Pano Tablet

Generic Name(s): Pantoprazole Sodium Sesquihydrate

Why it's used

Pano Tablet is a prescription medicine that is used for the short-term treatment of digestive diseases in which stomach acid and bile flows back and irritates the food-pipe, also known as GERD. This medicine works by suppressing the production of acid in the stomach. Pano Tablet is also used for the management of inflammation and irritation of the food pipe, to treat the overproduction of stomach acid, and to prevent stomach ulcers caused by the use of certain medicines (called as, NSAIDs).

Proton Pump Inhibitors

Pano belongs to the Proton Pump Inhibitors class of medicines. Proton-pump inhibitors (PPIs) are a group of medicines that significantly reduce stomach acid production. Excess acid production causes diseases related to the stomach and intestines. PPIs are used to treat such disorders.

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How to use

Follow directions on the product label, information guide, and provided by your doctor before using Pano. Use this medicine as per your doctor's instructions.

Pano is used with or without food. You should swallow Pano tablets whole. Do not split, crush or chew the tablets. Pano is used 30 minutes before meals with applesauce (for delayed-release oral suspension).

Typical Dosage

The typical adult dose of Pano is 40 mg once a day. The typical dose for children is 20 mg - 40 mg once a day. The maximum dose for adults of Pano is 240 mg per day. This medicine is commonly used for a period of 8 weeks for erosive esophagitis associated with GERD. Pano is typically used at the same time every day. It takes 2.5 hours for this medicine to start its action. There are no known habit-forming tendencies with this medicine.

Pano is to be used for longer periods of time. Pano may be prescribed for long-term treatment of hypersecretory conditions that produce excess stomach acid and for the long-term treatment of inflammation of the food pipe (erosive esophagitis). You should continue to use this medicine as directed by the doctor even if you feel well.

If using the liquid form of this medicine, measure the dose using the provided measuring cup, spoon, or dropper. Before pouring the medicine into the measuring device, you should check the measurement markings carefully. Then, pour the dose amount into the device. After use, clean and store the measuring device in a safe place for your next use. You should not use a tablespoon or teaspoon as the dose measuring devices since it can result in an incorrect dose. If indicated on the product package, shake the medicine before use.

If using the delayed-release form of this medicine, do not crush or chew the medicine, unless indicated on the package. Crushing or chewing of the medicine can result in unpleasant taste resulting in patients not following the medicine schedule. Crushing or chewing can also release all of the medicine at once, resulting in a decrease of effectiveness and a possible increase in side-effects.

The injection form of this medicine is for intravenous use only.

Talk to Your Doctor

Tell your doctor if your condition does not improve or worsens. Talk to your doctor if conditions like irregular and tremor, dizziness, abnormal or fast heartbeat, shaking movements of the body, muscle weakness, and muscle pain occurs. If you have issues with the health of your liver, a daily dose of 20 mg will usually be prescribed in patients having issues with their liver. Consult with your doctor before stopping the use of Pano Tablet.

To see the impact of Pano Tablet on the body, your doctor may recommend a lower initial dose. Please follow your doctor's instructions carefully.

Use in Children

If you are giving Pano Tablet to a child, be sure to use a product that is meant for use in children. Before giving this medicine, use the child's weight or age to find the right dose from the leaflet or product package. You can also read the dosage section of this page to know the correct dose for your child. Else, consult with your doctor and follow their recommendation.

Lab Tests

Your doctor may require that certain tests be performed before using Pano Tablet. The doctor may ask you to have Magnesium test. Magnesium levels in the body should be checked before starting the treatment because low magnesium can happen in individuals who take a proton pump inhibitor medicine after three months of treatment.

Storage

Store Pano Tablet at room temperature 15° to 30°C (59° to 86°F), and away from moisture. Keep this medicine away from children and pets.

Medicines may be given for uses other than those listed in the medicine guide. Do not use Pano Tablet for symptoms for which it was not prescribed. Do not give Pano Tablet to others who may have similar symptoms as you. Self-medication can cause harm.

Read more: What are the uses of Pano?

