Consumer medicine information

Panthron

Pantoprazole

BRAND INFORMATION

Brand name

Panthron

Active ingredient

Pantoprazole

Schedule

S4

 

Consumer medicine information (CMI) leaflet

Please read this leaflet carefully before you start using Panthron.

What is in this leaflet

This leaflet answers some common questions about PANTHRON™. It does not contain all the available information.

It does not take the place of talking to your doctor or pharmacist.

All medicines have risks and benefits. Your doctor has weighed the risks of you taking PANTHRON™ against the benefits they expect it will have for you.

If you have any concerns about taking this medicine, ask your doctor or pharmacist.

Keep this leaflet with the medicine. You may need to read it again.

What is PANTHRON™ used for

The name of your medicine is PANTHRON™. It contains the active ingredient called pantoprazole (as sodium sesquihydrate).

Ulcers:
PANTHRON™ is used to treat and help heal duodenal and gastric ulcers.

Depending on the position of the ulcer it is called a gastric or duodenal ulcer. A gastric ulcer occurs in the stomach. A duodenal ulcer occurs in the duodenum which is the tube leading out of the stomach.

These can be caused in part by too much acid being made in the stomach.

PANTHRON™ may be used to prevent ulcers associated with the use of non-steroidal anti-inflammatory drugs (NSAIDs). These are medicines used to relieve pain, swelling and other symptoms of inflammation, including arthritis (inflammation of the joints).

Reflux disease:
PANTHRON™ is used to treat reflux oesophagitis or reflux disease. This can be caused by "washing back" (reflux) of food and acid from the stomach into the food pipe, also known as the oesophagus.

Reflux can cause a burning sensation in the chest rising up to the throat, also known as heartburn.

PANTHRON™ is also used to prevent reflux oesophagitis from coming back.

Zollinger-Ellison syndrome:
PANTHRON™ is used to treat a rare condition called Zollinger-Ellison syndrome, where the stomach produces very large amounts of acid, much more than in ulcers and reflux disease.

Ask your doctor if you have any questions about why PANTHRON™ has been prescribed for you. Your doctor may have prescribed it for another reason.

How PANTHRON™ works

PANTHRON™ belongs to a group of medicines called proton pump inhibitors (PPIs).

PANTHRON™ works by decreasing the amount of acid the stomach makes, to give relief from the symptoms and allow healing to take place.

There is no evidence that PANTHRON™ is addictive.

This medicine is available only with a doctor's prescription.

This medicine is not expected to affect your ability to drive a car or operate machinery.

However, do not drive a car or operate machines if you experience side effects such as dizziness or blurred vision.

PANTHRON™ should not be given to children under 5 years of age. There is not enough information to recommend the use of this medicine for children under the age of 5 years.

Before you take PANTHRON™

When you must not take it

Do not take PANTHRON™ if you have an allergy to:

  • any medicine containing pantoprazole
  • any of the ingredients listed at the end of this leaflet.

Some of the symptoms of an allergic reaction may include:

  • shortness of breath
  • wheezing or difficulty breathing
  • swelling of the face, lips, tongue or other parts of the body
  • rash, itching or hives on the skin.

Do not take PANTHRON™ if you have severe liver disease or cirrhosis.

Do not take PANTHRON™ in combination with antibiotics or any other medicine if:

  • you are allergic to any of the antibiotics or medicines your doctor may prescribe with PANTHRON™
  • you have moderate to severe liver or kidney disease.

If you are not sure whether you should start taking Panthron™ alone, or Panthron™ in combination with antibiotics, talk to your doctor.

Do not take PANTHRON™ in combination with atazanavir or nelfinavir (anti-viral medications).

Do not take PANTHRON™ if the packaging is torn or shows signs of tampering. If it is damaged, return it to your pharmacist for disposal.

Do not take PANTHRON™ after the expiry date (EXP) printed on the pack has passed. If it has expired or is damaged return it to your pharmacist for disposal.

Before you start to take it

Tell your doctor or pharmacist if you have any allergies to any other medicines, foods, preservatives or dyes.

Tell your doctor if you have or have had any other medical conditions.

Tell your doctor if you are pregnant, intend to become pregnant, or are breast-feeding or intend to breastfeed. Your doctor can discuss the risks and benefits involved. If you have not told your doctor about any of the above, tell them before you take PANTHRON™.

Tell your doctor if you have any of the following symptoms:

  • unintentional weight loss
  • repeated vomiting
  • vomiting blood
  • difficulty or pain when swallowing
  • you look pale and feel weak
  • you notice blood in your stools

Your doctor may need to perform some additional tests before you take PANTHRON™.

