Pantocid Dsr

📦 Každá objednávka je pokryta naší Zárukou opětovného odeslání — pokud vaše zásilka nedorazí do 20 pracovních dnů, přeposíláme ji.

Proč objednávat z MedsBase

Naše generické léky pocházejí od výrobců certifikovaných WHO-GMP a jsou expedovány po celém světě v diskrétním, nenápadném balení – na vnější straně balíku není uveden název léku. Platby kartou jsou směrovány prostřednictvím regulovaného procesoru (popisky na výpisu zahrnují regulovaného procesora plateb kartou – nikdy “MedsBase” nebo název léku). Přijímáme také kryptoměny a bankovní převody SEPA. Každá objednávka je zajištěna naší politikou přeposlání.

What Pantocid DSR Is

Pantocid DSR is a Sun Pharma fixed-dose combination capsule containing 40 mg of pantoprazole (a proton-pump inhibitor, in delayed-release pellet form) and 30 mg of domperidone (a peripheral dopamine D₂ antagonist, in sustained-release pellet form). The “DSR” in the brand name reflects the modified-release technology used to deliver both components from one capsule.

How Pantocid DSR Works

Pantoprazol irreversibly inhibits the H⁺/K⁺-ATPase proton pump in stomach parietal cells, reducing acid secretion for 24–72 hours per dose. Domperidone antagonises peripheral D₂ receptors in the upper gastrointestinal tract, which increases lower-oesophageal-sphincter tone, accelerates gastric emptying, and reduces post-prandial regurgitation. Domperidone does not cross the blood-brain barrier well, so it lacks the central extrapyramidal side effects of metoclopramide. The two mechanisms are complementary: pantoprazole reduces the volume and acidity of refluxed material; domperidone reduces how much material refluxes in the first place.

Indications — When Pantocid DSR Is Useful

1. GERD with prominent regurgitation or post-prandial fullness

Where heartburn is well controlled by a PPI but regurgitation, water-brash, or feeling of food sitting on the chest persists, a prokinetic adds clinical benefit. Pantocid DSR addresses both problems with one capsule.

2. Gastroparesis

Diabetic gastroparesis (long-standing type 1 or type 2 diabetes), post-surgical gastroparesis (after vagotomy or fundoplication), and opioid-induced gastroparesis. Domperidone is one of the few prokinetics with reasonable evidence in gastroparesis, though most authorities now advocate the lower 10 mg three-times-daily dose limited to 7 days at a time.

3. Functional dyspepsia — post-prandial distress subtype

For patients whose dominant symptom is early satiety, post-prandial fullness, or bloating, a PPI alone often gives an incomplete response. Adding a prokinetic improves the response in this subgroup.

Dávkování

Swallow the capsule whole — do not break, crush or chew. The pellet technology depends on intact capsule architecture for delayed and sustained release. Take 30–60 minutes before breakfast.

Vedlejší účinky

From the pantoprazole component (1–10%): headache, diarrhoea, nausea, abdominal pain, mild rash. Long-term: B₁₂ deficiency, magnesium deficiency, fracture, fundic gland polyps.

From the domperidone component:

• Hyperprolactinaemia — raised serum prolactin, causing menstrual disturbance, breast tenderness, galactorrhoea (milk discharge), and rarely gynaecomastia in men. Usually reversible on stopping.
• Dry mouth, headache, abdominal cramps
• QT-interval prolongation — dose-related, more common in older patients and those with electrolyte disturbance
• Rare ventricular arrhythmia and sudden cardiac death (the basis of the EMA restriction)
• Rare extrapyramidal effects (despite limited blood-brain barrier penetration, occasional cases reported)

Interakce s léčivy

Kontraindikace

• Known hypersensitivity to pantoprazole or domperidone
• Significant cardiac disease — long-QT syndrome, recent myocardial infarction, decompensated heart failure
• Hypokalaemia, hypomagnesaemia (correct first)
• Concurrent strong CYP3A4 inhibitor (azole antifungal, macrolide antibiotic, certain HIV antivirals)
• Concurrent QT-prolonging drug (Class I/III antiarrhythmic, methadone, citalopram > 20 mg, haloperidol)
• Těžké jaterní poškození
• Bowel obstruction, perforation, or active GI haemorrhage (prokinetic contraindicated)
• Prolactinoma (relative)

Pregnancy, Breastfeeding, and Children

Pregnancy: Avoid during pregnancy unless benefits clearly outweigh risks. Plain pantoprazole or omeprazole is preferred where PPI is needed in pregnancy.

Breastfeeding: Domperidone passes into breast milk in small amounts; avoid in breastfeeding mothers, particularly because of the QT signal. Domperidone has historically been used off-label as a galactagogue in some markets, but this practice is now discouraged because of cardiac safety concerns.

