INTRODUCTION

ULPAN D is a combination of Domperidone and Pantoprazole which belongs to the group of medicines called Prokinetic Drugs and Proton pump inhibitors respectively. It is used to treat peptic ulcers, gastroesophageal reflux disease (GERD) and reflux esophagitis.

Peptic ulcers are painful sores that develop on the linings of the stomach, esophagus or intestines. It causes severe stomach pain with sensation of flatulence, indigestion, vomiting and fatigue.

GERD is a chronic digestive disease in which the acid from the stomach frequently flows into the esophagus leading to irritation of lining of food pipe. Symptoms include heartburn, chest pain, nausea, sensation of lump in throat and stomach discomfort.

Reflux esophagitis can be defined as the inflammation of the food pipe accompanied with acid reflex.

ULPAN D acts by reducing the production of gastric acid. It also speeds up the movement of food from the stomach to the intestines, thereby reducing the signs of nausea, vomiting and acid reflux. Due to these actions, it can also reduce the unpleasant signs of GI tract such as nausea, vomiting, indigestion, burping, bloating, acidity or heartburn.

ULPAN D is suitable for use both in adults and in children (aged 12 years or above weighing 35 kg or more). It should be taken at least 15-30 minutes before meals. During treatment with ULPAN D your doctor will closely monitor your kidney functions, liver functions and blood magnesium levels to avoid the risk of unwanted side effects.

Before taking ULPAN D inform your doctor if you have any liver, kidney or heart problems. You must also inform your doctor if you have any blockage or tears in the gut or have weak bones.

ULPAN D is not recommended for use in patients having bleeding from the gut. Consult your doctor before taking ULPAN D if you are pregnant or breastfeeding. The most common side effects of taking ULPAN D are dryness of mouth, constipation and flatulence. Consult your doctor if any of these side effect bothers you.

You must also inform your doctor immediately if you experience any signs of low magnesium levels in blood (such as tiredness, abnormal muscle movements, dizziness, confusion, disorientation, irregular heartbeat).

USES OF ULPAN D

It is used in adults and in children (aged 12 years or older weighing 35 kg or more) to treat:

• Peptic ulcer
• Gastrointestinal Reflux disease (GERD)
• Reflux esophagitis (inflammation of the esophagus)
• Nausea and Vomiting
• Acidity, Heartburn
• Signs of indigestion (such as burping, bloating)

HOW ULPAN D WORKS

ULPAN D contains two medicines namely domperidone and pantoprazole. Domperidone is a prokinetic medicine with anti-emetic properties. It works by blocking the actions of a chemical messenger called dopamine in the gut and across the brain and spinal cord.

This action stimulates the gut, reduces acid reflux and speeds up the movements of food from the stomach into the intestines. It also blocks the transmission of nerve signals between the vomiting centers and brain which reduces the onset of nausea and vomiting.

Pantoprazole is a proton pump inhibitor. It reduces gastric acid secretion by the blocking the actions of a protein membrane called H+K+Atpase (proton pump) present in the lining of the stomach.

By reducing stomach acid production, ULPAN D it prevents the worsening of ulcers, heals the existing ulcers and esophageal lesions and provides relief from the unpleasant symptoms of GI tract (such as acidity, bloating, burping and indigestion).

DIRECTIONS FOR USE

Take ULPAN D 15-30 minutes before meals or as advised by your physician. Swallow the medicine with a glass of water. Do not crush or chew the medicine.

Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and disease condition. Do not stop taking ULPAN D unless your doctor advice you to stop.

SIDE EFFECTS OF ULPAN D

HOW TO MANAGE SIDE EFFECTS

Nausea or vomiting:

Try to take ULPAN D with or just after meals. Stick to simple meals and avoid oil rich or spicy foods. Consult your doctor if nausea worsens.

Headache:

Rest and relax. Keep yourself hydrated by drinking plenty of fluids such as water or electrolytes. Applying a pain-relieving balm on your forehead can be beneficial. Do not consume excessive alcohol, as it could aggravate your headache. Consult your doctor if your headache worsens.

