apentral-d 10mg/40mg tablet - Domperidone (10mg) + Pantoprazole (40mg) medicine

Actopan D 10mg/40mg Tablet: Complete Guide to Uses, Side Effects, and Safety

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🏭 Arlak Biotech Pvt Ltd 📦 Varies by brand 💊 Allopathy 📅 Updated: Sep 24, 2026
⚠️ Hepatotoxicity Risk 📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: Moderate to well-established for individual components; combination evidence is limited.
Reviewed by
SaathiMed Expert Panel | Sep 24, 2026

When to Call Your Doctor IMMEDIATELY

  • Blood in vomit or black, tarry stools
  • Severe abdominal pain or persistent vomiting
  • Chest pain, palpitations, or fainting
  • Swelling of face, lips, or throat, or difficulty breathing
  • Yellowing of skin or eyes, or dark urine
  • Unusual muscle stiffness, tremors, or involuntary movements
  • Decreased urine output or swelling in legs

If experiencing severe symptoms, call emergency services immediately.

What is apentral-d 10mg/40mg tablet used for?

This medicine is a combination of Domperidone 10 mg and Pantoprazole 40 mg used to treat acid reflux, GERD, and related nausea. It works by reducing stomach acid and improving gastric emptying. It is taken once daily on an empty stomach, usually before breakfast.

  • Generic Name: Domperidone + Pantoprazole
  • Manufacturer: Arlak Biotech Pvt Ltd
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 apentral-d 10mg/40mg tablet के बारे में (Hindi Summary)

उपयोग: यह दवा डोम्पेरिडोन 10 मिलीग्राम और पैंटोप्राजोल 40 मिलीग्राम का संयोजन है। इसका उपयोग एसिड रिफ्लक्स, गैस्ट्रोएसोफेजियल रिफ्लक्स डिजीज (GERD), पेप्टिक अल्सर, और अपच जैसी समस्याओं के इलाज के लिए किया जाता है। यह पेट में एसिड का उत्पादन कम करती है और पेट खाली होने की प्रक्रिया को तेज करती है, जिससे जलन, उल्टी, और पेट फूलने जैसे लक्षणों में राहत मिलती है।

साइड इफेक्ट्स: इस दवा के सामान्य दुष्प्रभावों में सिरदर्द, मुँह सूखना, दस्त, मतली, पेट दर्द, और गैस शामिल हैं। ये आमतौर पर हल्के होते हैं और कुछ समय में ठीक हो जाते हैं। गंभीर दुष्प्रभावों में अनियमित दिल की धड़कन, स्तन में दर्द या सूजन, और मांसपेशियों में अकड़न शामिल हो सकते हैं। अगर आपको कोई भी असामान्य लक्षण महसूस हो, तो तुरंत डॉक्टर से संपर्क करें।

सुरक्षा सलाह: इस दवा को डॉक्टर के बताए अनुसार ही लें। इसे खाने से 30 से 60 मिनट पहले खाली पेट लें। टैबलेट को चबाएं या तोड़ें नहीं, पूरा निगल लें। दवा लेते समय शराब का सेवन न करें। अगर आपको दिल, लीवर, या किडनी की कोई समस्या है, तो डॉक्टर को बताएं। बिना डॉक्टर की सलाह के दवा बंद न करें।

💡 Did You Know? India has the highest number of USFDA-compliant plants outside the USA.

💊 apentral-d 10mg/40mg tablet Uses & Benefits

[{"condition":"Gastroesophageal reflux disease (GERD)","description":"Reduces stomach acid and improves gastric emptying, relieving heartburn and regurgitation.","evidence":"Well-established"},{"condition":"Peptic ulcer disease","description":"Helps heal ulcers by reducing acid secretion and improving gastric motility.","evidence":"Well-established"},{"condition":"Functional dyspepsia","description":"Relieves symptoms like bloating, early satiety, and upper abdominal discomfort.","evidence":"Moderate"},{"condition":"Gastroparesis","description":"Improves gastric emptying and reduces nausea and vomiting in diabetic or idiopathic gastroparesis.","evidence":"Moderate"},{"condition":"Nausea and vomiting associated with acid-related disorders","description":"Domperidone component helps control nausea and vomiting while pantoprazole treats the underlying acid condition.","evidence":"Moderate"}]