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How to take Pano

Your dose and how often you take Pano will depend on the following factors:

age
weight
patient's health
the health of the patient's kidneys
medicines recommended by the doctor
any other medicines being used
herbal supplements in use
response to the medicine

Pano Dosage

Dosage for short-term treatment of GERD

Adult

Recommended: 40 mg once daily for up to 8 weeks

Children (5 years and older having weight more than or equal to 40 kg/88 lb)

Recommended: 40 mg

Children (5 years and older with weight between 15-40 kg/33-88 lb)

Recommended: 20 mg once daily for up to 8 weeks

Dosage for the healing of inflammation of food pipe

Adult

Recommended: 40 mg once daily

Dosage for overproduction of stomach acid (Zollinger-Ellison syndrome)

Adult

Recommended: 40 mg twice daily (adjust dosage based on patient needs)
Maximum: 240 mg per day

Minimum Age

5 years

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Forms

Delayed-release tablet

Strength: 20 mg, 40 mg

Delayed-release oral suspension

Strength: 40 mg

Powder for solution for injection

Strength: 40 mg

Special Instructions

Tablet

If you are not able to swallow a single 40 mg tablet, take two 20 mg tablets instead.

Delayed release oral suspension in applesauce

Prepare the granules in one teaspoonful (5 ml) of applesauce and do not use other food. Take this suspension within 10 minutes of preparation. Do not chew or crush the granules.

Suspension use through nose or stomach

Prepare the granules in two teaspoonfuls (10 ml) of apple juice and shake the preparation well. Repeat this procedure at least twice using the same method each time, and no granules should be present in the tube.

Delayed release oral suspension in applejuice

Prepare the granules in one teaspoonful (5 ml) of apple juice. Stir the preparation for 5 seconds and swallow immediately.

Powder for solution for injection

After preparation, use the solution within 12 hours.

Missed Dose

In case a dose is missed, take it as soon as you remember but if it is the time of the next dose then take the next regular dose. Two doses at the same time should not be taken to compensate for the missed dose.

Overdose

What to do if you overdose on Pano?

The treatment should depend upon the symptoms that appear (symptomatic and supportive treatment).

If you think you have overdosed on Pano Tablet, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Pano

Before you use Pano, tell your doctor of your medical and health history including the following:

disease in which body attacks its own tissues (also known as, systemic lupus erythematosus)
low magnesium level
low vitamin B12 level in the body
stomach ulcers
upper gastrointestinal bleeding
weak bone density caused by osteoporosis

Before you use Pano Tablet, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Tell your doctor if you are allergic to benzimidazole.

The use of this medicine may change the vitamin B12 level in the body. If you are taking any proton pump inhibitor over a period of more than three years, it may lead to the body not absorbing vitamin B12 properly.

The use of Pano Tablet may change magnesium levels in the body. If you are taking any proton pump inhibitor for at least three months, this can lead to low level of magnesium in your body.

Use in Pregnancy

Consult with your doctor on the use of Pano Tablet during pregnancy. It is not known if this medicine can harm the unborn baby. There have been no controlled studies in humans so its best to only use Pano in pregnancy when required.

Use while Breastfeeding

Consult with your doctor on the use of Pano during breastfeeding. This medicine may pass into breast milk but your doctor can best judge if it can impact the baby.

Impact on Fertility

Consult with your doctor on the use of Pano Tablet, if you are trying to conceive. Impact of this medicine on fertility is not known although animal studies have shown no negative impact on fertility.

Seizures

Pano Tablet can make you feel sleepy. Be careful while driving, using machinery, or doing any other activity that needs you to be alert. The consumption of alcohol with Pano Tablet can make you feel more sleepy. Pano Tablet may cause seizures in some people. Discuss with your doctor if you perform activities where a loss of consciousness may cause you or others harm.

Increased Risk

This medicine may increase your sensitivity to sunlight. If this happens, limit your time outdoors and prevent sunburns. Cover your skin or use a sunscreen.

Side-effects in Children

Children using this medicine may see an increased risk of vomiting, headache, rash, fever, stomach pain, diarrhea, and lung infection.

What precautions should be taken during Pregnancy and Nursing, and administering Pano to Children or the Older Adults?

Pregnant Women

Only When Necessary

Warning: It is not known if Pano can harm the unborn baby.

Breastfeeding

Precaution

Warning: The medicine may pass into breast milk. Consult with your doctor about the best possible way to feed a baby while taking this medicine.

Younger Adults Population

Possibly safe

Warning: Pano has not been indicated other than erosive esophagitis associated with GERD in pediatrics. It is not for use in children less than 5 years.

Older Adults Population

Precaution

Warning: High doses of proton pump inhibitors (PPIs) taken over a long duration (>1 year), may increase the risk of wrist, spine, and hip fractures.

