Pan-D Capsule - Uses, Side Effects, Composition, Dosage & Price

Manufactured by: Alkem Laboratories Limited, Mumbai, India.

Pan-D composition: Each Pan-D capsule 15'S (15 capsules per strip) contains 30 mg of domperidone and 40 mg of pantoprazole.

Overview

Pan-D is composed of two medicines, pantoprazole and domperidone, and the combination of these is used to treat gastrointestinal tract disorders (GIT). This drug combination has anti-inflammatory (reduces swelling), anti-reflux, anti-ulcer, and antiemetics (relieves vomiting) properties.

• Pantoprazole is a proton pump inhibitor (PPI) which helps in reducing the gastric acid secretion and thereby relieves from the symptom of heartburn.
• Domperidone belongs to dopamine antagonists, which act as a D2 receptor. This is an antiemetic used to treat dyspepsia, epigastric pain, nausea and vomiting.
• Domperidone, a peripheral-specific antagonist of the dopamine D2 receptor, is an antiemetic (relieves vomiting) gastrokinetic agent with galactagogue properties.
• This domperidone drug binds to D2R, expressed by peripheral neurons, which inhibits dopamine binding and D2R-mediated signalling.
• Inhibition of peripheral D2R signalling prevents or relieves various gastrointestinal (GIT) symptoms, such as nausea and vomiting, and may help relieve reflux and a variety of other upper gastrointestinal disorder-related symptoms. 
• It was released in the United States as early as 1989 for pharmaceutical purposes.

Pan-D Price

Maximum retail price as per year 2024: ₹231.00 for one strip (15 capsules in each strip). Pan-D capsule is available at mostly each and every pharmacy.

Pan-D uses

Pan-D is one of the most prescribed adjuvant medicines, often with drugs related to other disorders or as a monotherapy to treat gastrointestinal disorders. Pan-D capsule uses include the following: 

• Pan-D is used for treating acid reflux, heartburn, and other digestive disorders such as peptic ulcer disease, gastroesophageal reflux disease (GERD) and Zollinger-Ellison syndrome. 
• Pantoprazole is a proton pump inhibitor (PPI) that helps to reduce the gastric acid secretion and reduces the heartburn.
• Domperidone is an antiemetic drug that helps to relieve the sensation of nausea or episodes of vomiting, dyspepsia, and epigastric pain.

Guidelines to follow while taking the Pan-D Capsule

Pan-D Capsule is taken on an empty stomach 30 minutes before breakfast. 

• It is recommended that this medicine be taken as prescribed by the general physician, within the prescribed strength of the drug formulation.
• In general, Pan-D is not recommended for children younger than five years.
• In case of missed or forgotten doses, the patient is advised not to increase the standard prescribed dose to match up the missed dose, as this might lead to drug overdosage. The patient can have the next dose per stipulated time intervals, and the dose should not be doubled.
  

Pan-D Mechanism of action

The proton pump inhibitor is responsible for stomach acid secretion. This class of drugs binds to the H+ pump in the stomach and blocks acid secretion. Domperidone prevents acid reflux by increasing intestinal motility.

• Pantoprazole irreversibly inhibits the H+ or K+ ATP pumps by increasing the rate of pantoprazole degradation inversely to the environmental pH. 
• Pantoprazole medication becomes therapeutically active in the stomach, where the H+or K+ ATP pumps are located (especially within the parietal cells of the stomach lining). The gastric acidic secretion is controlled by binding the pantoprazole with the H+/K+ ATP pumps.
• Domperidone is an antiemetic used to treat dyspepsia, epigastric pain, nausea, and vomiting. It acts as a gastrointestinal emptying adjunct and peristaltic stimulant. The gastroprokinetic properties of domperidone are associated to its peripheral dopamine receptor-blocking properties.
  

