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Why it's used

Panflo DSR Tablet is a prescription medicine that is used to treat backflow of the stomach acid into the food pipe, inflammation of the lining of food pipe, stomach and duodenal ulcers. This medicine contains Pantoprazole and Domperidone. Pantoprazole works by preventing the acid secretion in the stomach. Domperidone works by blocking the brain cell receptors and gives an antiemetic effect. Panflo DSR Tablet is also used to relieve the symptoms of nausea and vomiting, upper stomach discomfort, indigestion with the feeling of fullness and backflow of food from food pipe to mouth.
Proton Pump Inhibitors
Panflo DSR belongs to the Proton Pump Inhibitors class of medicines. Proton-pump inhibitors (PPIs) are a group of medicines that significantly reduce stomach acid production. Excess acid production causes diseases related to the stomach and intestines. PPIs are used to treat such disorders.

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How to use

Follow directions on the product label, information guide, and provided by your doctor before using Panflo DSR. Eat this medicine as per your doctor's instructions.
Panflo DSR is eaten before food. Domperidone should be given 15-30 minutes before food to patients with stomach and intestinal problems.

Typical Dosage

The typical adult dose of Panflo DSR is 40 mg pantoprazole and 30 mg domperidone once daily. Panflo DSR is typically used at the same time every day. Panflo DSR capsules should be taken before breakfast.
Panflo DSR is to be used for longer periods of time.

Talk to Your Doctor

Tell your doctor if your condition persists. Talk to your doctor if nausea, and vomiting. If you have issues with the health of your liver, the level of Pantoprazole in the blood may increase in patients with mild to severe abnormal functioning of the liver. More than 40 mg/day dose of Pantoprazole has not been studied in patients with liver problems.

Use in Children

If you are giving Panflo DSR Tablet to a child, be sure to use a product that is meant for use in children. Before giving this medicine, use the child's weight or age to find the right dose from the leaflet or product package. Consult with your doctor if the product package does not provide specific information for children.

Storage

Store Panflo DSR Tablet below 25°C (77°F), away from moisture, and away from light. Keep this medicine away from children and pets.
Medicines may be given for uses other than those listed in the medicine guide. Do not use Panflo DSR Tablet for symptoms for which it was not prescribed. Do not give Panflo DSR Tablet to others who may have similar symptoms as you. Self-medication can cause harm.

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How to take Panflo DSR

Your dose and how often you take Panflo DSR will depend on the following factors:
  • age
  • weight
  • the health of the patient's kidneys

Panflo DSR Dosage

Dosage for acid backflow into food pipe

Adult
  • Recommended: 40 mg pantoprazole and 30 mg domperidone once daily

Dosage for inflammation of the food pipe lining

Adult
  • Recommended: 40 mg pantoprazole and 30 mg domperidone once daily

Dosage for stomach and duodenal ulcers

Adult
  • Recommended: 40 mg pantoprazole and 30 mg domperidone once daily

Dosage for relieving symptoms of nausea and vomiting

Adult
  • Recommended: 40 mg pantoprazole and 30 mg domperidone once daily

Dosage for relieving symptoms of upper stomach discomfort

Adult
  • Recommended: 40 mg pantoprazole and 30 mg domperidone once daily

Dosage for relieving symptoms of feeling fullness

Adult
  • Recommended: 40 mg pantoprazole and 30 mg domperidone once daily

Dosage for backflow of food to the mouth

Adult
  • Recommended: 40 mg pantoprazole and 30 mg domperidone once daily

Forms

Capsule
Strength: 40 mg pantoprazole and 30 mg domperidone

Special Instructions

Liver Problems
The level of Pantoprazole may increase in the blood in patients with liver problems. More than 40 mg/day dose of Pantoprazole has not been studied in patients with liver problems.

