DEWPAN

*Helicobacter pylori eradication:* Adult: 40 mg twice daily, in combination with amoxicillin and clarithromycin; or in combination with clarithromycin and metronidazole. *Benign gastric ulcer:* ORAL: Adult: 40 mg daily for 8 weeks; increased if necessary up to 80 mg daily, dose increased in severe cases BY IV INJ, OR BY IV INF: Adult: 40 mg daily until oral administration can be resumed, injection to be given over at least 2 minutes *Benign Duodenal ulcer:* ORAL: Adult: 40 mg daily for 4 weeks; increased if necessary up to 80 mg daily, dose increased in severe cases BY IV INJ, OR BY IV INF: Adult: 40 mg daily until oral administration can be resumed, injection to be given over at least 2 minutes *Prophylaxis of NSAID-associated gastric ulcer and duodenal ulcer with continued NSAID treatment:* Adult: 20 mg daily *Gastro-oesophageal reflux disease:* ORAL: Adult: 20-80 mg daily for 4 weeks, continued for further 4 weeks if not fully healed, dose to be taken in the morning; maintenance 20 mg daily and increased to 40 mg daily, increased only if symptoms return BY IV INJ, OR BY IV INF: Adult: 40 mg daily until oral administration can be resumed, injection to be given over at least 2 minutes *Zollinger-Ellison syndrome (and other hypersecretory conditions):* ORAL: Adult: Initially 80 mg daily (max. per dose 80 mg), adjusted according to response. Elderly: 40 mg daily BY IV INJ, OR BY IV INF: Adult: Initially 80 mg, alternatively 160 mg in 2 divided doses, if rapid acid control required, then 80 mg once daily (max. per dose 80 mg), adjusted according to response *Recurring symptoms in healed reflux disease:* Adult: 20 mg once daily when required. *Triple therapy against H. Pylori:* Adult: 40 mg twice daily with either clarithromycin 250 mg and metronidazole 400 mg both twice daily for one week or clarithromycin 500 mg and amoxicillin 1 gm both twice daily for one week. Children: Not recommended.

IV: Infuse over 15 min at a rate not to exceed 3 mg/min. Use in-line filter. Flush IV line with D5W, NS, or lactated Ringers injection before and after giving drug. Reconstitute each 40 mg vial with 10 ml 0.9% NaCI and dilute with 100 ml infusion fluid, give 40 mg over 15 min. Use within 12 hrs.

Renal and hepatic impairment. Exclude malignancy before and during treatment. Monitor liver enzyme, discontinue if elevated.

Drugs whose absorption is pH dependent e.g. Ketoconazole, Anticoagulants.

Hyperlipidaemia, weight changes, Constipation, Nausea, headache, diarrhoea, skin rashes