Panrazol Special Precautions

If the patient has severe liver problems. Tell the doctor if the patient ever had liver problems in the past. He will check the liver enzymes more frequently, especially when the patient is taking Panrazol as a long-term treatment. In the case of a rise of liver enzymes the treatment should be stopped.
If the patient has reduced body stores or risk factors for reduced vitamin B12 and receive pantoprazole long-term treatment. As with all acid reducing agents, pantoprazole may lead to a reduced absorption of vitamin B12.
If the patient is taking a medicine containing atazanavir (for the treatment of HIV-infection) at the same time as pantoprazole, ask the doctor for specific advise.
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.
Taking a proton pump inhibitor like Pantoprazole, especially over a period of more than one year, may slightly increase the patient's risk of fracture in the hip, wrist or spine. Tell the doctor if the patient has osteoporosis or if he/she is taking corticosteroids (which can increase the risk of osteoporosis).
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.
Tell the doctor immediately if the patient notices any of the following symptoms: an unintentional loss of weight; repeated vomiting; difficulty in swallowing; vomiting blood; looks pale and feel weak (anaemia); blood in the stools; severe and/or persistent diarrhoea, as Panrazol has been associated with a small increase in infectious diarrhoea.
The doctor may decide that the patient needs some tests to rule out malignant disease because pantoprazole also alleviates the symptoms of cancer and could cause delay in diagnosing it. If the symptoms continue in spite of the treatment, further investigations will be considered.
If the patient takes Panrazol on a long-term basis (longer than 1 year) the doctor will probably keep the patient under regular surveillance. The patient should report any new and exceptional symptoms and circumstances whenever he/she sees the doctor.
Driving and using machines: If the patient experiences side effects like dizziness or disturbed vision, he/she should not drive or operate machines.
EC tab 20 mg: If the patient needs to take medicines called NSAIDs continuously and receive Panrazol because of an increased risk of developing stomach and intestinal complications. Any increased risk will be assessed according to the patient's own personal risk factors such as age (65 years old or more), a history of stomach or duodenal ulcers or of stomach or intestinal bleeding.