Consumer medicine information

Pantoprazole Sandoz Tablets

Pantoprazole

BRAND INFORMATION

Brand name

Pantoprazole Sandoz Tablets

Active ingredient

Pantoprazole

Schedule

S4

 

Consumer medicine information (CMI) leaflet

Please read this leaflet carefully before you start using Pantoprazole Sandoz Tablets.

What is in this leaflet

This leaflet answers some common questions about Pantoprazole Sandoz.

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 this medicine 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 PANTOPRAZOLE SANDOZ IS USED FOR

This medicine contains the active ingredient pantoprazole. It belongs to a group of medicines called proton pump inhibitors (PPIs).

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

Ulcers
Pantoprazole Sandoz 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.

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

Most people who have a peptic ulcer also have bacteria called Helicobacter pylori in their stomach. When Pantoprazole Sandoz is taken with antibiotics the combination therapy will kill the Helicobacter pylori and let your ulcer heal.

This medicine may also 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
Pantoprazole Sandoz is also 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.

This medicine is also used to prevent reflux oesophagitis from coming back.

Zollinger-Ellison syndrome
Pantoprazole Sandoz 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 this medicine has been prescribed for you. Your doctor may have prescribed it for another reason.

This medicine is not addictive.

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.

There is not enough information to recommend the use of this medicine for children.

BEFORE YOU TAKE PANTOPRAZOLE SANDOZ

When you must not take it

Do not take this medicine if you have an allergy to:

  • the active ingredient pantoprazole or to any of the other ingredients listed at the end of this leaflet under Product Description.
  • any other similar medicines.

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
  • skin rash, itching or hives on the skin.

Do not take Pantoprazole Sandoz in combination with atazanavir or nelfinavir (an anti-viral medication).

Do not take this medicine if you have cirrhosis or severe liver disease.

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

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

This medicine should not be given to children under the age of 5 years. Safety and effectiveness in children younger than 5 years has not been established.

Do not take this medicine after the expiry date printed on the pack or if the packaging is torn or shows signs of tampering. If it has expired or is damaged, return it to your pharmacist for disposal.

If you are not sure whether you should start taking this medicine, talk to your doctor.

Before you start to take it

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

Tell your doctor if you are pregnant or plan to become pregnant or are breastfeeding. Your doctor can discuss with you the risks and benefits involved.

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

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 Pantoprazole Sandoz.

If you have not told your doctor about any of the above, tell him/her before you start taking Pantoprazole Sandoz.

Taking other medicines

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

Some medicines and Pantoprazole Sandoz may interfere with each other. These include:

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

These medicines may be affected by Pantoprazole Sandoz or may affect how well it works. You may need different amounts of your medicines, or you may need to take different medicines.

Your doctor and pharmacist have more information on medicines to be careful with or avoid while taking this medicine.

HOW TO TAKE PANTOPRAZOLE SANDOZ

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, ask your doctor or pharmacist for help.

How much to take

The usual dose is 40 mg per day.

However, if your doctor also prescribes antibiotics in combination with Pantoprazole Sandoz for the treatment of duodenal ulcers, the dose of Pantoprazole Sandoz is 80 mg per day. The first 40 mg dose should be taken in the morning and the second should be taken before the evening meal for 7 days.

Your doctor may have prescribed a different dose.

The dose and frequency of Pantoprazole Sandoz that your doctor prescribes for you depends on your medical condition.

Your doctor may change the dose as your condition changes.

Ask your doctor or pharmacist if you are unsure of the correct dose for you. They will tell you exactly how much to take.

Follow the instructions they give you. If you take the wrong dose, Pantoprazole Sandoz may not work as well and your problem may not improve.

How to take it

Swallow the tablets whole with a full glass of water with or without food.

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

When to take Pantoprazole Sandoz

Take your medicine at about the same time each day. Taking it at the same time each day will have the best effect. It will also help you remember when to take it.

