of syndrome ZoIlinger-Ellison and other disorders associated with hypersecretion of hydrochloric acid in the stomach
The usual starting dose is two tablets a day.
Take the two tablets 1 hour before a meal. Then your doctor may adjust the dose depending on the amount secreted hydrochloric acid. If the prescribed more than two tablets per day, the tablets should be taken twice daily.
In the event that your doctor has appointed a daily dose of more than four tablets a day, it will notify you when to stop taking the drug.

Special populations
If you have kidney problems, moderate or severe liver problems should not take Pantul 40 mg removing Helicobacter pylori;
If you suffer from severe liver disease should not take more than one tablet 20 mg pantoprazole a day (for this purpose are available tablets containing 20 mg pantoprazole);
Children under 12 years old. These tablets are not recommended for use in children below 12 years of age.
If you take more dose of 40 mg of Pantul
Tell your doctor or pharmacist. No known symptoms of overdose.

If you forget to take 40 mg of Pantul
Do not take a double dose to make up the missed dose. Continue with the next dose at the usual time.

If you stop taking 40 mg of Pantul
Do not stop taking the tablets without first checking with your doctor or pharmacist.

If you have any further questions on the use of this product, ask your doctor or pharmacist.

4. POSSIBLE SIDE EFFECTS
Like all medicines, Pantul 40 mg may cause side effects, although not everybody gets them.
The frequency of adverse reactions is determined by the following criteria:
Very common (affecting more than 1 in 10 treated patients);
common (affects 1 to 10 in 100 patients treated);
Uncommon (affects 1 to 10 in 1,000 patients);
rare (affects 1 to 10 in 10,000 patients treated);
very rare (affects less than 1 in 10,000 patients treated);
not known (frequency can not be estimated from available data).
If you experience any of these side effects, stop taking these tablets and tell your doctor immediately or go to the emergency room of the nearest hospital:
Significant allergic reactions (rarely indicated): swelling of the tongue and / or the heart, difficulty swallowing, hives (urticaria), difficulty breathing, allergic facial swelling (edema Quincke / angioedema), dizziness expressed an accelerated heartbeat and diaphoresis;
Significant skin reactions (frequency not known): blistering of the skin and rapid deterioration of general condition, erosion (including slight bleeding) of eyes, nose, mouth / lips or genitals (Syndrome Stevens-Johnson, Syndrome Lyell, Erythema multiforme) and photosensitivity;
Other serious conditions (frequency not known): yellowing of the skin or whites (severe damage to liver cells, jaundice) or fever, rash, and enlarged kidneys, sometimes accompanied by painful urination and lower back pain (serious inflammation of the kidneys).
Other side effects include:
Uncommon (affects 1 to 10 in 1,000 patients):
headache, dizziness; diarrhea; malaise; vomiting; bloating and flatulence (gas); constipation; dry mouth; abdominal pain and discomfort; skin rash; exanthema; eruptions; itching; feeling weak, exhausted or generally unwell; sleep disorders; fractures of the hip, wrist or spine.
Rare (affects 1 to 10 in 10,000 patients treated):
visual disturbances such as blurred vision; hives; joint pain; muscle aches; changes in body weight; increase in body temperature; swelling of the extremities (peripheral edema); allergic reactions; depression; breast enlargement in men.
Very rare (affects less than 1 to 10 out of 10,000 patients treated):
disorientation.
Not known (frequency can not be estimated from available data):
Hallucinations, confusion (especially in patients with a history of these symptoms); reduced sodium levels in the blood.
Side effects identified through blood tests:
Uncommon (affects 1 to 10 in 1,000 patients):
increase in liver enzymes.
Rare (affects 1 to 10 in 10,000 patients treated):
increase in bilirubin; increase fats in the blood.
Very rare (affects less than 1 in 10,000 patients treated):
Reduction in blood platelets, which can cause more frequent than normal bleeding or bruising; decrease in white blood cells, which can lead to more frequent infections.
If you accept Pantul 40 mg of more than three months, it is possible levels of magnesium in your blood drop. Low serum magnesium levels can manifest as general fatigue, involuntary muscle contractions, disorientation, convulsions, dizziness and increased heart rate. If you have any of these symptoms, consult your doctor. The low serum level of magnesium may result in a decrease in serum levels of potassium or calcium. Your doctor may decide to prescribe you periodically measuring serum magnesium.

If any of the side effects gets serious, or you notice other effects not listed in this leaflet, please tell your doctor or pharmacist.

5. HOW TO STORE PANTUL 40 MG
Keep out of reach of children.
Do not use Pantul 40 mg after the expiry date stated on the blister and carton after "EXP". The expiry date refers to the last day of that month.
For tablets in plastic banks: Pantul 40 mg may be used three months after the opening of the bank.
This medicinal product does not require any special storage conditions.
Medicines should not be disposed of in wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. These measures will help to protect the environment.

6. FURTHER INFORMATION
What Pantul 40 mg of
The active substance is pantoprazole.
Each gastro-resistant tablet contains 40 mg of pantoprazole (pantoprazole sodium sesquihydrate).

Other ingredients are:
Core:
Maltitol (E965), crospovidone type B, carmellose sodium, sodium carbonate, anhydrous (E500), calcium stearate.

Tablet coating:
Poly (vinyl alcohol), talc (E553b), titanium dioxide (E 171), macrogol 3350, soya lecithin (E322), yellow iron oxide (E172), sodium carbonate (E500), methacrylic acid-ethyl acrylate copolymer (1: 1), sodium dodecyl sulfate, polysorbate 80, triethyl citrate (E1505).