Pan 40 dosage: how to take it

How to take Pan 40

Take Pan 40 exactly as your doctor advises or as printed on the pack. The dose and how long you take it depend on the condition being treated.

• It is usually taken once a day, before breakfast (commonly 30 to 60 minutes before the meal). Some conditions need it twice a day; follow your prescription.
• Swallow the tablet whole with water. Do not crush, chew or break it, because the coating protects the medicine from stomach acid.
• If you miss a dose, take it when you remember. If it is almost time for the next dose, skip the missed one. Do not take two doses together.
• Symptoms often ease within 2 to 3 days, but full benefit can take up to 4 weeks. Take it for as long as your doctor advises.
• Long-term use should be reviewed by a doctor regularly. Do not keep taking it for months on your own.
• People with severe liver disease may need a lower dose. Tell your doctor about any liver problems.
• Pan 40 is not usually used for children. Any use in children is decided by a doctor.

Who should be careful

Some people need to check with a doctor before taking pantoprazole, or need extra checks while taking it, especially for a long time.

• Warning signs that need a doctor's check first: unexplained weight loss, difficulty or pain when swallowing, repeated vomiting, vomiting blood, or black stools. Pantoprazole can ease symptoms and hide a more serious problem such as stomach cancer
• Long-term use (especially more than a year): it can lower vitamin B12 (tiredness, tingling, a sore red tongue) and slightly raise the risk of bone fractures, gut infections and harmless stomach growths called fundic gland polyps. Your doctor may review whether you still need it
• Low magnesium, or taking medicines such as water tablets (diuretics) or digoxin: your doctor may check magnesium levels
• Weak bones (osteoporosis) or a high risk of fractures
• Liver disease
• A past skin reaction to pantoprazole or a similar medicine, such as a lupus-type rash
• A planned blood test for chromogranin A or tests for neuroendocrine tumours: pantoprazole may need to be stopped for some time beforehand, so tell the doctor doing the test
• Pregnancy or breastfeeding: there is limited information in pregnancy, so ask your doctor; only very small amounts pass into breast milk
• Past allergic reaction to pantoprazole or similar medicines such as omeprazole, esomeprazole or rabeprazole

Medicines and things that interact with Pan 40

Pantoprazole lowers stomach acid, which changes how some medicines are absorbed, and it affects a few others directly. Tell your doctor or pharmacist about everything you take.

• HIV medicines atazanavir, nelfinavir and rilpivirine: pantoprazole can sharply lower their levels and make them less effective. Rilpivirine must not be taken with it
• Methotrexate, especially at high doses: levels of methotrexate may rise and stay high for longer
• Warfarin and similar blood thinners: changes in blood clotting tests and bleeding have been reported, so your doctor may check your INR more often
• Medicines that need stomach acid to be absorbed, such as ketoconazole and itraconazole (antifungals), iron tablets, and some cancer medicines such as erlotinib, dasatinib and nilotinib: they may work less well
• Mycophenolate (used after organ transplants): may be absorbed less well
• Rifampicin (a TB medicine) and St John's wort: may lower pantoprazole levels
• Some laboratory tests: pantoprazole can falsely raise chromogranin A levels and can rarely cause a false positive urine drug test for cannabis (THC)

If someone takes too much

Common questions