8. Cautions with other medicines
Some medicines can interfere with Topan and make you more likely to have side effects.
Tell your doctor if you're taking these medicines before you start Topan treatment:
- digoxin (a heart medicine)
- antifungal medicines such as itraconazole, ketoconazole, posaconazole and voriconazole
- methotrexate (a medicine used to treat cancer, psoriasis and rheumatoid arthritis)
- HIV medicines
- rifampicin (an antibiotic)
- blood-thinning medicines, such as clopidogrel and warfarin
For erosive esophagitis, doctors can prescribe tablets or oral suspension Topan.
Adults can take 20 mg or 40 mg daily depending on the severity of the condition. Doctors will typically prescribe Topan for 8 weeks.
If the drug is not effective after 8 weeks, a person can, in some cases, continue taking the lowest effective dosage for another 8 weeks.
Topan and Magnesium
Low magnesium levels can also occur in people on Topan for at least three months.
Tell your doctor if you have ever had low magnesium in your blood or if you have ever tested positive for the bacteria H. pylori.
Low magnesium levels can result in serious adverse events such as:
- Muscle spasms
- Irregular heartbeat
If you have low magnesium levels while using Topan, your doctor may advise you to take a magnesium supplement or discontinue treatment.
Where can I get more information (Protonix, Protonix IV)?
Your pharmacist can provide more information about Topan.
What to do about:
- headaches - make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches usually go away after the first week of taking Topan. Talk to your doctor if they last longer than a week or are severe.
- diarrhoea - drink plenty of water by having small, frequent sips to avoid dehydration. Signs of dehydration include peeing less than usual or having strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.
- feeling sick or being sick (nausea or vomiting) - stick to simple meals and do not eat rich or spicy food. If you're vomiting, try small frequent sips of water. Do not take any other medicines to treat vomiting without speaking to a pharmacist or doctor.
- constipation - get more fibre into your diet such as fresh fruit and vegetables and cereals, and drink plenty of water. Try to exercise, for example, by going for a daily walk or run. If this doesn't help, talk to your pharmacist or doctor.
- stomach pain or wind - steer clear of foods that cause wind, such as lentils, beans and onions. It might also help to eat smaller and more frequent meals, eat and drink slowly, and exercise regularly. Some pharmacy remedies, such as simethicone, may relieve the symptoms of wind.
Topan, brand name Protonix, is a drug that belongs to the class of drugs called proton pump inhibitors (PPIs). Protonix is used for the treatment of GERD (gastroesophageal reflux disease), stomach (peptic) and duodenum ulcers, and Zollinger-Ellison syndrome. Side effects of Protonix include phototoxicity (sensitivity to light) dizziness, rash, nausea, vomiting, diarrhea constipation, headaches, stomach pain, gas, dizziness, and joint pain. Serious side effects of Protonix are live damage, rhabdomyolysis (muscle breakdown), pancreatitis, and reduces levels of blood cells. Adverse effects and risks of Protonix used in high doses and long-term (one year or longer) include osteoporosis, C. diff infection, low levels of magnesium, and heart attacks.
Some people taking warfarin with Topan can experience increases in INR and prothrombin time (PT). This can lead to an increased risk of severe bleeding. If you take these drugs together, your doctor should monitor you for increases in INR and PT.
Clinical Trials Experience
The adverse reaction profiles for PROTONIX (Topan sodium) For Delayed-Release Oral Suspension and PROTONIX (Topan sodium) Delayed-Release Tablets are similar.
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in clinical practice.
Before taking Topan, tell your doctor and pharmacist about all medications you are taking (including vitamins and herbal supplements).
Topan shouldn't be taken with atazanavir (Reyataz) or nelfinavir (Viracept), which are medications used to treat HIV and AIDS.
Other drugs that may interact with Topan include:
- Ampicillin (Omnipen, Principen, Amcill)
- Warfarin (Coumadin, Jantoven)
- Digoxin (Lanoxin, Lanoxicaps)
- Diuretics (water pills)
- Antifungals such as ketoconazole (Nizoral), itraconazole (Sporanox), and voriconazole (Vfend)
- Iron supplements/ferrous sulfate (Feosol, Mol-Iron, Fergon, Femiron)
- Methotrexate (Trexall)
- Delavirdine (Rescriptor)
Unless otherwise instructed, you can continue a normal diet and normal activities while taking Topan.
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PROTONIX (Topan sodium) Delayed-Release Tablets
PROTONIX (Topan sodium) for Delayed-Release Oral Suspension
How much will I take?