Pano Side-effects

The following side-effects may commonly occur when using Pano Tablet. If any of these side-effects worsen or last for a long time, you should consult with your doctor:

abnormal tissue growth on stomach's lining
diarrhea
dizziness
gas formation
headache
nausea
pain in the joints
stomach pain
vomiting

The following side-effects may commonly occur in children when using Pano Tablet. Discuss with your doctor if any of these side-effects last for a long time or are severe:

fever
frequent passing of loose or watery stools (diarrhea)
headache
lung infection
rash
stomach pain
vomiting

Rarely, the use of Pano Tablet may cause the following side-effects:

abnormal sensations in the body
blurred vision
burned skin layer (Lyell syndrome)
burning sensation in body parts
constipation
dry mouth
facial swelling
fatigue
feeling of discomfort
fluid collection in body tissues
fracture of the hip, wrist or spine
gas or fluid, abdominal distension/bloating
hallucination
high lipid levels in the body
increased creatine kinase level
increased levels of fatty acids
increased transaminases level
inflammation of the liver (hepatitis)
insomnia
involuntary contraction of muscles
kidney failure
loss of body balance
lupus
mental confusion
muscle pain
physical weakness
severe itching of the skin
skin rash
skin rash caused by disease or fever
skin rashes with itchy and raised bumps
stomach discomfort
swelling due to fluid build up inside the veins and arteries
swelling in-between kidney tubules (interstitial nephritis)
swollen male breast tissue
taste disorder
weight changes

The following severe side-effects may also occur when using Pano Tablet:

Blood and lymphatic system disorders

Symptoms: low levels of thrombocytes, deficiency of red blood cells, white blood cells and platelets
Vitamin B12 deficiency
Liver disorders

Symptoms: injury of the liver, liver failure jaundice
Skin disorders (severe injury to skin tissues (Stevens-Johnson syndrome))

Symptoms: sensitivity to light, red coloured rashes on the skin swelling of the lower layer of skin
Low levels of magnesium

Symptoms: seizures, dizziness, abnormal or fast heartbeat, jerking or shaking movements of the body, muscle weakness, uncontrolled muscle contractions of the hands and feet, muscle ache involuntary muscle contractions of the voice box
Mental disorders

Symptoms: depression, hallucination, state of mental confusion disorientation
Metabolism and nutrition disorders

Symptoms: low calcium levels, low potassium levels low level of sodium in the blood

Your doctor has prescribed Pano Tablet because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious side-effects. This page does not list all possible side-effects of Pano Tablet.

If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Side-effects and Allergic Reactions of Pano by Severity and Frequency

Common Side-effects

Following are the common side-effects of this medicine:

diarrhea
dizziness
fundic gland polyps
gas formation
headache
nausea
pain in the joints
stomach pain
vomiting

Infrequent and Rare Side-effects

Following are the infrequent and rare side-effects of this medicine:

Lyell syndrome
abdominal bloating
abdominal discomfort
abdominal distension
abdominal pain
arthralgia
asthenia
blurred vision
constipation
cramps or muscle ache
diarrhea
dizziness
dry mouth
elevated triglycerides levels
exanthema
facial edema
fatigue
flatulence
fracture of the hip, wrist or spine
generalized edema
gynaecomastia
headache
hepatitis
hyperlipidaemias
increased creatine kinase level
increased transaminases level
interstitial nephritis
malaise
muscle spasm
myalgia
nausea
paresthesia
peripheral edema
photosensitivity reaction
pruritus
skin rash
sleep disorder
spasms of the hands and feet
subacute cutaneous lupus erythematosus
taste disorder
urticaria
vertigo
vomiting
weight changes

Severe Side-effects

Following are the severe side-effects of this medicine:

Stevens-Johnson syndrome
abnormal or fast heartbeat
agranulocytosis
angioedema
angioedema
bilirubin increased
depression
erythema multiforme
hallucinations
hepatocellular failure
hepatocellular injury
hypocalcaemia
hypokalaemia
hypomagnesaemia
hyponatremia
jaundice
leukopenia
mental confusion
pancytopenia
photosensitivity
thrombocytopenia
tremors
vitamin B12 deficiency

Side-effects in Children

Following are the side-effects of this medicine in young patients:

diarrhea)
fever
headache
rash
stomach pain
upper respiratory infection (lung infection)
vomiting

Mild Allergic Reactions

Following are the symptoms of mild allergic reactions to this medicine:

skin rash

Serious Allergic Reactions

Following are the symptoms of serious allergic reactions to this medicine:

anaphylactic shock
difficulty in breathing
facial swelling
throat tightness

Discuss with the doctor if your side effects are bothering you.