Overdose

What to do if you overdose on Panflo DSR?
In case of overdose, close supervision with supportive care and treatment according to the symptoms should be provided. Stomach emptying should be performed by cleaning out the contents of the stomach or by using activated charcoal, a substance that absorbs poisons from the stomach. Also, provide treatment with anticholinergic or anti-Parkinson drugs to control extrapyramidal reactions.
Symptoms of an overdose of Panflo DSR
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
  • agitation
  • altered consciousness
  • an absence of ear reflex
  • decreased activity
  • disorientation
  • drowsiness
  • extra-pyramidal reactions
  • hunched sitting
  • lateral position
  • limb-splay
  • loss of body movement
  • segregation
  • seizures
  • tremor
If you think you have overdosed on Panflo DSR Tablet, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Panflo DSR

Before you use Panflo DSR Tablet, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Tell your doctor if you are allergic to substituted benzimidazole.
The use of this medicine may change the magnesium level. This medicine may decrease the magnesium level in the blood. Due to this, patients may suffer from severe side effects including involuntary contraction of muscles, irregular heartbeat, and seizures. Most of these patients require discontinuation of the proton pump inhibitors and magnesium replacement.
The use of Panflo DSR Tablet may change the prolactin level. The level of prolactin may get increased when using this medicine.
The use of this medicine may change the sodium level. This medicine may decrease the sodium level in the blood.

Use in Pregnancy

Panflo DSR Tablet should be used in pregnancy only when required. There are no well-controlled and adequate studies in pregnant women. Pantoprazole can be used during pregnancy only if needed. Domperidone can only be used during pregnancy when confirmed by the expected therapeutic benefit.

Use while Breastfeeding

Panflo DSR should be used while breastfeeding only when required. This medicine may pass into breast milk. So, it should not be used during breastfeeding in mothers taking domperidone. A judgment should be made whether to discontinue breastfeeding or medicine, taking into account the advantage of the drug to the mother.

Seizures

Panflo DSR Tablet can make you feel sleepy. Be careful while driving, using machinery, or doing any other activity that needs you to be alert. The consumption of alcohol with Panflo DSR Tablet can make you feel more sleepy. Panflo DSR Tablet may cause seizures in some people. Discuss with your doctor if you perform activities where a loss of consciousness may cause you or others harm.

Increased Risk

This medicine may increase your sensitivity to sunlight. If this happens, limit your time outdoors and prevent sunburns. Cover your skin or use a sunscreen.

Side-effects in Children

Panflo DSR Tablet may cause an increased risk of side-effects in younger patients. Children using this medicine may see an increased risk of upper respiratory infection, headache, fever, diarrhea, vomiting, skin rash, and abdominal pain.

Side-effects in Older Patients

Panflo DSR Tablet may increase side-effects in older patients. Elderly patients may see an increased risk of abnormal heartbeat, and loss of heart function.

Long Term Use

When using this medicine for the long term, the patient may suffer from decreased magnesium level, stomach inflammation (atrophic gastritis), vitamin B12 deficiency, and bone fracture. The patient may also have stomach or intestinal cancer, increased levels of a hormone in the stomach (called as gastrin), and a rise in the specific endocrine cells in the stomach.

Panflo DSR Side-effects

The following side-effects may commonly occur when using Panflo DSR Tablet. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
The following side-effects may commonly occur in older patients on the use of Panflo DSR Tablet. Discuss with your doctor if any of these side-effects last for a long time or are severe:
  • abnormal heartbeat
  • loss of heart function
The following side-effects may commonly occur in children when using Panflo DSR Tablet. Discuss with your doctor if any of these side-effects last for a long time or are severe:
Rarely, the use of Panflo DSR Tablet may cause the following side-effects:
  • a feeling of discomfort
  • abnormal liver function test
  • bloating
  • breast pain
  • breast tenderness
  • enlarged breasts in men (gynecomastia)
  • fatigue
  • fracture of the wrist
  • hives
  • increased prolactin levels
  • insomnia
  • involuntary movements of the eyeballs
  • lack of energy
  • lack of menstrual cycle (amenorrhoea)
  • loss of libido
  • loss of taste (ageusia)
  • milky nipple discharge
  • muscle pain
  • nervousness
  • skin itching
  • stomach discomfort
  • stomach distension
  • swelling of the face
  • swelling of the legs
  • temporary intestinal cramps
  • vertigo
  • weight changes
The following severe side-effects may also occur when using Panflo DSR Tablet:
  • Symptoms: low count of white blood cells abnormally low level of platelets
  • Heart disorders
    Symptoms: abnormal heartbeat loss of heart function
  • Metabolic and nutritional disorders
    Symptoms: increased level of creatine kinase enzyme, swelling of the body, increased level of triglycerides, increased level of liver enzymes, increased level of bilirubin, decreased level of sodium decreased level of magnesium
    Patients with low magnesium level may require discontinuation of the proton pump inhibitors and magnesium replacement.
  • Eye disorders
    Symptoms: blurred vision
  • Kidney disorders
    Symptoms: swelling in between the kidney tubules (interstitial nephritis)
  • Stomach and intestinal disorders
    Symptoms: diarrhea, constipation vomiting
  • Psychiatric disorders
  • Urinary disorders
    Symptoms: an inability to empty the bladder
  • Symptoms: fracture of the hip fracture of the spine
  • Liver disorders
    Symptoms: liver damage, jaundice, liver failure an inflammation of the liver (hepatitis)
Your doctor has prescribed Panflo DSR Tablet because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious side-effects. This page does not list all possible side-effects of Panflo DSR Tablet.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