Taking other medicines

Tell your doctor if you are taking any other medicines, including medicines that you buy without a prescription from your pharmacy, supermarket or health food shop.

Some medicines may be affected by PANTHRON™, or may affect how well it works. These may include:

  • warfarin, phenprocoumon - medicines used to prevent blood clots (anticoagulants)
  • atazanavir, nelfinavir - medicines used to treat viral infections such as HIV
  • ketoconazole, itraconazole, posaconazole - medicines used to treat fungal infection
  • methotrexate - a medicine used to treat arthritis and some types of cancer
  • erlotinib or related medicines used to treat cancer
  • tacrolimus, mycophenolate mofetil - medicines used to suppress the immune system
  • fluvoxamine - a medicine used to treat anxiety and depression

These medicines may be affected by PANTHRON™, or may affect how well it works. You may need to use different amounts of your medicine, or take different medicines.

Your doctor or pharmacist has more information on medicines to be careful with or to avoid while taking PANTHRON™.

How to take PANTHRON™

Follow all directions given to you by your doctor or pharmacist carefully. They may differ from the information contained in this leaflet.

If you do not understand the instructions on the box/bottle, ask your doctor or pharmacist for help.

How much to take

The usual dose is one tablet per day.

Your doctor will prescribe the dose that is right for you.

The dose and frequency of PANTHRON™ that your doctor prescribes for you depends on your medical condition. Your doctor may change the dose as your condition changes.

How and when to take it

Swallow your tablets whole with a little water with or without food.

Do not crush or chew the tablets. PANTHRON™ tablets have a special coating to protect them form the acidic contents of your stomach. For PANTHRON™ to work effectively, this coating must not be broken.

How long to take it

You doctor will tell you how long to take your tablets.

If you forget to take it

If it is almost time for your next dose, skip the dose you missed and take your next dose when you are meant to.

Otherwise, take it as soon as you remember, and then go back to taking it as you would normally.

Do not take a double dose to make up for the dose that you missed. This may increase the chance of you getting an unwanted side effect.

If you have trouble remembering to take your medicine, ask your pharmacist for some hints.

If you take too much (overdose)

Immediately telephone your doctor or Poisons Information Centre (Australia 13 11 26) for advice, or go to Accident and Emergency (Casualty) at your nearest hospital, if you think that you or anyone else may have taken too much PANTHRON™. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.

While you are taking PANTHRON™

Things you must do

Use PANTHRON™ exactly as your doctor has prescribed.

If you are about to be started on any new medicine, remind your doctor and pharmacist that you are taking PANTHRON™.

Tell your doctor immediately if you became pregnant while you are taking PANTHRON™.

Tell any other doctors, dentists and pharmacists who are treating you that you are taking PANTHRON™.

If you take PANTHRON™ for a long period of time, e.g. over 1 year, you will need to see your doctor regularly so that he/she can monitor your condition.

Tell your doctor if you do not feel better while taking PANTHRON™. Your doctor may recommend further examination.

Things you must not do

Do not give PANTHRON™ to anyone else, even if they have the same symptoms as you.

Do not take PANTHRON™ to treat any other complaints unless your doctor tells you to.

Things that may help your condition

Some self-help measures suggested below may help your condition. Talk to your doctor or pharmacist about these measures and for more information.

  • Alcohol - your doctor may advise you to limit your alcohol intake.
  • Aspirin and many other medicines used to treat arthritis/ period pain/headaches-these medicines may irritate the stomach and may make your condition worse. Your doctor or pharmacist may suggest other medicines you can take.
  • Caffeine - your doctor may advise you to limit the number of drinks which contain caffeine, such as coffee, tea, cocoa and cola drinks, because they contain ingredients that may irritate your stomach.
  • Eating habits - eat smaller, more frequent meals. Eat slowly and chew your food carefully. Try not to rush at meal times.
  • Smoking - your doctor may advise you to stop smoking or at least cut down.
  • Weight - your doctor may suggest losing some weight to help your condition.

Side effects

Tell your doctor or pharmacist as soon as possible if you do not feel well while you are taking PANTHRON™, even if you do not think the problems are connected with the medicine or they are not listed in this leaflet.

Like other medicines, PANTHRON™ can cause some side effects. If they occur, most are likely to be minor and temporary. However, some may be serious and need medical attention.

Do not be alarmed by the following list of side effects. You may not experience any of them.

Ask your doctor or pharmacist to answer any questions you may have.

Tell your doctor or pharmacist if you notice any of the following and they worry you:

  • headache
  • dizziness
  • diarrhoea
  • nausea or vomiting
  • stomach pain
  • excessive gas in the stomach or bowel
  • indigestion
  • constipation
  • dry mouth
  • metallic taste
  • weakness or tiredness
  • increased sweating
  • blurred vision
  • skin problems such as itchiness and rash.