Pan-D Side Effects

This proton pump inhibitor and antiemetic drug combination generally don't cause any potential side effects. Nonetheless, some of the common side effects of Pan-D one can notice while using it are as mentioned below:

• Headache 
• Stomach pain (abdominal pain)
• Facial edema (swelling in the face)
• Generalized edema 
• Diarrhoea (loose, watery stools)
• Constipation (hard-to-pass stools)
• Pruritus (itching)
• Rash (red spots)
• Hyperglycaemia (high blood glucose) 

Though very rare, some severe side effects of Pan-D could be caused by medication Non-Compliance. In most cases, this could mainly be due to medication non-compliance. Some of the severe Pan-D capsule side effects are given below:

• Atrophic gastritis (chronic inflammation and thinning of your stomach lining)
• Hepatocellular damage (liver damage)
• Interstitial nephritis (inflammation in the spaces between the kidney tubules)
• Pancreatitis (swelling of the pancreas)
• Pancytopenia (low levels of blood cells)
• Rhabdomyolysis (breakdown of muscle tissue)
• Anaphylaxis (allergic reaction)
• Stevens-Johnson syndrome (skin and mucous membrane disorder)
• Epidermal necrolysis (Peeling and blistering of the skin)
• Erythema multiforme (rashes with red spots over skin)
• Extrapyramidal effect (involuntary movements)
• Hyperprolactinemia (greater levels of prolactin in the blood) 

NOTE: If any of the above symptoms were seen, immediately contact the concerned doctor or a physician.

Pan-D Dosage

Pan-D Capsule dosage is prescribed by the general physicians or gastroenterologists based on the patient’s age, weight, and disease symptoms.

Pan-D Dosage for adults

Pan-D is available as a combination of 40 mg of pantoprazole and 30 mg of domperidone in each capsule. However, the dosage of pan D varies based on the patient's clinical conditions. 

Pan-D Dosage for children

• Pan-D is not recommended for children younger than five year. However, the individualized dose of Pan-D for gastrointestinal problems and stomach discomforts in children above five year is based on the child's weight.
• In most cases, the physician would recommend 20 mg as a pediatric dose. 
• Under medical supervision, the Pan-D capsule is taken on an empty stomach half an hour before breakfast for an average of 5–7 days.
  

Pan-D in pregnancy 

Due to pantoprazole substance in Pan-D capsule, it is generally not recommended for use during pregnancy, domperidone may be considered in certain cases. Domperidone is typically prescribed to treat nausea and vomiting in pregnant women only when other antiemetic medications prove ineffective. It's important to consult with a doctor to determine the most appropriate treatment based on individual circumstances.

Pan-D during breastfeeding

• Pantoprazole passes into breast milk in a negligible amount. Even if some does transfer, it is likely degraded in the infant's gastrointestinal tract, minimizing any potential risks. Therefore, Pan-D can be prescribed to breastfeeding mothers when deemed necessary by doctors.
• Domperidone is almost similar to pantoprazole in the case of breastfeeding women, where it gets passed to breast milk in minimal concentration, which does not carry any kind of side effects in the baby. Hence, it is considered safe in lactating women.
• Pan-D capsules, containing domperidone, can be used to help increase breast milk supply in some lactating women. Domperidone works by stimulating the release of prolactin, a hormone that promotes milk production.

Pan-D drug interactions with foods, drugs and diseases 

A drug interaction is a reaction between two or more drugs, whereas it is called a food interaction if the interaction is between the food and the drug. In case of an interaction between a medical illness and a drug, it would be called a disease-drug interaction. 

• Food interactions: It is recommended to avoid spicy and fatty foods, caffeinated drinks such as tea and coffee, soft drinks like cola, and alcoholic beverages . 
• Drug interactions: If a person is on medications such as clopidogrel, antipyrine, carbamazepine, cisapride, diazepam, diclofenac, digoxin, ethanol, glyburide, levonorgestrel / ethinyl estradiol (an oral contraceptive), metoprolol, nifedipine, phenytoin, theophylline, or warfarin, the use of Pan -D should be under close medical monitoring as there could be a possibility of sub-therapeutic efficacy or therapeutic failure of either drug. 
• Disease interactions: A person with liver disease, bone fractures, vitamin B12 deficiency, anaemia, and low magnesium (hypomagnesemia) conditions should use the medication under the supervision of a doctor.

Pan-D Storage

• Pan-D should be stored away from moisture at room temperature, not exceeding 25 centigrade. The medicine need to be kept in a safe place and out of children’s reach. The Pan-D capsule should not be chewed or crushed, but to be swallowed.
• Direct exposure to heat, air and light may damage the medication's shelf life.