Pantoloc Control Special Precautions

Talk to the doctor before taking PANTOLOC Control: If the patient has been treated for heartburn or indigestion continuously for 4 or more weeks; if the patients is over 55 years old and taking non-prescription indigestion treatment on a daily basis; if the patient is over 55 years old with any new or recently changed reflux symptoms; if the patient has previously had a gastric ulcer or stomach surgery; if the patient has liver problems or jaundice (yellowing of skin or eyes); if the patient regularly sees the doctor for serious complaints or conditions; if the patient is due to have an endoscopy or a breath test called a C-urea test; if the patient has ever had a skin reaction after treatment with a medicine similar to PANTOLOC Control that reduces stomach acid; if the patient is due to have a specific blood test (Chromogranin A); If the patient is taking HIV protease inhibitors such as atazanavir, nelfinavir (for the treatment of HIV-infection) at the same time as pantoprazole, ask the doctor for specific advice.
Do not take this product for longer than 4 weeks without consulting the doctor. If the reflux symptoms (heartburn or acid regurgitation) persist for longer than 2 weeks, consult the doctor who will decide about the need for long-term intake of this medicinal product.
If the patient takes Pantoloc Control for longer periods, this may cause additional risks, such as: reduced absorption of Vitamin B12, and Vitamin B12 deficiency if already having low body stores of Vitamin B12; fracture of the hip, wrist or spine, especially if already suffering from osteoporosis or taking corticosteroids (which can increase the risk of osteoporosis); falling magnesium levels in the blood (potential symptoms: fatigue, involuntary muscle contractions, disorientation, convulsions, dizziness, increased heart rate). Low levels of magnesium can also lead to a reduction in potassium or calcium levels in the blood. Talk to the doctor if the patient has been using this product for more than 4 weeks.
The doctor may decide to perform regular blood tests to monitor the levels of magnesium.
Hypomagnesemia, symptomatic and asymptomatic, has been reported rarely in patients treated with PPIs for at least three months, in most cases after a year of therapy. Serious adverse events include tetany, arrhythmias, and seizures. In most patients, treatment of hypomagnesemia required magnesium replacement and discontinuation of the PPI.
For patients expected to be on prolonged treatment or who take PPIs with medications such as digoxin or drugs that may cause hypomagnesemia (e.g., diuretics), health care professionals may consider monitoring magnesium levels prior to initiation of PPI treatment and periodically.
Decreased gastric acidity due to any means, including proton pump inhibitors, increases gastric counts of bacteria normally present in the gastrointestinal tract. Treatment with proton pump inhibitors may lead to slightly increased risk of gastrointestinal infections such as Salmonella and Campylobacter and possibly Clostridium difficile.
Concomitant use of Proton Pump Inhibitors (PPIs) with Methotrexate: Literature suggests that concomitant use of PPIs with methotrexate (primarily at high dose) may elevate and prolong serum levels of methotrexate and/or its metabolite, possibly leading to methotrexate toxicities. A temporary withdrawal of the PPI may be considered in some patients receiving treatments with high dose methotrexate.
Case reports, published population pharmacokinetic studies, and retrospective analyses suggest that concomitant administration of PPIs and methotrexate (primarily at high dose) may elevate and prolong serum levels of methotrexate and/or its metabolite hydroxymethotrexate. However, no formal drug interaction studies of methotrexate with PPIs have been conducted.
Long-term (a year or longer) and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist or spine. Patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated.
Subacute cutaneous lupus erythematosus (SCLE): Proton pump inhibitors are associated with very infrequent cases of SCLE. If lesions occur, especially in sun-exposed areas of the skin, and if accompanied by arthralgia, the patient should seek medical help promptly and the health care professional should consider stopping Pantoloc Control. SCLE after previous treatment with a proton pump inhibitor may increase the risk of SCLE with other proton pump inhibitors.
Tell the doctor immediately, before or after taking this medicine, if the patient notices any of the following symptoms, which could be a sign of another, more serious, disease: an unintentional loss of weight (not related to a diet or an exercise programme); vomiting, particularly if repeated; vomiting blood; this may appear as dark coffee grounds in the vomit; blood in the stools; which may be black or tarry in appearance; difficulty in swallowing or pain when swallowing; looking pale and feeling weak (anaemia); chest pain; stomach pain; severe and/or persistent diarrhoea, because this medicine has been associated with a small increase in infectious diarrhoea; if the patient gets a rash on the skin, especially in areas exposed to the sun, tell the doctor as soon as possible, as there may be a need to stop the treatment with PANTOLOC Control.
Remember to also mention any other ill effects like pain in the joints.
The doctor may decide that the patient needs some tests.
If the patient is due to have a blood test, tell the doctor that he/she is taking this medicine.
The patient may experience relief from acid reflux and heartburn symptoms after just one day of treatment with PANTOLOC Control, but this medicine is not meant to bring immediate relief.
The patient should not take it as a preventive measure.
If the patient has been suffering from repetitive heartburn or indigestion symptoms for some time, remember to see the doctor regularly.
The following recommendations for lifestyle and dietary changes may also help to relieve heartburn or acid related symptoms: Avoid large meals; Eat slowly; Stop smoking; Reduce alcohol and caffeine consumption; Reduce weight (if overweight); Avoid tight-fitting clothing or belts; Avoid eating less than three hours before bedtime; Elevate bedhead (if the patient suffers from nocturnal symptoms); Reduce intake of food that can cause heartburn. These might include: Chocolate, peppermint, spearmint, fatty and fried food, acidic food, spicy food, citrus fruits and fruit juices, tomatoes.
Driving and using machines: If the patient experiences side effects like dizziness or disturbed vision, he/she should not drive or use machines.
Use in Children: PANTOLOC Control should not be used by children and adolescents under 18 years of age due to a lack of safety information in this younger age group.