Off-label uses: [{"condition":"Refractory nausea and vomiting","description":"Sometimes used off-label when other antiemetics are ineffective, but only under specialist supervision.","evidence":"Limited"},{"condition":"Prevention of NSAID-induced ulcers","description":"Pantoprazole component may be used off-label for prevention in high-risk patients, but combination with domperidone is not standard.","evidence":"Limited"}]

Primary treatment for: Gastroesophageal reflux disease (GERD)

Also treats: Peptic ulcer disease, Functional dyspepsia, Gastroparesis, Nausea and vomiting

📋 Drug Information

Generic Name(s)Domperidone + Pantoprazole
Brand NameAnleo-DSR Capsule
ManufacturerArlak Biotech Pvt Ltd
Packaging / FormVaries by brand (Allopathy)
Therapeutic ClassGASTRO INTESTINAL
Action ClassProkinetic agent + Proton pump inhibitor
Route of AdministrationOral
StorageStore at room temperature between 15°C and 30°C (59°F to 86°F). Protect from light and moisture. Keep in the original container.
Shelf Life24 months from the date of manufacture.
WHO GuidelineNot established from the available information.
ICMR GuidelineNot established from the available information.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Take this medicine on an empty stomach, at least 30 to 60 minutes before breakfast, for best results.
2
Do not crush or chew the tablet; swallow it whole with water.
3
Avoid alcohol while taking this medicine to prevent stomach irritation and increased side effects.
4
Do not take this medicine for longer than prescribed without medical supervision.
5
Inform your doctor if you have heart, liver, or kidney problems before starting this medicine.
6
Report any unusual muscle movements, palpitations, or breast changes to your doctor immediately.
7
Maintain a healthy diet and lifestyle to support treatment outcomes.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

Heartburn
This medicine is commonly prescribed for this.
Likely Use
Nausea
Domperidone component helps relieve nausea.
Likely Use
Bloating
Prokinetic effect helps reduce bloating.
Likely Use
Fever
This medicine is not a fever reducer.
Not Primary
Headache
This medicine is not for headache relief; it may cause headache as a side effect.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionDomperidone is rapidly absorbed after oral administration, with peak plasma concentrations occurring within 30 to 60 minutes. Pantoprazole is also rapidly absorbed, with peak plasma levels reached within 2 to 3 hours. Food may slightly delay the absorption of pantoprazole but does not significantly affect the extent of absorption. Domperidone absorption is reduced when taken with food, so it is recommended to take this medicine on an empty stomach.
DistributionDomperidone is widely distributed in the body but does not readily cross the blood-brain barrier. It is highly protein-bound (approximately 91-93%). Pantoprazole is also highly protein-bound (about 98%) and distributes into gastric parietal cells. Both drugs have large volumes of distribution.
Protein BindingDomperidone: approximately 91-93% bound to plasma proteins. Pantoprazole: approximately 98% bound to plasma proteins.
MetabolismDomperidone undergoes extensive first-pass metabolism in the liver and intestinal wall via CYP3A4 and CYP1A2 enzymes. Pantoprazole is metabolized in the liver by CYP2C19 and CYP3A4 enzymes. Genetic variations in CYP2C19 can affect pantoprazole metabolism, leading to differences in plasma levels among individuals.
Half-LifeDomperidone: approximately 7 to 9 hours in healthy individuals. Pantoprazole: approximately 1 to 2 hours.
ExcretionDomperidone is excreted primarily in the feces (about 66%) and urine (about 33%) as metabolites. Pantoprazole is excreted mainly in the urine (about 80%) and feces (about 20%) as metabolites.
BioavailabilityDomperidone: approximately 15% due to extensive first-pass metabolism. Pantoprazole: approximately 77% after oral administration.
Onset of ActionDomperidone: within 30 to 60 minutes. Pantoprazole: within 1 hour for acid suppression, but maximal effect may take 2 to 4 days of regular dosing.
Peak Plasma TimeDomperidone: 0.5 to 1 hour. Pantoprazole: 2 to 3 hours.
Duration of ActionDomperidone: approximately 6 to 8 hours. Pantoprazole: acid suppression lasts up to 24 hours, allowing once-daily dosing.