Děti: Avoid in children < 12 years and in children < 35 kg — weight-based dosing exists but the EMA restricted paediatric domperidone after the QT signal emerged.

Skladování

Store at 15–30 °C in the original blister, protected from moisture. Keep out of reach of children. Do not use beyond expiry date.

Často kladené dotazy

When is Pantocid DSR better than a plain PPI?

When motility is the dominant problem — post-prandial fullness, regurgitation, or bloating that persists despite acid control with a PPI alone — the prokinetic component of Pantocid DSR adds value. For straightforward GERD or peptic ulcer disease where heartburn is the main symptom and there is no significant motility issue, a plain PPI (Pantodac, Pan, Omez) is safer and equally effective.

Why was domperidone restricted by the EMA?

A 2014 EMA review of cardiac safety data concluded that domperidone has a small but real signal for QT prolongation, ventricular arrhythmia and sudden cardiac death, particularly at higher doses, in older patients, in cardiac disease, in electrolyte disturbance, and with concurrent QT-prolonging drugs. The EMA restricted domperidone to a maximum of 10 mg three times daily for up to 7 days for nausea/vomiting. Pantocid DSR contains 30 mg sustained-release domperidone — this exceeds the EMA dose cap and should not be used long-term.

Can it cause breast discharge?

Yes — domperidone raises prolactin, which can cause breast tenderness, milk discharge (galactorrhoea), and menstrual disturbance in women, and very rarely gynaecomastia in men. The effect usually reverses within weeks of stopping. If it occurs, switch to plain PPI.

Should I have an ECG before starting?

If you are aged > 60, have known cardiac disease, take any QT-prolonging drug, have low potassium or magnesium, or have a family history of unexplained sudden cardiac death, an ECG before starting is reasonable. The QT interval (QTc) should be < 450 ms in men and < 470 ms in women before starting domperidone.

How long should I take Pantocid DSR?

The EMA-recommended limit on domperidone is 7 days for nausea/vomiting. For motility-driven GERD or gastroparesis, 4 weeks is a reasonable initial course, with reassessment of need afterwards. Long-term continuous use is not recommended — if symptoms persist beyond 4–8 weeks, step down to a plain PPI and reassess for an alternative diagnosis (eosinophilic oesophagitis, cardiac chest pain, achalasia).

Can I drink alcohol with it?

No direct dangerous interaction with alcohol, but alcohol relaxes the lower oesophageal sphincter and worsens reflux. If reflux is the indication, cutting back on alcohol substantially improves the response.

Can I take it with antibiotics?

Avoid combination with macrolide antibiotics (erythromycin, clarithromycin) and azole antifungals (ketoconazole, itraconazole) — they raise domperidone levels and QT risk. Azithromycin is the safer macrolide choice; amoxicillin and tetracyclines are unaffected.

Is Pantocid DSR safe for diabetic gastroparesis?

Domperidone is one of the few prokinetics with reasonable evidence in diabetic gastroparesis, but specialist gastroenterology supervision is appropriate. Monitor blood glucose because gastroparesis itself causes erratic post-prandial glucose readings. ECG screening before starting is reasonable.

Can I switch to a plain PPI?

Yes — if motility symptoms (regurgitation, fullness, bloating) are not bothersome, switch to plain pantoprazole 40 mg (Pantodac) once daily. The acid-suppression component is unchanged. This is the safer long-term strategy.

Will it interact with my Parkinson’s medication?

Yes — domperidone is a dopamine D₂ antagonist, the same mechanism that levodopa and dopamine agonists work against. Pantocid DSR will antagonise Parkinson’s therapy. Switch to a plain PPI if you have Parkinson’s disease.

Other Acid Reflux Medications at MedsBase

• Pantodac — pantoprazole 40 mg — standard once-daily PPI; minimal CYP impact
• Esoprol — esomeprazole 20/40 mg — S-isomer of omeprazole; ~30% AUC advantage with less inter-individual variability
• Razo — rabeprazole 10/20 mg — quicker pH rise on day 1; less CYP-dependent
• Omez — omeprazole 10/40 mg — broad strength range; lower 10 mg dose useful for step-down
• Famocid — famotidine 20/40 mg — H2 antagonist; the safe modern substitute for ranitidine; useful for nocturnal acid breakthrough

More options in Anti Emetic

Řazeno podle nedávného objemu objednávek na MedsBase — co si ostatní zákazníci v této kategorii vybírají.

Doxinate

US$11.00 – US$117.00Cenové rozpětí: US$11.00 až US$117.00

Emeset

US$14.00 – US$152.00Cenové rozpětí: US$14.00 až US$152.00