CYP3A4 Inhibitors

Domperidone should not be taken with oral erythromycin, ketoconazole or any other CYP3A4 inhibitors that prolong the heartbeat.

Birth Problems

Patients with birth problems are at an increased risk while using this medicine. This medicine contains lactose and may be inadequate for patients with galactosemia, lactose intolerance or abnormal absorption of glucose/galactose.

Stomach and Intestinal Infections

Patients taking pantoprazole may see an increased risk of stomach and intestine infections produced by bacteria (for example campylobacter and salmonella). Pantoprazole may increase the number of bacteria usually present in the upper tract of the stomach and intestine.

Long-term Treatment

Regularly monitor the patients who are on long term therapy, especially more than one year.

Ability to Produce or Develop Cancer

Patients using pantoprazole for a long-term may have the potential to develop cancer, which is due to the severe type of digestive disorder (GERD).

Decreased Blood Magnesium Levels

Patients taking long-term treatment of proton pump inhibitors for three months to 1 year are at an increased risk. These patients may suffer from involuntary contraction of muscles, irregular heartbeat and seizures. Low level of magnesium in the blood should be treated by discontinuation of the proton pump inhibitor and magnesium replacement. Regular monitoring of the magnesium levels before starting treatment with proton pump inhibitor should be done in patients expected with long term therapy or who have to take proton pump inhibitors with digoxin or diuretics.

Bone Fracture

Patients taking high doses, multiple daily doses or long term therapy (more than a year) of proton pump inhibitor (PPI) are at increased risk of fracture. There is an increased risk for bone diseases related fractures of wrist, spine or hip in patients receiving proton pump inhibitor therapy. Such patients should use the lowest dose and shortest term of therapy as suitable to the disease. Patients having bone diseases related fractures should manage as per the guidelines of the treatment.

Vitamin B12 Deficiency

Patients taking long-term treatment of acid-suppressing medicines are at an increased risk. These patients may suffer from abnormal absorption of vitamin B12 due to decreased or absence of stomach acid. Monitoring of vitamin B12 deficiency should be considered in such patients.

Stomach Inflammation

Patients taking pantoprazole may see an increased risk of stomach inflammation. Stomach inflammation may occur in patients using pantoprazole for long-term, especially in patients with Helicobacter pylori infection.

Existing Stomach Cancer

Treatment given according to the symptoms with pantoprazole does not prevent existing stomach cancer.

Effects on the Heart

Patients aged more than 60 years and taking daily 30 mg of domperidone are at an increased risk. These patients may suffer from serious irregular heartbeat or sudden loss of heart function. Use the lowest effective dose of domperidone in adults and children. Take necessary precautions in patients using domperidone and other medicines which prolong heartbeat, and patients with electrolyte disturbances or having heart diseases such as heart failure.

Kidney Problem

Kidney problems are observed in patients taking proton pump inhibitor like pantoprazole. During any time of proton pump inhibitor therapy, kidney problems and an unknown allergic reaction may occur. If kidney problem occurs then stop taking pantoprazole.

Diarrhea

Patients taking proton pump inhibitor therapy such as pantoprazole and hospitalized patients are at an increased risk. Patients taking pantoprazole may experience an increased risk of bacteria (Clostridium difficile) associated diarrhea. Diagnosis should be carried out if diarrhea persists. Patients taking proton pump inhibitor therapy should use the lowest dose and shortest term of the treatment according to the condition.

