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Pantoprazole 40 Mg Gastro-Resistant Tablets

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PACKAGE LEAFLET: INFORMATION FOR THE USER

Pantoprazole 40 mg gastro-resistant Tablets

Pantoprazole

Read all of this leaflet carefully before you start taking this medicine.

-    Keep this leaflet. You may need to read it again.

-    If you have any further questions, ask your doctor or pharmacist

-    This medicine has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same yours.

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

Pantoprazole 40mg gastro-resistant Tablets will be referred to as Pantoprazole Tablets in this leaflet.

In this leaflet:

1.    What Pantoprazole T ablets are and what they are used for

2.    Before you take Pantoprazole T ablets

3.    How to take Pantoprazole Tablets

4.    Possible side effects

5.    How to store Pantoprazole Tablets

6.    Further information

1. WHAT PANTOPRAZOLE TABLETS ARE AND WHAT THEY ARE USED FOR

Pantoprazole Tablets belongs to a group of medicines called proton pump inhibitors. Proton pump inhibitors reduce the amount of acid that your stomach makes.

You have been given Pantoprazole Tablets because you have a condition caused by stomach acid.

Pantoprazole Tablets are used in the short-term treatment and to relieve the symptoms of:

-    duodenal ulcer

-    gastric ulcer

oesophagitis (inflammation of oesophagus) caused by acid secretion.

Additionally, the preparation is used:

-    in combination with antibiotics in patients whose ulceration is related to Helicobacter pylori bacteria

-    in the long-term treatment of conditions where gastric acid is constantly being secreted too much (e.g. Zollinger-Ellison syndrome).

2. BEFORE YOU TAKE PANTOPRAZOLE TABLETS

Do not take Pantoprazole Tablets:

-    if you are allergic (hypersensitive) to pantoprazole or any of the other ingredients of Pantoprazole Tablets

-    if you are taking atazanavir (which is used for the treatment of HIV infection)

-    if you have any relevant impairment of liver or kidney function and the product has been prescribed for you for the eradication of Helicobacter pylori.

Take special care with Pantoprazole Tablets

Please tell the doctor who prescribed this medicine:

-    if you have severe liver impairment. In case of severe hepatic disorder your doctor should monitor your liver function while you use Pantoprazole Tablets

-    if you have been diagnosed with vitamin B12 malabsorption

-    if your doctor has given you Pantoprazole T ablets in addition to other medicines intended for the treatment of Helicobacter pylori infection (antibiotics): please also read the package leaflets of these medicines carefully.

If you are on Pantoprazole Tablets for more than three months it is possible that the levels of magnesium in your blood may fall. Low levels of magnesium can be seen as fatigue, involuntary muscle contractions, disorientation, convulsions, dizziness, increased heart rate. If you get any of these symptoms, please tell your doctor promptly. Low levels of magnesium can also lead to a reduction in potassium or calcium levels in the blood. Your doctor may decide to perform regular blood tests to monitor your levels of magnesium.

Taking a proton pump inhibitor like pantoprazole, especially over a period of more than one year, may slightly increase your risk of fracture in 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).

Please tell your doctor if you suffer or have recently suffered from any of the following symptoms: unintentional weight loss, vomiting of blood or recurrent vomiting or dark stool. Your doctor may perform or have performed an additional investigation called an endoscopy in order to diagnose your condition and/or exclude malignant disease.

Taking other medicines

Other concomitant medication may affect the efficacy and safety of this medicine. Pantoprazole Tablets may also affect the efficacy and safety of other medications. Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. Remember to tell your doctor about your treatment with Pantoprazole Tablets if you are prescribed another medicine while the treatment is still ongoing.

It is especially important to tell your doctor:

-    if you are using atazanavir which is used for the treatment of HIV infection

-    if you are using ketoconazole or itraconazole which are used for the treatment of fungal infections, since pantoprazole may affect their concentrations in your body

-    if you are using anticoagulant medicines, e.g. warfarin, since it may be necessary to monitor your blood coagulation tests more often.

Taking Pantoprazole Tablets with food and drink

The gastro-resistant tablets should be taken 1 hour before food with water.

Pregnancy and breast-feeding

Ask your doctor or pharmacist for advice before taking any medicine. Experience with use of Pantoprazole Tablets in pregnant women is limited. There is no information on the excretion of pantoprazole into human breast milk. If you are pregnant or if you are breast-feeding, you should use this medicine only if your treating physician considers the benefit for you greater than the potential risk for your unborn child or baby.

Driving and using machines

There are no known effects on the ability to drive and use machines. Adverse drug reactions such as dizziness and visual disturbances may occur and which may decrease the ability to react.

Important information about some of the ingredients of Pantoprazole Tablets

This medicinal product contains phenylalanine. May be harmful for the people with phenylketonuria.

3. HOW TO TAKE PANTOPRAZOLE TABLETS

Always take Pantoprazole Tablets exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure.

Method of administration

The tablets should be swallowed whole, with sufficient fluid (e.g. one glass of water) and should not be chewed or crushed.

Dosage

Always take Pantoprazole Tablets exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure about the dosage.

Adults and adolescents 12 years of age and above:

Oesophagitis (inflammation of oesophagus) caused by acid secretion: The recommended dose is 1 tablet (40 mg) daily.

Adults:

Duodenal ulcer:

The recommended dose is 1 tablet (40 mg) daily.

Gastric ulcer:

The recommended dose is 1 tablet (40 mg) daily.

In combination with antibiotics in patients whose ulceration is related to Helicobacter pylori bacteria:

The recommended dose is 1 tablet (40 mg) two times daily in combination with antibiotics. The second pantoprazole tablet should be taken before the evening meal.