How It Works

This medicine combines two active ingredients with complementary mechanisms. Domperidone is a peripheral dopamine D2 receptor antagonist that blocks dopamine receptors in the chemoreceptor trigger zone and the gastrointestinal tract. This action enhances gastric motility and accelerates gastric emptying without significant central nervous system effects because it does not readily cross the blood-brain barrier. Pantoprazole is a proton pump inhibitor that irreversibly inhibits the H+/K+-ATPase enzyme in the gastric parietal cells. This enzyme is responsible for the final step of acid secretion. By blocking this pump, pantoprazole reduces both basal and stimulated gastric acid secretion, leading to a sustained increase in gastric pH.

Mechanism Steps

1
Domperidone blocks peripheral dopamine D2 receptors: Domperidone antagonizes dopamine D2 receptors in the gastrointestinal tract and chemoreceptor trigger zone, leading to enhanced gastric motility and antiemetic effects.
2
Pantoprazole inhibits proton pumps: Pantoprazole is activated in the acidic environment of the parietal cell canaliculi and irreversibly binds to H+/K+-ATPase, blocking the final step of acid secretion.
3
Combined effect on GERD and dyspepsia: The prokinetic action of domperidone reduces reflux and improves gastric emptying, while pantoprazole reduces the acidity of any refluxate, protecting the esophageal mucosa.

💡 How to Take apentral-d 10mg/40mg tablet

Strength: Tablet containing Domperidone 10 mg and Pantoprazole 40 mg.

1Take the tablet at least 30 to 60 minutes before a meal, preferably breakfast.
2Swallow the tablet whole with a glass of water. Do not crush, chew, or break it.
3Do not take with food, as food may reduce the absorption of domperidone.
4If you miss a dose, follow the missed dose instructions.
5Do not take an extra dose to make up for a missed one.
6Follow your doctor's prescribed duration of treatment.

Dosage Information

Adult DosageThe usual adult dose of this medicine is one tablet taken orally once daily on an empty stomach, at least 30 to 60 minutes before breakfast. However, the dose and duration of treatment must be individualized by a qualified clinician based on the specific indication, severity of symptoms, age, weight, renal and hepatic function, and response to therapy. Do not self-adjust the dose. Follow your doctor's instructions exactly.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician.
Elderly DosageElderly patients may be more sensitive to the side effects of this medicine, especially QT prolongation and extrapyramidal symptoms. Use with caution and consider dose reduction based on renal and hepatic function. Regular monitoring is recommended.
Renal ImpairmentDose adjustment may be necessary in patients with severe renal impairment. Consult your doctor for individualized dosing.
Hepatic ImpairmentThis medicine is contraindicated in severe hepatic impairment. In mild to moderate hepatic impairment, dose reduction may be necessary. Consult your doctor for individualized dosing.
Maximum Daily DoseThe maximum recommended daily dose is one tablet (Domperidone 10 mg + Pantoprazole 40 mg) per day. Do not exceed this dose unless directed by your doctor.

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

🍽️ Food Timing Guide

With food
Take on an empty stomach
Food reduces the absorption of domperidone and may delay pantoprazole absorption.
Grapefruit juice
Avoid
May increase domperidone levels and risk of side effects.
Alcohol
Avoid
Increases stomach irritation and risk of side effects.

⏰ What to Do If You Miss a Dose

📌 Less than half the dosing interval has passed
→ Take the missed dose as soon as you remember.
💡 Continue with the regular schedule.
📌 More than half the dosing interval has passed
→ Skip the missed dose.
💡 Do not double dose to catch up.

