PPIs treat clinical conditions caused by either an overproduction of stomach acid or exacerbated by stomach acid. Omeprazole is a prototype member of substituted benzimidazoles which inhibits the final common step in gastric acid secretion. Pantoprazole, a popular molecule, has similar potency and clinical efficacy to omeprazole but is more acid-stable and has higher oral bioavailability. Pantoprazole interacts with some medications, so co-administration should be monitored. Pantoprazole + Domperidone is the most commonly used combination. Popular brands are PAN, PANTOCID AND PANTODAC. This article highlights Pantoprazole uses and popular market preparations of Pantoprazole Brands.
Are you aware that the weekly prevalence of GERD is about 7.6% in the Indian population? Also, the prevalence rate of GERD in 2 nd and 3 rd trimesters of pregnancy is about almost 50%! So, let us learn more about the most commonly used drugs to treat GERD and similar conditions. A class of medications called Proton Pump Inhibitors (PPIs) which have overtaken H2 blockers for acid-peptic disorders.
Mechanism of Action-
Pantoprazole is a PPI (Proton Pump Inhibitor) that suppresses gastric acid production. Pantoprazole covalently binds to the (H+, K+)-ATPase enzyme, the system at the secretory surface of the gastric parietal cell. It further leads to inhibition of basal acid and stimulated gastric acid secretion, irrespective of the stimulus. The binding to the (H+, K+)-ATPase causes an anti-secretory effect. The action persists longer than 24 hours for all doses tested (20 mg to 120 mg). Refer to the list of Pantoprazole Brands for popular market preparations.
Indications-
Pantoprazole (Pantoprazole Brands) is used to treat-
- 1. Peptic Ulcer
- 2. Bleeding peptic ulcer
- 3. Stress Ulcers
- 4. Gastroesophageal reflux disease (GERD)
- 5. Zollinger-Ellison syndrome
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Side Effects-Pantoprazole Brands
Pantoprazole’s common side effects are Diarrhea, Flatulence, Headache, Nausea, Stomach pain, Abdominal pain, Muscle and joint pain, Leukopenia &Dizziness. No harmful effects or PPIs during pregnancy are known. PPIs are often used for GERD during pregnancy.
Drug-drug Interactions-
- Concomitant use of nelfinavir or atazanavir with proton pump inhibitors is not recommended. Coadministration is expected to decrease atazanavir or nelfinavir plasma concentrations substantially and may result in a decrease in the therapeutic effect. There is also a high probability of drug resistance.
- Patients receiving Proton Pump Inhibitors like Pantoprazole and warfarin concomitantly should be monitored for increases in INR (International Normalized Ratio) and prothrombin time as Coadministration increases INR and prothrombin time which leads to abnormal bleeding and could even cause death.
- Pantoprazole causes prolonged inhibition of gastric acid secretion. It can interfere with the absorption of drugs where gastric pH is an essential determinant of their bioavailability (e.g., Ampicillin esters, Ketoconazole, and iron salts).
Drug-Food Interactions-
Pantoprazole has no severe interactions with food and drinks. However, one should take Pantoprazole at least half an hour before a meal for better action.
Popular Combinations-Pantoprazole Brands
Prokinetics are added to PPIs and used as dual combination therapy as they achieve symptomatic improvement compared to monotherapy, thus can enhance the quality of life of GERD patients. Refer to the list of Pantoprazole Brands for popular market preparations.
1. Pantoprazole + Domperidone– Domperidone is a prokinetic that works on the upper digestive tract. It increases the movement of the stomach and intestines, allowing the food to move more quickly through the stomach. However, Pantoprazole is a Proton Pump Inhibitor (PPI) that reduces the amount of acid in the stomach. Thus, it helps relieve acid-related indigestion and heartburn. The mode of action of both is different and complementary to each other.
2. Pantoprazole + Levosulpiride- Levosulpiride is a prokinetic that works by increasing the release of acetylcholine (a chemical messenger), increasing the movement of the stomach and intestines, and prevents reflux (acid going up to the food pipe).
3. Pantoprazole + Itopride- Itopride is a prokinetic that increases the movement of the upper digestive tract allowing food to move more quickly through the stomach.
4. Pantoprazole + Cinitapride- Cinitapride is a prokinetic that facilitates the movement of intestines, thereby increasing the frequency of bowel movement, softening stools, and reducing abdominal pain/discomfort. It is used in combination with Pantoprazole as it directly stimulates the release of acetylcholine, increasing the intestine’s motility.
5. Pantoprazole + Amoxycillin + Clarithromycin– Clarithromycin, an antibiotic that stops bacteria from growing by preventing the synthesis of essential proteins necessary for their survival. Amoxicillin – an antibiotic that kills bacteria by preventing forming the bacterial protective covering (cell wall). Together, they treat your infection effectively. In duodenal ulcers, Pantoprazole is given together with antibiotics to help eliminate helicobacter pylori from the stomach.
Molecule | Pantoprazole Brands | Company |
Pantoprazole | PAN, PANTIN, PANTOCID, PANTODAC, PANTOP | Alkem Laboratories Hetero Drugs Ltd. Sun Pharmaceuticals Zydus Cadila Aristo Pharmaceuticals |
Pantoprazole + Domperidone | PAN D, DOMPAN, PANTOCID DSR, PANTODAC DSR, PANTOP D SR, PANTOP D | Alkem Laboratories Medley Pharmaceuticals Sun Pharmaceuticals Zydus Cadila Aristo Pharmaceuticals Aristo Pharmaceuticals |
Pantoprazole + Itropride | PANTOCID IT, GANATON TOTAL | Sun Pharmaceuticals Abbott |
Pantoprazole + Cinitapride | CINTODAC, PANTAKIND FLUX, NUPENTA CP | Zydus Cadila Mankind Pharma Ltd. Macleods Pharmaceuticals Pvt Ltd |
Pantoprazole + Levosulpiride | PANTOCID- L, PANTIN-L, PANTOP LS, PAN L | Sun Pharmaceuticals Hetero Drugs Ltd. Aristo Pharmaceuticals Alkem Laboratories |
Pantoprazole + Amoxycillin + Clarithromycin | PANTOCID HP | Sun Pharmaceuticals |
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