These are the more common side effects of PANTHRON™. Some of these side effects may be due to the combination of other medicines you are taking with PANTHRON™.

Tell your doctor immediately if you notice any of the following:

  • unusual tiredness or weakness
  • nausea, vomiting, loss of appetite, feeling generally unwell, fever, itching, yellowing of the skin and eyes, and dark coloured urine.
  • skin problems such as itchiness and rash, or swelling, blistering or peeling of the skin
  • swelling of the face, lips, mouth, tongue or throat which may cause difficulty in swallowing or breathing
  • frequent infections such as fever, severe chills, sore throat or mouth ulcers
  • chest pain
  • shortness of breath
  • high blood pressure
  • swelling of the legs
  • bleeding or bruising more easily than normal
  • depression, confusion or anxiety.

These may be serious side effects and you may need urgent medical attention. Serious side effects are rare. Other side effects not listed above may also occur in some people.

Do not be alarmed by this list of possible side effects. You may not experience any of them.

Tell your doctor if you notice anything that is making you feel unwell when you are taking, or soon after you have finished taking PANTHRON™.

After taking PANTHRON™

Storage

Keep your tablets in their blister pack until it is time to take them. If you take the tablets out of the blister pack they may not keep well.

Keep PANTHRON™ in a cool dry place where the temperature stays below 25 °C.

Do not store PANTHRON™ or any other medicines in a bathroom or near a sink.

Do not leave it in the car or on window sills. Heat and dampness can destroy some medicines.

Keep PANTHRON™ where children cannot reach it. A locked cupboard at least one-and- a-half meters above the ground is a good place to store medicines.

Disposal

If your doctor tells you to stop taking PANTHRON™ or the expiry date has passed, ask your pharmacist what to do with any tablets that are left over.

Product description

What it looks like

PANTHRON™ is available as 20 mg and 40 mg tablets. The tablets have an acid-resistant coating called an enteric coating.

The 20 mg tablets are yellow to pale yellow oval shaped, plain on both sides.

The 40 mg tablets are yellow to pale yellow oval shaped, plain on both sides.

The 20 mg and 40 mg tablets are available in blister packs of 5, 14, 15, 28, 30, 50, 56, 60, 100 and 140 tablets. (Not all pack sizes may be marketed).

Ingredients

The active ingredient in PANTHRON™ tablets is pantoprazole (as sodium sesquihydrate).

PANTHRON™ 40 mg tablets contain the equivalent of 40 mg pantoprazole and;

PANTHRON™ 20 mg tablets contain the equivalent of 20 mg pantoprazole.

PANTHRON™ tablets also contain Mannitol, Sodium carbonate, Sodium starch glycollate, Crospovidone, Colloidal anhydrous silica, Calcium stearate, Hypromellose, Macrogol 6000, Purified water, Sodium hydroxide, Eudragit L30-D55 and Opadry AMB Aqueous Moisture Barrier Coating System 80W52172 Yellow.

PANTHRON™ does not contain gluten, lactose, sucrose, tartrazine or any other azo dyes.

Supplier

PANTHRON™ is supplied by:

Strides Pharma Science Pty Ltd
Sydney, Australia
www.stridespharma.com.au

Australian registration numbers:

Panthron™ 20 mg – AUST R 158192

Panthron™ 40 mg – AUST R 158195

This leaflet was prepared in February 2021.

Version 3.0

Published by MIMS June 2021

BRAND INFORMATION

Brand name

Panthron

Active ingredient

Pantoprazole

Schedule

S4

 

1 Name of Medicine

Pantoprazole sodium sesquihydrate.

2 Qualitative and Quantitative Composition

Each Panthron 40 mg enteric coated tablet contains 45.4 mg of pantoprazole sodium sesquihydrate equivalent to 40 mg of pantoprazole.
Each Panthron 20 mg enteric coated tablet contains 22.7 mg pantoprazole sodium sesquihydrate equivalent to 20 mg of pantoprazole.
For the full list of excipients, see Section 6.1 List of Excipients.

3 Pharmaceutical Form

Panthron is available as 20 mg (yellow, oval shaped, plain on both sides) and 40 mg (yellow, oval shaped, plain on both sides) biconvex, enteric-coated tablets.

4 Clinical Particulars

4.9 Overdose

There are no known symptoms of overdosage in humans. In individual cases, 240 mg was administered i.v. or p.o. and was well tolerated. Standard detoxification procedures apply.
As pantoprazole is extensively protein bound, it is not readily dialyzable. As in any case of overdosage, treatment should be symptomatic and supportive measures should be utilised.
For information on the management of overdose, contact the Poisons Information Centre on 13 11 26 (Australia).