Warnings

Increased Levels of Chromogranin A (protein)

This medicine increases chromogranin A level, which can interfere in the examination of neuroendocrine tumors. Pano treatment should be discontinued for at least five days before the start of chromogranin A measurements.

Risk of Bacterial Infections

This medicine may lead to increased risk of infections caused by bacteria such as Salmonella and Campylobacter in the stomach or intestines.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Patients who are using Pano to prevent stomach and intestinal issues because of treatment with NSAIDs should be evaluated. The evaluation should make sure that they need NSAIDs and have risk factors that may cause them to develop stomach and intestinal issues caused by NSAIDs.

Stomach Cancer

Patients with stomach cancer are at an increased risk when using this medicine. Effect of Pano overlaps the symptoms of stomach cancer and may delay its diagnosis.

Abnormal Liver Function

Patients having issues with the functioning of their liver are at an increased risk when using this medicine. Such patients may see an increase in levels of liver enzymes. Liver enzymes should be monitored regularly by your doctor during long-term therapy of Pano. The patient should discontinue the use of this medicine if there is an increase in levels of liver enzymes.

Magnesium Deficiency

Patients undergoing treatment with proton pump inhibitors for at least three months and after a year of therapy are at increased risk. Such patients may see an increased risk of side effects which include muscular spasms, palpitation, and seizures. In such cases, the level of magnesium in the body should be monitored before the start of treatment with Pano.

Long-Term Therapy Using Pano

Patients who are on high-dose and follow the long-term therapy of proton pump inhibitors are at an increased risk. Such patients may see an increased risk for fractures of the hip, wrist, or spinal area. These patients should use the lowest effective dose for a shorter duration of time.

Vitamin B12 Deficiency

Patients who use acid-suppressing medicines for long periods of time are at an increased risk. These patients may develop a vitamin B12 deficiency.

Use of Pano with Methotrexate

Patients undergoing treatment with both proton pump inhibitors and methotrexate are at an increased risk. Pano may increase the level and effects of methotrexate on the body. Withdrawal of the proton pump inhibitor on a temporary basis may be considered in these patients.

Helicobacter Pylori (Bacteria) Positive Patients

Such patients are at an increased risk when using this medicine. These patients may suffer from an increased risk of swelling and pain in the stomach, also known as atrophic gastritis.

Interactions with Pano

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.

This page does not contain all the possible interactions of Pano Tablet. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Antiretroviral Drugs

Pano Tablet may interact with antiretroviral drugs (atazanavir or nelfinavir), which are used to treat HIV infections. The combined use of these medicines reduces the level of HIV medicines in the body. This may lead to the loss of effects of the HIV medicines and development of resistance to the medicines.

Coumarin Anticoagulants

There may be an interaction of Pano with coumarin anticoagulants (warfarin and phenprocoumon), which are used to prolong the time needed for blood to clot. Abnormal bleeding occurs when both the medicines are used together which can be possibly fatal. Patients undergoing treatment with both the drugs should be closely monitored for an increase in bleeding time.

Antimetabolites

Pano Tablet interacts with methotrexate, which is used to treat rheumatoid arthritis, itchy, psoriasis, and cancer. The combined use of these medicines may lead to increased level and effects of methotrexate on the body. In such cases, the temporary withdrawal of Pano may be required.

Azole Antifungals

Special instructions need to be followed while taking this medicine along with azole antifungals (ketoconazole, itraconazole, and posaconazole) which are used to treat fungal infections. Pano may interfere with absorption of these medicines.

Urine Screening Tests

Your doctor's guidelines may need to be followed while taking this medicine along with Urine tests. False positive urine screening tests for certain chemicals (such as, tetrahydrocannabinol) has been reported in patients using Pano. Another test may need to be conducted to verify the results.

Interactions of Pano by Severity

Severe

The following medicines are usually not to be taken together without consulting with your doctor or pharmacist.

Serious

The following medicines may interact when taken together and can cause harmful effects in the body. Please consult with your doctor or pharmacist before taking these medicines together.

Warfarin

Moderate

The following medicines may interact when taken together and can increase your risk of harmful effects. Please consult with your doctor or pharmacist before taking these medicines together.

When should Pano be not used?

Allergic to Pano

This medicine should not be used in patients who are allergic to it.

Allergic to Substituted Benzimidazoles

benzimidazole, which is used to treat infections (viral and fungal), pain, heart disease. This medicine should not be used in patients who are allergic to it.

Traveling With Medication

Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Pano is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

If there are disposal instructions on the package, please follow the instructions.
If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.

This page provides information for Pano Tablet .

Peptic Ulcer

GERD

Esophagus Disorders