Each tablet contains 20mg or 40mg of Topan. You can buy Topan 20mg tablets from pharmacies. These are suitable for the short-term treatment of heartburn and acid reflux in adults.
Liquid Topan can be prescribed for people who cannot swallow tablets. It will come with a syringe or spoon to help you take the right amount. If you don't have a syringe or spoon, ask your pharmacist for one.
The usual dose to treat:
- heartburn and acid reflux is 20mg a day
- gastro-oesophageal reflux disease is 20mg to 40mg a day
- stomach ulcers is 20mg to 40mg a day
- Zollinger-Ellison syndrome is 40mg to 80mg a day - this can increase to 160mg a day depending on how well it works for you
COMMON BRAND(S): Protonix
GENERIC NAME(S): Topan
OTHER NAME(S): Topan Tablet, Delayed Release (Enteric Coated)
Topan is used to treat certain stomach and esophagus problems (such as acid reflux). It works by decreasing the amount of acid your stomach makes. This medication relieves symptoms such as heartburn, difficulty swallowing, and persistent cough. It helps heal acid damage to the stomach and esophagus, helps prevent ulcers, and may help prevent cancer of the esophagus. Topan belongs to a class of drugs known as proton pump inhibitors (PPIs).
How it works
Topan belongs to a class of drugs called proton pump inhibitors. It works to shut off the acid-pumping cells in your stomach. It reduces the amount of stomach acid and helps to reduce painful symptoms related to conditions such as GERD.
Topan oral tablet does not cause drowsiness. However, it can cause other side effects.
Getting the most from your treatment
- Try to keep your regular appointments with your doctor. This is so your progress can be checked. If you are taking Topan on a long-term basis your doctor will want to review your treatment at least once a year to make sure it is still right for you.
- A typical course of treatment lasts for one or two weeks if you are taking Topan for Helicobacter pylori eradication. It will last for one or two months if it is to allow an ulcer to heal. For all other reasons for taking Topan, your treatment will last for as long as is necessary to control your symptoms.
- Some foods may make your symptoms worse. Foods and drinks that have been suspected of this include peppermint, tomatoes, chocolate, spicy foods, hot drinks, coffee, and alcoholic drinks. If it seems that a food is aggravating your symptoms, try avoiding it for a while to see if your symptoms improve. Also, try avoiding eating large meals, as these can make your symptoms worse too.
- If you are overweight, it puts extra pressure on your stomach and encourages the symptoms of acid reflux. Losing some weight and eating a healthy balanced diet may help you.
- Smoking increases the amount of acid produced by the stomach and may make your symptoms worse. If you are a smoker, speak with your doctor or pharmacist about how to quit.
- Recent studies suggest that there may be a slight increase in the risk of bone fractures when proton pump inhibitors like Topan are taken for longer than a year. If this affects you, your doctor will check that you are taking enough vitamin D and calcium to reduce this risk.
- If you buy any medicines 'over the counter', always check with a pharmacist that they are safe to take alongside your other medicines.
Why it’s used
Topan oral tablet is used to reduce the amount of stomach acid your body makes. It helps treat painful symptoms caused by conditions such as gastroesophageal reflux disease (GERD). With GERD, gastric juices flow upward from your stomach and into the esophagus.
Topan oral tablet is also used to treat other conditions in which the stomach makes excess acid, such as Zollinger-Ellison syndrome.
Topan and Pregnancy
Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding before taking Topan.
Although there is no evidence suggesting that Topan use is harmful during pregnancy, it's recommended that the drug only be used during pregnancy as needed, when no other options are available.
Research indicates that Topan and its metabolites are excreted in the milk of rats, and that they may be excreted in human breast milk as well.
The manufacturer recommends that due to the potential for serious adverse reactions in breastfeeding infants, mothers using Topan may want to discontinue breastfeeding or discontinue use of the drug.
What is the most important information I should know about Topan (Protonix, Protonix IV)?
Topan can cause kidney problems. Tell your doctor if you are urinating less than usual, or if you have blood in your urine.
Diarrhea may be a sign of a new infection. Call your doctor if you have diarrhea that is watery or has blood in it.
Topan may cause new or worsening symptoms of lupus. Tell your doctor if you have joint pain and a skin rash on your cheeks or arms that worsens in sunlight.
You may be more likely to have a broken bone while taking this medicine long term or more than once per day.
What other drugs will affect Topan?
Tell your doctor about all your other medicines. Some may interact with Topan, especially:
a diuretic or "water pill."
This list is not complete. Other drugs may affect Topan, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.