Pannex-D 20mg/40mg Capsule SR is composed of two medicines, Domperidone and Pantoprazole. Domperidone is a prokinetic and anti-nausea agent that helps to treat indigestion and stomach pain. On the other hand, Pantoprazole is a proton pump inhibitor that reduces excess stomach acid formation by blocking the actions of an enzyme (H+/K+ ATPase or gastric proton pump). Pannex-D 20mg/40mg Capsule SR is a widely used medicine to treat peptic ulcers and gastroesophageal reflux disease (GERD). Pannex-D 20mg/40mg Capsule SR prevents the release of stomach acid and relieves symptoms of food pipe lining inflammation (esophagitis), and gastroesophageal reflux disease (GERD), or heartburn.

Domperidone works by increasing the movement of food through the stomach and the digestive tract more quickly and, in this way, reduces the feeling of bloating, fullness and indigestion. On the other hand, it effectively blocks the action of a vomiting centre (chemoreceptor trigger zone - CTZ) located in your brain, which is responsible for inducing the feeling of nausea and vomiting. Pantoprazole helps in reducing the stomach acid by blocking the actions of an enzyme (H+/K+ ATPase or gastric proton pump). This proton pump lies in the cells of the stomach wall and is responsible for the release of gastric acid secretion, damaging tissues in the food pipe, stomach, and duodenum.

It should be taken as prescribed by the doctor. Like all medicines, Pannex-D 20mg/40mg Capsule SR may cause side effects, although not everybody gets them. The most common side effects of Pannex-D 20mg/40mg Capsule SR are diarrhoea, stomach pain, flatulence (gas), dryness in the mouth, dizziness, and headache. Everyone doesn't need to experience the above side effects. In case of any discomfort, speak with your doctor.

It is recommended not to use it if you are allergic to any of its ingredients. Prolonged intake of Pantoprazole is associated with a low level of Vitamin B12 and low magnesium. Hence, a yearly test of Vitamin B12 and magnesium is required if you are taking Pannex-D 20mg/40mg Capsule SR for the long term. Use of Pannex-D 20mg/40mg Capsule SR is contraindicated in people with lupus (autoimmune inflammatory disease). Try to avoid caffeine-containing beverages (coffee, tea), spicy/deep-fried/processed foods, carbonated drinks, and acidic foods like citrus fruits/vegetables (tomatoes).

Pannex-D 20mg/40mg Capsule SR plays a vital role in preventing nausea, vomiting, stomach upset, stomach pain, peptic ulcer, and other conditions due to hyperacidity or acid reflux. Pantoprazole prevents the proton pump gate from producing an excessive amount of stomach acid. While Domperidone stops nausea (feeling sick) and vomiting (being sick), it blocks messages between parts of your brain called the chemoreceptor trigger zone (CTZ) and the vomiting centre.

• Headache
• Diarrhoea
• Nausea
• Abdominal pain
• Vomiting
• Flatulence
• Dizziness
• Arthralgia (joint pain)

You should avoid taking Pannex-D 20mg/40mg Capsule SR if you are allergic to Pannex-D 20mg/40mg Capsule SR or proton pump inhibitors, have gastric cancer, liver disease, low magnesium level (osteoporosis), low vitamin B12, pregnant or planning for pregnancy, and breastfeeding mothers. Pannex-D 20mg/40mg Capsule SR may interact with a blood thinner (warfarin), antifungal (ketoconazole), anti-HIV drug (atazanavir, nelfinavir), iron supplements, ampicillin antibiotic, anti-cancer drug (methotrexate). Let your doctor know if you are taking these medicines. Prolonged intake of Pannex-D 20mg/40mg Capsule SR may cause lupus erythematosus (an inflammatory condition in which the immune system attacks its own tissues), Vitamin B12, and magnesium deficiency. Intake of Pannex-D 20mg/40mg Capsule SR may mask the symptoms of gastric cancer, so if you have any severe stomach pain or gastric bleeding (blood in mucous or stool), immediately consult the doctor.

Drug-Drug Interactions: Pannex-D 20mg/40mg Capsule SR may interact with a blood thinner (e.g. clopidogrel, warfarin), antifungal (e.g. ketoconazole, voriconazole, itraconazole, posaconazole), anti-HIV drug (e.g. atazanavir, nelfinavir), iron supplements, antibiotic (e.g. ampicillin, rifampicin), heart medicine (e.g. digoxin) and anti-cancer drug (e.g. methotrexate). Let your doctor know if you are taking these medicines.

Drug-Food Interactions: Pannex-D 20mg/40mg Capsule SR interacts with St John's wort plant that is used as an anti-depressant. This plant may affect the working of Pannex-D 20mg/40mg Capsule SR. So avoid its intake with Pannex-D 20mg/40mg Capsule SR.

Drug-Disease Interactions: Pannex-D 20mg/40mg Capsule SR should not be given in patients with C. difficile-induced colitis, liver disease, bone fractures, low Vitamin B12 (anaemia), and low magnesium (hypomagnesemia).

• CLOPIDOGREL
• WARFARIN
• KETOCONAZOLE
• VORICONAZOLE
• ITRACONAZOLE
• POSACONAZOLE
• ATAZANAVIR
• NELFINAVIR
• AMPICILLIN
• RIFAMPICIN
• DIGOXIN
• METHOTREXATE

• Avoid intake of acid or heartburn-triggering foods or drinks like onions, peppermint, chocolate, caffeinated beverages, citrus fruits or juices, tomatoes and high-fat and spicy foods.
• Before going to sleep, try to raise your bedhead so that your head and chest are higher than your feet. Do not use piles of pillows; one raised block is fine. This will not allow the stomach acid to backflow through your food pipe.
• Avoid taking alcohol and smoking cigarettes. Alcohol can raise the level of production of stomach acid leading to heartburn and acid reflux. On the other hand, nicotine smoking damages the valve (sphincter), which prevents the backflow of the stomach acid back into the food pipe.
• Include high fibre-containing foods, berries, cherries, leafy green veggies (kale, spinach) and black peppers in your meal. These foods are full of antioxidants, calcium and vitamin B 12 that can help cope with the long-term effects of the medicine. Fermented dairy products like miso, sauerkraut, and kimchi contain probiotics which help prevent excess stomach acid production. Cranberry juice can be beneficial for peptic ulcers and H Pyroli infection.
• Avoid regular sitting continuously, as it can increase stomach acid production. Take a break of 5 minutes in 1 hour by brisk walking or stretching.

Acidity: Normally a thick layer of mucous protects the stomach against its own acid secretion. But, in the long run, it gets eroded by excessive stomach acid production, leading to complications like GERD, peptic ulcer, and Zollinger-Ellison syndrome. Gastroesophageal reflux disease (GERD) is a gastrointestinal disorder that occurs when stomach acid frequently flows back into the food pipe (oesophagus). This backflow (acid reflux) irritates the food pipe and causes heartburn. On the other hand, a peptic ulcer is a painful condition followed by the development of sores or ulcers in the stomach lining or duodenum (the first part of the small intestine). Zollinger-Ellison syndrome is a rare condition in which a gastrin-secreting tumour of the pancreas causes excessive acid production, leading to peptic ulcers.