⚠️ Side Effects of apentral-d 10mg/40mg tablet

✅ Common Side Effects

Headache (Common (5-10%))
Usually resolves on its own. Consult doctor if persistent or severe.
Dry mouth (Common (5-10%))
Stay hydrated, chew sugar-free gum, or use saliva substitutes. Consult doctor if bothersome.
Diarrhea (Common (5-10%))
Drink plenty of fluids. Consult doctor if diarrhea persists or is severe.
Nausea (Common (5-10%))
Take with a light snack if allowed. Consult doctor if it continues.
Abdominal pain (Common (5-10%))
Usually mild and temporary. Consult doctor if pain is severe or persistent.
Flatulence (Common (5-10%))
Avoid gas-producing foods. Consult doctor if it becomes bothersome.

🚨 Serious Side Effects

QT prolongation and ventricular arrhythmias (Rare (<0.1%))
Seek immediate medical attention if you experience palpitations, dizziness, or fainting.
Extrapyramidal symptoms (muscle stiffness, tremor, involuntary movements) (Rare (<0.1%))
Contact your doctor immediately if you notice any unusual muscle movements.
Hyperprolactinemia (breast enlargement, galactorrhea, menstrual irregularities) (Uncommon (0.1-1%))
Consult your doctor if you experience these symptoms; dose adjustment may be needed.
Severe allergic reactions (anaphylaxis, angioedema) (Rare (<0.1%))
Seek emergency medical help if you experience swelling of face, lips, throat, or difficulty breathing.
Liver toxicity (hepatitis, jaundice) (Rare (<0.1%))
Report yellowing of skin or eyes, dark urine, or severe fatigue to your doctor immediately.

⚠️ Rare Side Effects

Agranulocytosis
Seek immediate medical attention if you develop fever, sore throat, or mouth ulcers.
Tardive dyskinesia
Report any involuntary repetitive movements to your doctor immediately.
Interstitial nephritis
Seek medical attention if you experience decreased urine output, swelling, or fatigue.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
Ketoconazole Major
Clarithromycin Major
Amiodarone Major
Clopidogrel Moderate
Warfarin Moderate
Methotrexate Moderate
Digoxin Moderate
Antacids Minor
Iron supplements Minor
Vitamin B12 Minor

🚨 Major Interactions

  • Ketoconazole, itraconazole, clarithromycin, ritonavir
  • QT-prolonging drugs (e.g., amiodarone, sotalol, haloperidol)
  • Atazanavir, nelfinavir

⚡ Moderate Interactions

  • Clopidogrel
  • Methotrexate
  • Warfarin
  • Digoxin

🍷 Alcohol Interaction

Alcohol should be avoided while taking this medicine. Alcohol can increase stomach acid production, irritate the stomach lining, and worsen the condition being treated. It may also increase the risk of side effects such as dizziness, drowsiness, and gastrointestinal discomfort. Additionally, alcohol may affect the metabolism of domperidone and pantoprazole, potentially leading to increased drug levels and toxicity.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Known hypersensitivity to domperidone, pantoprazole, or any component of the formulation","Prolactin-releasing pituitary tumor (prolactinoma)","Severe hepatic impairment","Known QT prolongation or congenital long QT syndrome","Concomitant use with strong CYP3A4 inhibitors that prolong QT (e.g., ketoconazole, clarithromycin)","Concomitant use with HIV protease inhibitors (e.g., atazanavir, nelfinavir)","Gastrointestinal obstruction, perforation, or bleeding","Active peptic ulcer with complications"]

⚠️ Warnings & Precautions

["Use with caution in patients with cardiovascular disease or risk factors for QT prolongation.","Avoid in patients with electrolyte imbalances (hypokalemia, hypomagnesemia).","May cause drowsiness; avoid driving or operating machinery until effects are known.","Long-term use may lead to vitamin B12 deficiency and increased risk of bone fractures.","May mask symptoms of gastric malignancy; ensure appropriate evaluation before starting therapy.","Use with caution in elderly patients due to increased risk of side effects.","Do not use for longer than 12 weeks without medical reassessment.","Inform your doctor if you have kidney or liver disease."]

🤱 Lactation Safety

Domperidone is excreted in breast milk and may cause side effects in the infant. Pantoprazole is also excreted in breast milk. This medicine is not recommended during breastfeeding unless clearly needed and under medical supervision.