Dizziness:

Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines completely while you are feeling dizzy. Do not consume excessive alcohol, as it could aggravate your dizziness. Consult your doctor if your dizziness worsens.

Constipation:

Taking ULPAN D with meals may reduce the chances of constipation. However, if you experience constipation, eat plenty of fiber rich foods such as fresh fruits, vegetables and cereals. Drink plenty of fluids. Exercise more regularly. Consult your doctor if this side effect bothers you.

WARNING & PRECAUTIONS

INTERACTIONS

A. Drug-Drug interactions:

Before taking ULPAN D inform your doctor if you are taking any of the following medicines such as:

• other medicines used to treat gastrointestinal problems (Ex. cisapride, dolasetron, prucalopride, diphemanil)
• medicines used to treat heart problems or hypertension (Ex. digoxin, apomorphine, disopyramide, hydroquinidine, quinidine, amiodarone, dofetilide, dronedarone, ibutilide, sotalol, diltiazem or verapamil)
• medicines used to treat HIV infection (Ex. atazanavir, nelfinavir, saquinavir)
• medicines used to treat fungal infections (such as ketoconazole, itraconazole, posaconazole)
• medicines used for blood thinning (Ex. warfarin and phenprocoumon)
• medicines used to treat hepatitis C (Ex. telaprevir)
• antipsychotics (used to treat mental illness) Ex. haloperidol, pimozide, sertindole
• antidepressants (used to treat depression) Ex. escitalopram or citalopram, fluvoxamine, St John’s wort
• antibiotics (used to treat bacterial infections) Ex. moxifloxacin, erythromycin, levofloxacin, clarithromycin, telithromycin or amoxicillin
• medicines used to treat malaria (Ex. halofantrine, lumefantrine)
• antihistamines (used to treat allergies) Ex. mizolastine, mequitazine
• medicines used to treat cancer (Ex. toremifene, vandetanib, vincamine, erlotinib, dasatinib, nilotinib)
• methotrexate (used to treat cancer and auto-immune disease)
• bepridil (used to treat hypertension)
• methadone (used to relieve pain)
• iron salts (used to treat iron deficiency anemia)
• tacrolimus or mycophenolate mofetil (used to prevent graft rejection)
• pentamidine (used to treat parasite infections)
• rifampicin (a medicine used to treat tuberculosis)

Overdosage:

If you or anyone else accidentally took more ULPAN D, contact your doctor immediately or go to a hospital straight away. Symptoms of overdosage might include sleepiness, confusion, uncontrollable body movements (including eye and tongue), twisted neck and abnormal body posture.

SYNOPSIS

MORE INFORMATION

• Keep ULPAN D out of the sight and reach of children
• Store ULPAN D at room temperature

FAQs ABOUT ULPAN D

What is ULPAN D used for?

ULPAN D is used to treat peptic ulcers, GERD and reflux esophagitis. It can also be used to treat nausea, vomiting, bloating, burping, acidity and heartburn.

How and when to take ULPAN D?

Take ULPAN D at least 15-30 minutes before meals. Swallow the medicine with a glass of water. Do not cursh or chew the medicine. Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and disease condition.

How long should I take ULPAN D?

You need to take ULPAN D for the stipulated duration prescribed by your doctor. Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body weight and disease condition.

What is the best time to take ULPAN D?

ULPAN D must be taken before meals to avoid gastrointestinal side effects.

What to do if I forgot to take a dose of ULPAN D?

If you forgot to take a dose of ULPAN D, take it as soon as you remember. However, if it is time for the next dose of ULPAN D, skip the missed dose and take the next one regularly. Do not take a double dose of ULPAN D to compensate the missed ones.

What are the most common side effects of taking ULPAN D?

The most common side effects of taking ULPAN D are dryness of mouth, constipation and flatulence. Consult your doctor if any of these side effect bothers you.

Can I stop taking ULPAN D without consulting your doctor?

No. You should not stop taking ULPAN D without consulting your doctor because it may lead to reversal of symptoms. If you feel better after using ULPAN D, consult your doctor for advice.

Will taking a higher dose of ULPAN D be more effective?