Other Conditions

Patients taking domperidone continuously and experienced symptoms after taking the meal that persists for more than two weeks should talk with their doctor. Patients should consult their doctor if their nausea and vomiting persist for more than 48 hours. Domperidone should not be used for the treatment of motion sickness and in patients with existing heart diseases.

Interactions with Panflo DSR

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
This page does not contain all the possible interactions of Panflo DSR Tablet. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

CYP3A4 Inhibitors

Panflo DSR Tablet may interact with CYP3A4 inhibitors (ketoconazole, ritonavir, and erythromycin), which are used to treat HIV/AIDS, bacterial and viral infections. The blood level of domperidone may get increased when Panflo DSR is used with CYP3A4 inhibitors. Panflo DSR should not be used in combination with erythromycin, ketoconazole, or other CYP3A4 inhibitors.

Oral Drugs

There may be an interaction of Panflo DSR with oral drugs. Domperidone increases the contractions of smooth muscles of the stomach. It may impact on absorption of the drugs taken orally especially those which are enteric-coated or sustained-release formulations.

Hypoprolactinemic Agents

Panflo DSR Tablet interacts with Hypoprolactinemic agents, which are used to decrease blood level of prolactin. The use of domperidone with hypoprolactinemic agents may interfere in the blood levels of prolactin.

Anticholinergic Drugs

Special instructions need to be followed while taking this medicine along with Anticholinergic drugs, which are used to treat brain and non-brain related disorders. Treatment of indigestion by domperidone may get blocked while using with anticholinergic drugs.

Antimuscarinic Agents

Your doctor's guidelines may need to be followed while taking this medicine along with Antimuscarinic agents, which are used for the treatment of stomach and intestinal disorders. Use of opioid analgesics with antimuscarinic agents may oppose the effect of domperidone.

Antacids and Antisecretory Agents

Panflo DSR Tablet may interact with Antacids and antisecretory agents (sodium carbonate and cimetidine), which are used to treat acidity and reduce acid secretion in the stomach respectively. Antisecretory agents and antacids decrease the absorption of domperidone in the blood due to prior use of cimetidine or sodium carbonate.

Antiretroviral Therapy

There may be an interaction of Panflo DSR with Antiretroviral therapy, which is used to treat HIV infections. When nelfinavir or atazanavir is used with proton pump inhibitors, it may cause a decreased level of nelfinavir or atazanavir in the blood and also reduce their activity. Proton pump inhibitors should not be used in combination with nelfinavir or atazanavir.

Coumarin Anticoagulants

Panflo DSR Tablet interacts with Coumarin anticoagulants (warfarin), which are used to prevent blood clot formation. Patients taking proton pump inhibitors, including pantoprazole with warfarin may see an increase in the prothrombin time and international normalized ratio (INR). Increase in prothrombin time and INR may result in abnormal bleeding and can be fatal. Increases in INR and prothrombin time should be monitored in such patients.

Drugs that Affect Stomach pH

Special instructions need to be followed while taking this medicine along with Drugs that affect stomach pH. Use of pantoprazole may cause long-lasting blockage of stomach acid secretion. There are some drugs (for example, ampicillin esters, iron salts, erlotinib, mycophenolate mofetil (MMF) and ketoconazole) where stomach acid is essential for their absorption. Thus, pantoprazole may interfere with their absorption. Transplant patients taking mycophenolate mofetil (MMF) should use pantoprazole with caution.

Urine Test

Your doctor's guidelines may need to be followed while taking this medicine along with Urine test. Patients using proton pump inhibitor may have false-positive urine tests for tetrahydrocannabinol (THC). To verify positive results patients should consider an alternative confirmatory method.

Immunosuppressant

Panflo DSR Tablet may interact with Immunosuppressant such as methotrexate, which is used to treat cancer. When methotrexate and proton pump inhibitors are taken together, they may increase the amount of methotrexate and its metabolite hydroxymethotrexate in the blood.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Panflo DSR is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Panflo DSR Tablet .
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Duodenal Ulcer
Stomach Disorders
Nausea and Vomiting

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