💊 Overdose Management

Overdose of this medicine may cause symptoms such as drowsiness, extrapyramidal reactions, hypotension, and QT prolongation. If overdose is suspected, seek emergency medical attention immediately. Treatment is supportive and symptomatic. Activated charcoal may be considered if ingestion occurred within 1-2 hours. Monitor ECG and vital signs. There is no specific antidote. Hemodialysis is not effective in removing domperidone or pantoprazole.

⏰ Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.

Additional Safety Advice

General Safety

Take this medicine exactly as prescribed by your doctor. Do not crush, chew, or break the tablet; swallow it whole with a glass of water. It is best taken on an empty stomach, at least 30 to 60 minutes before a meal, to maximize its effectiveness. Avoid alcohol while taking this medicine, as it can worsen stomach irritation and increase the risk of side effects. Do not drive or operate heavy machinery until you know how this medicine affects you, as it may cause dizziness. Inform your doctor if you have a history of heart problems, liver disease, kidney disease, or electrolyte imbalances. Do not take this medicine for longer than recommended without medical supervision. Keep all follow-up appointments and report any unusual symptoms immediately.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients are at higher risk of QT prolongation, extrapyramidal symptoms, and electrolyte imbalances. Use with caution, monitor ECG and electrolytes, and adjust dose based on renal and hepatic function.

🤰 Pregnancy Planning (TTC)

If you are planning pregnancy or are pregnant, consult your doctor before taking this medicine. The safety of this combination during pregnancy is not well established. Alternative treatments may be considered.

🏥 Post-Surgery Considerations

After surgery, consult your doctor before resuming this medicine. It may affect gastric motility and acid secretion, which could impact postoperative recovery. Individualized assessment is needed.

🦷 Dental Procedures

Inform your dentist if you are taking this medicine. It may increase the risk of bleeding during dental procedures due to potential interactions with anticoagulants. Your dentist may recommend precautions.

💚 Lifestyle Tips for Better Results

🏃
Eat smaller, more frequent meals to reduce acid reflux.
🥗
Avoid lying down immediately after eating; wait at least 2-3 hours.
😴
Elevate the head of your bed by 6-8 inches to prevent nighttime reflux.
💧
Maintain a healthy weight to reduce pressure on the stomach.
🧘
Avoid trigger foods such as spicy, fatty, or acidic foods.
🌞
Quit smoking and limit alcohol consumption.
🚭
Manage stress through relaxation techniques like yoga or meditation.

🏋️ Exercise Considerations

Moderate exercise is generally safe, but avoid vigorous activities immediately after meals as they may worsen reflux. If you experience dizziness or palpitations, stop exercising and consult your doctor.

🥗 Diet Recommendations

Include high-fiber foods like fruits, vegetables, and whole grains.
Choose lean proteins such as chicken, fish, and tofu.
Avoid spicy, fatty, and fried foods.
Limit caffeine and carbonated beverages.
Stay well hydrated with water throughout the day.

💼 Impact on Daily Work & Life

This medicine may cause dizziness or drowsiness in some individuals. Avoid driving or operating heavy machinery until you know how it affects you. It is generally safe to continue desk work, but take regular breaks and avoid heavy lifting after meals.

🛑 When to Stop This Medicine

Do not stop taking this medicine without consulting your doctor. If you experience serious side effects such as severe palpitations, muscle stiffness, or allergic reactions, seek immediate medical attention. Your doctor may adjust the dose or switch to an alternative.

📅 Long-Term Use Effects

Long-term use of this medicine may lead to vitamin B12 deficiency, increased risk of bone fractures, and electrolyte imbalances. Domperidone can cause hyperprolactinemia and rarely tardive dyskinesia. Regular monitoring of vitamin B12, magnesium, and bone health is recommended. Periodic reassessment of the need for continued therapy is advised.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Lifestyle modifications

Dietary changes, weight loss, and elevating the head of the bed can reduce reflux symptoms.

Evidence: Well-established
Other proton pump inhibitors

Omeprazole, esomeprazole, or rabeprazole may be used instead of pantoprazole.