No, taking a higher dose of ULPAN D will not be effective rather it can lead to toxicity. Always take the dose prescribed by your doctor. If the prescribed dose is not effective for you, consult your doctor for advice. Your doctor might increase the dose or suggest an alternative therapy.

What precautions do I need to follow while taking ULPAN D?

Make sure to take ULPAN D 30 minutes before meals. Before taking ULPAN D inform your doctor if you have any liver, kidney or heart problems. You must also inform your doctor if you have any blockage or tears in the gut or have weak bones. Consult your doctor before taking ULPAN D if you are pregnant or breastfeeding. Regularly visit your doctor and take all the blood tests recommended by your doctor without fail.

Can I take medication for high blood pressure along with ULPAN D?

It is not advisable to take medicines to control blood pressure while taking ULPAN D without consulting your doctor as they have known interactions with ULPAN D.

Can ULPAN D be used in pregnant women?

ULPAN D should be used in pregnant women only if it is considered necessary by the physician. Therefore, consult your doctor before taking it.

How to take ULPAN D?

You must take ULPAN D as advised by your physician. Try to take ULPAN D 30 minutes before and swallow it with a glass of water. Do not crush or chew the medicine.

How much ULPAN D should I take?

ULPAN D should be used only under medical supervision. Your doctor will decide the correct dose and duration of therapy for you depending upon your age, body condition and severity of the disease condition.

Can ULPAN D cause constipation?

Yes. Constipation is a common side effect of using ULPAN D. Eat plenty of fiber rich foods such as fresh fruits, vegetables, cereals as well as drink plenty of water and exercise more regularly when taking this medicine. Contact your doctor if this side effect bothers you.

Can ULPAN D cause dry mouth?

Yes. Dry mouth is a common side effect of using ULPAN D. Contact your doctor if this side effect bothers you.

REFERENCES

1. KD. Tripathi. Antiemetic, Prokinetic and Digestant drugs & Drugs for Peptic Ulcer and Gastroesophageal Reflux Disease. Essentials of medical pharmacology. Seventh edition. 2013. Page – 666 & 653.

2. Nur Fathurah Zamani, Afifah Sjamun Sjahid, Tuan Hairulnizam Tuan Kamauzaman, Yeong Yeh Lee and Md Asiful Islam. Efficacy and Safety of Domperidone in Combination with Proton Pump Inhibitors in Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Journal of Clinical Medicine. August 2022. [Accessed on 21st October 2022]. https://www.mdpi.com/2077-0383/11/18/5268/htm

3. Cipla Ltd. NEW PANTOSEC D SR Capsules (Pantoprazole Gastro-resistant + Domperidone Prolonged Release Capsules IP). Ciplamed.com. [Revised in April 2020]. [Accessed on 21st October 2022]. https://www.ciplamed.com/content/new-pantosec-d-sr-capsules

4. Panacea Biotec Limited. OD-PEP-D CAPSULES. [Revised in July 2019]. [Accessed on 21st October 2022]. https://media.panaceabiotec.com/documents/2019/7/27/ProductMonograph-OP-PEP-D.pdf

5. Milpharm Limited. Electronic Medicines Compendium (EMC). [Revised in March 2021]. [Accessed on 21st October 2022]. https://www.medicines.org.uk/emc/files/pil.556.pdf

6. Takeda GmbH. Electronic Medicines Compendium (EMC). [Revised in April 2022]. [Accessed on 21st October 2022]. https://www.medicines.org.uk/emc/files/pil.483.pdf

7. Milpharm Limited. Electronic Medicines Compendium (EMC). [Revised in November 2021]. [Accessed on 21st October 2022]. https://www.medicines.org.uk/emc/files/pil.7090.pdf

8. Leeford Healthcare Ltd. Pantafol-D. [Accessed on 21st October 2022]. https://www.leeford.in/product/775/pantafol-d

9. Hetero Healthcare Ltd. Pantin RD Tablet. [Accessed on 21st October 2022]. https://www.heterohealthcare.com/pantin-rd-tablet

10. Central Drugs Standard Control Organization. Pantoprazole+Domperidone SR. [Revised in December 2004]. [Accessed on 21st October 2022]. https://cdscoonline.gov.in/CDSCO/Drugs