The recommended antibiotics to be taken concomitantly with Pantoprazole Tablets are the following:

Amoxicillin (1000 mg) and clarithromycin (500 mg) both taken twice daily or

Metronidazole (400mg or 500 mg) and clarithromycin (250 mg or 500 mg) both taken twice daily or

Amoxicillin (1000 mg) and metronidazole (400 mg or 500 mg) both taken twice daily.

Please ask your doctor if you are not sure.

Long-term treatment of conditions where gastric acid is constantly being secreted too much (e.g. Zollinger-Ellison syndrome):

Initial dose is 2 tablets (2 x 40 mg) daily. With doses above 80 mg daily, the dose should be divided and given twice daily.

Elderly, and patients with kidney problems:

Daily dose of 1 tablet (40 mg) should not be exceeded, except in elderly whose ulceration is related to Helicobacter pylori bacteria.

Patients with liver problems:

Dose of 1 tablet (40 mg) should be given every second day.

Children:

Pantoprazole Tablets are not recommended for use in children below 12 years.

If you take more Pantoprazole Tablets than you should

If you or someone you know accidentally takes a lot more than the stated dose (an overdose) you should contact a doctor immediately.

If you forget to take Pantoprazole Tablets

If you forget to take a dose, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a forgotten tablet.

If you stop taking Pantoprazole Tablets

Do not change the dosage or stop the medication without discussing it with your doctor first, especially if you are taking Pantoprazole Tablets together with antibiotics in order to eradicate Helicobacter pylori, as this may increase the resistance of the germ to certain antibiotics.

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

4. POSSIBLE SIDE EFFECTS

Like all medicines, Pantoprazole Tablets can cause side effects, although not everybody gets them.

Tell your doctor immediately or contact the casualty department at your nearest hospital, if you get any of the following serious side effects. Stop taking this medicine straight away, but take this leaflet and/or the tablets with you.

-    Serious allergic reactions (rare): hypersensitivity reactions, so-called anaphylactic reactions, anaphylactic shock and angioedema. Typical symptoms are: swelling of the face, lips, mouth, tongue and/or throat, which may cause difficulty in swallowing or breathing, hives (nettle rash), severe dizziness with very fast heartbeat and heavy sweating.

-    Serious skin reactions (frequency not known): rash with swelling, blistering or peeling of the skin, losing skin and bleeding around eyes, nose, mouth or genitals and rapid deterioration of your general health, or rash when exposed to the sun.

-    Other serious reactions (frequency not known): yellowing of the skin and eyes (due to severe liver damage), or kidney problems such as painful urination and lower back pain with fever.

Other known side effects include:

-    Uncommon side effects (affects 1 to 10 users in 1,000): headache; dizziness; diarrhoea; feeling sick, vomiting; bloating and flatulence (wind); constipation; dry mouth; bellyache and discomfort; skin rash or hives; itching; feeling weak, exhausted or generally unwell; sleep disorders; increase in liver enzymes in a blood test, fracture of the hip, wrist or spine (see section 2 “Take special care with Pantoprazole Tablets”).

-    Rare side effects (affects 1 to 10 users in 10,000): disturbances in vision such as blurred vision; pain in the joints; muscle pains; weight changes; raised body temperature; swelling of the extremities; allergic reactions; depression; increased bilirubin and fat levels in blood (seen in blood tests).

-    Very rare side effects (affects less than 1 user in 10,000): disorientation; reduction in the number of blood platelets, which may cause you to bleed or bruise more than normal; reduction in the number of white blood cells, which may lead to more frequent infections.

-    Frequency not known (cannot currently be estimated): hallucination, confusion (especially in patients with a history of these symptoms); decreased level of sodium in blood, decreased levels of magnesium in blood, hypomagnesaemia) (see section 2.”Take special care with Pantoprazole Tablets”).

If any of the side effects gets serious, or if you notice any side effects

not listed in this leaflet, please tell your doctor or pharmacist.

5. HOW TO STORE PANTOPRAZOLE TABLETS

Keep out of the reach and sight of children.

Do not use Pantoprazole Tablets after the expiry date which is stated on the packaging. The expiry date refers to the last day of that month.

This medicine does not require any special storage conditions.

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.

6. FURTHER INFORMATION

What Pantoprazole Tablets contain

The active substance is pantoprazole.

Each gastro-resistant tablet contains 40 mg pantoprazole (as pantoprazole sodium sesquihydrate).

The other ingredients are Mannitol (E 421), Sodium carbonate, anhydrous (E 500), Crospovidone, Hydroxypropylcellulose, Zein F4000 (containing phenylalanine), Talc (E 553b), Calcium stearate, Methacrylic acid-ethyl acrylate copolymer (1:1), Triethyl citrate (E 1505), Titanium dioxide (E 171), Hypromellose, Macrogol 400, Iron oxides, yellow and black (E 172), Shellac (E 904), Propylene glycol (E 1520), Ammonium hydroxide (E527).

What Pantoprazole Tablets look like and contents of the pack

Yellow, round, biconvex coated tablets printed with “P40” on one side with black ink and plain on the other side.

Tablets are presented in blisters (aluminium base and lid) and packed in cartons of 2, 7, 14, 15, 28, 30, 50, 60, 100 tablets. Not all pack sizes may be marketed.

Marketing Authorisation Holder and Manufacturer

Dr. Reddy’s Laboratories (UK) Ltd, 6 Riverview Road, Beverley. HU17 0LD, UK.

This medicinal product is also authorised in the Member States of the EEA under the following names:

DE: Pantobeta 40 mg magensaftresistente Tabletten

ES: Pantoprazol Aphar 40 mg Comprimidos Gastrorresistentes

EFG

IT: Pantoprazolo Dr. Reddy’s 40 mg compresse gastroresistenti

This leaflet was last updated in 12/2012. PL 08553/0271