Brand Name: S-PANLOC
Generic Name: S-Pantoprazole
Preparation: 20 mg Enteric Coated Tablet
Pharmacological Categories: Proton Pump Inhibitor, Benzimidazole Derivative, Anti-ulcer

Mechanism of Action (MOA):
S-PANLOC (S-Pantoprazole) is the active form of Pantoprazole. It is an s enantiomer and is a prodrug. After administration, it diffuses into the parietal cell of the stomach and accumulates in the secretory canaliculi. In the acidic medium S-PANLOC is converted to sulfenamide. This sulfenamide covalently interacts with sulfhydryl group in the proton pump and inhibits the exchange of extracellular K+ for intracellular H+ ion. S-PANLOC irreversibly inhibits proton pumps and decreases gastric acid secretion

Absorption: Well absorbed
Bioavailability: 77%
Metabolism: Hepatic
Elimination Half-life: 0.9 to 1.9 hours

Indications and Dosage:
• Heartburn
• Peptic Ulcers
• Gastro-esophageal reflux disease

Dose: 20 mg OD before breakfast for 4-8 weeks depending upon condition and response

Side Effects:
Nausea, diarrhoea, headache, abdominal pain, muscle and joint pain, dizziness, rashes, leucopenia, hepatic dysfunction, atrophic gastritis

Hypersensitivity to S-pantoprazole, pantoprazole or other proton pump inhibitors (PPIs)

Warnings/ Precautions:
• Consider the diagnosis of Clostridium difficile-associated diarrhoea (CDAD) for PPIs taking patients, who have diarrhoea that does not improve.
• Caution in severe hepatic impairment.
• Avoid using for longer than medically indicated as cutaneous lupus erythematosus (CLE) and systemic lupus erythematosus (SLE) have been reported with PPIs.
• Use of PPI with prolonged and high dose may be associated with increased risk for osteoporosis-related fractures of the hip, wrist, or spine.
• Hypomagnesemia may occur with prolonged use more than one year leading to tetany, arrhythmias and seizure.
• Daily long-term use e.g. longer than 3 years may lead to malabsorption or deficiency of cyanocobalamin.
• Acute interstitial nephritis reported in patients taking proton pump inhibitors.
• The risk of salmonella and campylobacter infections is increased with the use of PPI.

Drug Interactions:
• Concomitant use of atazanavir or nelfinavir with proton pump inhibitor decreases the plasma concentration of atazanavir or nelfinavir.
• Concomitant use of warfarin and proton pump inhibitor increases International Normalized Ration (INR) and prothrombin time leading to abnormal bleeding and even death.
• Proton pump inhibitors can reduce the absorption of drugs where gastric pH is an important determinant of their bioavailability e.g. ketoconazole, ampicillin esters, atazanavir, iron salts, erlotinib and mycophenolate mofetil (MMF).
• There have been reports of false positive urine screening tests for tetrahydrocannabinol (THC) in patients receiving proton pump inhibitors.
• Concomitant administration of proton pump inhibitor and methotrexate primarily at a high dose may elevate and prolong serum levels of methotrexate.

Pregnancy Category: B

S-PANLOC: 10 X 10’s