Evidence: Well-established
H2 receptor antagonists

Ranitidine or famotidine may be alternatives for acid suppression.

Evidence: Well-established

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

No specific vaccine interactions are established. However, long-term acid suppression may slightly reduce the immune response to oral vaccines. Consult your doctor for personalized advice.

📦 Storage Guide

✅ DO

Store at room temperature (15-30°C)

❌ DON'T

Do not refrigerate unless specified

✅ DO

Keep in original container

❌ DON'T

Do not transfer to unmarked containers

✅ DO

Keep away from direct sunlight

❌ DON'T

Do not store in bathroom cabinet

✈️ Traveling with This Medicine

When traveling, carry this medicine in its original packaging with a copy of your prescription. Store it at room temperature, away from direct sunlight and moisture. If crossing time zones, continue taking it at your usual time, but consult your doctor if adjustments are needed. Declare it at customs if required. Keep enough supply for your trip and a few extra days in case of delays.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 45-year-old man with chronic GERD and nausea
He was prescribed this medicine once daily before breakfast. After two weeks, his heartburn and nausea significantly improved. He noted that taking it on an empty stomach was key to its effectiveness.
💡 Lesson: Consistent timing on an empty stomach enhances the medicine's efficacy.
👤 A 60-year-old woman with diabetic gastroparesis
She experienced bloating and early fullness after meals. Her doctor added this medicine to her regimen. Over a month, her symptoms reduced, and she could eat more comfortably. She was monitored for heart rhythm and electrolyte levels.
💡 Lesson: Regular monitoring is important, especially in elderly patients with comorbidities.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: Domperidone starts working within 30-60 minutes, while pantoprazole may take 1-4 days for full acid-suppressive effect.

Q: Can I take it with food?

A: It is best taken on an empty stomach, at least 30-60 minutes before a meal, to maximize absorption.

Q: What are the common side effects?

A: Common side effects include headache, dry mouth, diarrhea, nausea, and abdominal pain. These are usually mild and temporary.

Q: Is it safe during pregnancy?

A: Consult your doctor. The safety of this combination during pregnancy is not well established.

Q: Can I stop taking it suddenly?

A: Do not stop without consulting your doctor, as abrupt discontinuation may cause rebound acid hypersecretion.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine long-term?
  • Will it affect my kidney function?
  • Can I drive after taking this medicine?
  • Does it interact with my blood pressure medicine?
  • What if I miss a dose?
  • Can I drink alcohol while taking this?

🔄 Substitutes for apentral-d 10mg/40mg tablet

View All

Alternative brands with exact same active ingredient:

Medical Note: Always consult your doctor before switching medications.

🛑 Myths vs. Facts

  • Myth: This medicine can be taken for immediate heartburn relief.
    Fact: This medicine is not for immediate relief. It is a long-acting acid suppressant and prokinetic, and it may take a few days to show full effect.
  • Myth: It is safe to take indefinitely without monitoring.
    Fact: Long-term use requires periodic monitoring for vitamin B12 deficiency, bone health, and electrolyte imbalances.
  • Myth: You can stop it abruptly without consulting a doctor.
    Fact: Abrupt discontinuation may cause rebound acid hypersecretion. Always consult your doctor before stopping.

🔄 Alternative Options

Generic Alternatives

  • Domperidone 10 mg + Pantoprazole 40 mg tablet (generic)

Brand Alternatives

  • Actopan D 10mg/40mg Tablet

📊 Comparison with Similar Medicines

[{"medicine":"This medicine","composition":"Domperidone 10 mg + Pantoprazole 40 mg","uses":"GERD, dyspepsia, gastroparesis","notes":"Combination provides prokinetic and acid-suppressive effects."},{"medicine":"Domperidone + Rabeprazole","composition":"Domperidone 10 mg + Rabeprazole 20 mg","uses":"GERD, dyspepsia","notes":"Rabeprazole has faster onset of acid suppression."},{"medicine":"Pantoprazole alone","composition":"Pantoprazole 40 mg","uses":"GERD, peptic ulcer","notes":"No prokinetic effect; may not relieve nausea or bloating."}]

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