5 Pharmacological Properties

5.3 Preclinical Safety Data

Genotoxicity. A number of in vitro and in vivo genotoxicity assays covering mutagenicity, clastogenicity and DNA damage end points were conducted on pantoprazole and the results were generally negative. Exposures achieved in the in vivo tests in mice and rats were well in excess of exposures expected clinically. However, pantoprazole was clearly positive in carefully conducted cytogenetic assays in human lymphocytes in vitro, both in the presence and absence of metabolic activation. Omeprazole was also positive in a comparable test conducted in the same laboratory, suggesting a possible class effect. A minute amount of radioactivity was bound to rat hepatic DNA after treatment with 200 mg/kg/day pantoprazole for 14 days. This is an estimated exposure 24-fold the clinical exposure from the 40 mg tablet. No distinct DNA-adduct has been detected.
Pantoprazole was found to be negative in the following studies: in vivo chromosome aberration assay in rat and bone marrow (126E/95), mouse lymphoma test (222E/95) and a gene mutation test in Chinese hamster ovary cells (in vitro) (188E/95). In addition, toxicokinetic studies were conducted in rats at the doses used in the bone marrow assay (50 to 1200 mg/kg) (56E/96) and in mice at the high dose from the earlier micronucleus test (710 mg/kg) (89E/96). Pantoprazole exposure was high with the respective rat and mouse plasma AUCs being 7 to 100 and 9- to 12-fold the clinical exposure from a 40 mg tablet.
Carcinogenicity. A two year oral carcinogenicity study in Sprague Dawley rats at doses up to 200 mg/kg/day gastric carcinoids were found after pantoprazole treatment at doses greater than 0.5 mg/kg/day in females and greater than 5 mg/kg/day in males, with none observed in controls. The estimated exposure (based on AUC) from these doses are at, or below, clinical exposure from a 40 mg tablet. The development of gastric tumours is attributed to chronic elevation of serum gastrin levels with associated histopathological changes in the gastrointestinal system.
In both male and female rats, the development of hepatocellular adenomas was increased at doses greater than 5 mg/kg/day and the development of hepatocellular carcinomas was increased at doses greater than 50 mg/kg/day, with respective estimated exposures of 1- and 9-fold the AUC of the 40 mg clinical dose. Hepatocellular tumours, which were also observed in female mice at oral doses greater than 25 mg/kg/day (exposure similar to clinical exposure), may be associated with pantoprazole-induced increases in hepatic enzyme activity.
Treatment with pantoprazole at doses greater than 50 mg/kg/day (exposure approximately 9-fold clinical exposure) also increased the development of thyroid follicular cell adenomas in male and female rats. Several studies in rats were conducted to investigate the effect of pantoprazole on the thyroid, the results of which suggested that the effect may be secondary to the induction of enzymes in the liver.
In a more recent carcinogenicity study, Fischer rats were studied using lower doses (5, 15 and 50 mg/kg, 0.5-, 2- and 7-fold the clinical AUC, respectively). Gastric carcinoids were detected at all doses in females and at the 15 and 50 mg/kg doses in males, while none were detected in controls. No metastases of these carcinoids were detected. There was no increase in incidence of liver tumours. The dose of 15 mg/kg is seen to be the no-effect level for liver tumours in rodents.
Consideration of the possible mechanisms involved in the development of the above drug-related tumour types suggests that it is unlikely that there is any carcinogenic risk in humans at therapeutic dose levels of pantoprazole for short term treatment.

6 Pharmaceutical Particulars

6.7 Physicochemical Properties

Pantoprazole is a substituted benzimidazole which inhibits basal and stimulated gastric secretion. It is a white to off white crystalline powder. Freely soluble in water and in ethanol (96 per cent), practically insoluble in hexane. Solubility is low at neutral pH and increases with increasing pH.
Chemical structure.
https://stagingapi.mims.com/au/public/v2/images/fullchemgif/CSPANSOS.gif CAS number. 164579-32-2.
Chemical name: Sodium 5-(difluoromethoxy)-2-[(RS)-[(3,4-dimethoxypyridin-2yl) methyl] sulphinyl] benzimidazol-1-ide sesquihydrate.
Molecular Formula: C16H14F2N3NaO4S.½H2O.
Molecular Weight (MW): 432.4 (sodium salt x 1.5 H2O).

7 Medicine Schedule (Poisons Standard)

S4 - Prescription Only Medicine.

Summary Table of Changes

https://stagingapi.mims.com/au/public/v2/images/fulltablegif/PANTHRST.gif