If you are taking other medicines, like antibiotics, in combination with Pantoprazole Sandoz therapy, follow the instructions for the use of each medicine carefully.

How long to take Pantoprazole Sandoz

Continue taking your medicine for as long as your doctor tells you.

If you forget to take it

Take your dose as soon as you remember, and continue to take it as you would normally.

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

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 are not sure what to do, ask your doctor or pharmacist.

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 the Poisons Information Centre (telephone Australia 13 11 26 or New Zealand 0800 POISON or 0800 764766) for advice, or go to Accident and Emergency at the nearest hospital, if you think that you or anyone else may have taken too much Pantoprazole Sandoz. Do this even if there are no signs of discomfort or poisoning. You may need urgent medical attention.

WHILE YOU ARE TAKING PANTOPRAZOLE SANDOZ

Things you must do

Always follow your doctor's instructions carefully.

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

Tell any other doctors, dentists, and pharmacists who treat you that you are taking this medicine.

If you are going to have surgery, tell the surgeon that you are taking this medicine.

If you become pregnant while you are taking this medicine, tell you doctor or pharmacist immediately.

If you are about to have any blood tests, tell your doctor that you are taking this medicine. It may interfere with the results of some tests.

Keep all of your doctor’s appointments so that your progress can be checked.

Your doctor may do some tests from time to time to make sure the medicine is working and to prevent unwanted side effects.

Tell your doctor if your reflux symptoms return after you stop taking this medicine. The symptoms of reflux may return after stopping this medicine suddenly, especially if you have taken it for a while.

Things you must not do

Do not take Pantoprazole Sandoz to treat any other complaints unless your doctor tells you to.

Do not give your medicine to anyone else, even if they have the same condition as you.

Things that may help your condition

Some self help measures suggested below may help your condition. Your doctor or pharmacist can give you more information about these measures.

  • 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 meals 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 Pantoprazole Sandoz.

All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical attention if you get some of the side effects.

Do not be alarmed by the following lists 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
  • nausea or vomiting
  • diarrhoea
  • stomach pain
  • excessive gas in the stomach or bowel
  • constipation
  • indigestion
  • dry mouth
  • metallic taste
  • weakness or tiredness
  • increased sweating or body temperature
  • blurred vision
  • skin problems such as itchiness and rash
  • trouble sleeping.

The above list includes the more common side effects of your medicine.

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

  • unusual tiredness or weakness
  • nausea or vomiting in combination with loss of appetite, feeling generally unwell, fever, itching, yellowing of the skin and eyes, and dark coloured urine
  • blood in the urine
  • increased or decreased need to urinate
  • severe skin problems such as itchiness, redness, rash with swelling, blistering or peeling of the skin or rash when exposed to sun, possibly with pain in the joints and general fever
  • 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
  • water retention, swelling
  • bleeding or bruising more easily than normal
  • depression, confusion or anxiety
  • bone fracture of the hip, wrist or spine (mainly a risk in people who take high doses of PPIs or use them long term (a year or longer))
  • symptoms such as seizures, abnormal or fast heartbeat or jerking/shaking movements. These can be a sign of low magnesium, calcium or potassium levels in your blood
  • severe and/or persistent diarrhoea, because this medicine has been associated with a small increase in infectious diarrhoea.

The above list includes serious side effects that may require urgent medical attention. Serious side effects are rare.

Tell your doctor or pharmacist if you notice anything else that is making you feel unwell. Other side effects not listed above may also occur in some people.

Ask your doctor or pharmacist if you do not understand anything in this list.

AFTER TAKING PANTOPRAZOLE SANDOZ

Storage

Keep your medicine in the original container.

If you take it out of its original container it may not keep well.

Keep your medicine in a cool dry place where the temperature stays below 25°C.

Do not store Pantoprazole Sandoz or any other medicine in the bathroom or near a sink. Do not leave it on a window sill or in the car.

Heat and dampness can destroy some medicines.

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

Disposal

If your doctor tells you to stop taking this medicine or the expiry date has passed, ask your pharmacist what to do with any medicine that is left over.

PRODUCT DESCRIPTION

What it looks like

Pantoprazole Sandoz comes in two types of tablets:

Pantoprazole Sandoz 20 mg - yellow and oval shaped enteric coated tablets.

Pantoprazole Sandoz 40 mg - yellow and oval shaped enteric coated tablets.

Pantoprazole Sandoz 20 mg is available in blister packs of 30 enteric coated tablets.

Pantoprazole Sandoz 40 mg is available in blister packs of 5 and 30 enteric coated tablets and in bottles of 30 enteric coated tablets.

Ingredients

Active ingredients:

  • Pantoprazole Sandoz 20 mg - 20 mg pantoprazole (as sodium sesquihydrate).
  • Pantoprazole Sandoz 40 mg - 40 mg pantoprazole (as sodium sesquihydrate).

Inactive ingredients:

  • sodium carbonate anhydrous
  • microcrystalline cellulose
  • crospovidone
  • hydroxypropylcellulose
  • colloidal anhydrous silica
  • calcium stearate
  • Opadry complete film coating system 03B22011 Yellow
  • Eudragit L30D-55
  • triethyl citrate

This medicine does not contain gluten, lactose or sucrose.

Supplier

Sandoz Pty Ltd
ABN 60 075 449 553
54 Waterloo Road,
Macquarie Park, NSW 2113
Australia
Tel: 1800 726 369

Novartis New Zealand Ltd
PO Box 99102
Newmarket
Auckland 1149
Tel: 0800 354 335

This leaflet was revised in October 2022.

Australian Register Numbers

Pantoprazole Sandoz 20 mg enteric-coated tablets: AUST R 147362 (blisters)

Pantoprazole Sandoz 40 mg enteric-coated tablets: AUST R 147367 (blisters)

Pantoprazole Sandoz 40 mg enteric-coated tablets: AUST R 147368 (bottles)

Published by MIMS November 2022

BRAND INFORMATION

Brand name

Pantoprazole Sandoz Tablets

Active ingredient

Pantoprazole

Schedule

S4

 

1 Name of Medicine

Pantoprazole sodium sesquihydrate.

2 Qualitative and Quantitative Composition

Each Pantoprazole Sandoz 20 mg enteric coated tablet contains 22.55 mg pantoprazole sodium sesquihydrate equivalent to 20 mg of pantoprazole.
Each Pantoprazole Sandoz 40 mg enteric coated tablet contains 45.10 mg of pantoprazole sodium sesquihydrate equivalent to 40 mg of pantoprazole.
For the full list of excipients, see Section 6.1 List of Excipients.

3 Pharmaceutical Form

Pantoprazole Sandoz 20 mg tablets are yellow and oval shaped enteric-coated tablets.
Pantoprazole Sandoz 40 mg tablets are yellow and oval shaped 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 131126 (Australia).

5 Pharmacological Properties

Pantoprazole is a substituted benzimidazole, which inhibits basal and stimulated gastric secretion.

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. In 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 sodium sesquihydrate is a white to off-white crystalline powder. Solubility is low at neutral pH and increases with increasing pH.
Chemical structure.
https://stagingapi.mims.com/au/public/v2/images/fullchemgif/CSPASOSE.gif Chemical name: 5-(Difluoromethoxy)-2-[[(3,4-dimethoxy-2-pyridinyl) methyl] sulfinyl]-1H-benzimidazole, sodium salt, sesquihydrate.
Molecular formula: C16H14F2N3NaO4S.1.5H2O.
Molecular weight: 432.4.
CAS number. 164579-32-2.

7 Medicine Schedule (Poisons Standard)

S4 - Prescription Only Medicine.

Summary Table of Changes

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