Your Prescription - Medicine-by-Medicine Guide

⚠️ Important: This is general educational information. Always follow your doctor's exact instructions. Some dosing columns in the image are cut off or stamped over - confirm the full schedule with your pharmacist.

1. Pantocid 40 (Pantoprazole 40 mg)

• Type: Proton Pump Inhibitor (PPI) - acid reducer
• Uses: Reduces excess stomach acid. Treats GERD (acid reflux), peptic ulcers, heartburn, esophagitis, and Zollinger-Ellison syndrome. Also used to protect the stomach when taking steroids (like Defcort).
• Your dose: 1 tablet before breakfast (on empty stomach, as written)
• How it works: Blocks the "proton pump" in stomach cells that produces acid
• Common side effects: Headache, diarrhea, nausea; long-term use can lower magnesium and slightly increase fracture risk

2. Defcort 6 mg (Deflazacort 6 mg)

• Type: Corticosteroid (steroid) - anti-inflammatory
• Uses: Treats inflammatory and autoimmune conditions - including arthritis, asthma, inflammatory bowel disease, allergies, kidney disorders (nephrotic syndrome), and Duchenne Muscular Dystrophy. It suppresses the immune system and reduces inflammation.
• Your dose: 1 tablet after breakfast (steroids should be taken with food to protect the stomach - that's also why Pantocid 40 is prescribed alongside it)
• How it works: Mimics cortisol, blocks inflammatory chemicals in the body
• Common side effects: Weight gain, increased blood sugar, mood changes, fluid retention, bone thinning with long-term use. Do not stop suddenly - must be tapered under doctor guidance.

3. DVK Plus (Calcium + Vitamin D3 + Vitamin K2)

• Type: Bone supplement
• Uses: Supplements calcium and vitamins D3 and K2. Given alongside steroids like Defcort specifically to prevent steroid-induced bone loss (osteoporosis). Vitamin K2 helps direct calcium into bones rather than blood vessels.
• Your dose: Written as "0" before breakfast - likely taken at a different time (after lunch or night). Check your pharmacist.
• Why it's prescribed: Steroids reduce calcium absorption and weaken bones over time; this supplement counteracts that effect.

4. TFCT Nib OD 11 mg

• Note: This is difficult to read clearly in the prescription - the handwriting is highly stylized and part of the text is unclear. It could refer to a tacrolimus-based formulation (immunosuppressant) or another specialty drug. The "OD" means Once Daily.
• Please confirm the exact name with your doctor or pharmacist before taking this medication.

5. Veloz 20 (Rabeprazole 20 mg)

• Type: Proton Pump Inhibitor (PPI) - acid reducer (same class as Pantocid but different molecule)
• Uses: Treats acidity, GERD (acid reflux), peptic ulcers, and Zollinger-Ellison syndrome. It also helps eradicate H. pylori infection when combined with antibiotics.
• Your dose: Timing column is obscured by the dispensing stamp - check the original prescription or ask your pharmacist.
• Note: Having both Pantocid (pantoprazole) and Veloz (rabeprazole) is somewhat unusual. One may be for morning and the other for evening/night - confirm with your doctor.

6. Syp Instamuff (Syrup)

• Type: Likely a mucolytic or cough/throat syrup ("Instamuff" suggests a preparation for mucus/cough relief)
• Uses: Likely used to relieve cough, thin mucus secretions, or soothe the throat/airways
• Your dose: Dosage columns are covered by the "DISPENSED" stamp - refer to the bottle label or ask the pharmacist for exact ml/teaspoons and frequency.

7. TP Care - (½) pack

• Type: Likely a protein/nutritional supplement powder
• Uses: Nutritional support - provides protein, vitamins, and minerals. Often given to patients on steroids or those with chronic illness to support muscle mass and overall nutrition.
• Your dose: ½ pack as indicated on the prescription. Typically mixed with water or milk.

Summary Table

Please confirm medicines #4 and #6 dosing with your pharmacist, as parts of the prescription are not fully visible.

What Are Steroids?

How Do Corticosteroids Work?

• They inhibit phospholipase A2 - an enzyme that starts the inflammation cascade
• They suppress COX-2 - the enzyme that produces pain and swelling signals (prostaglandins)
• They reduce leukocyte (white blood cell) activity - calming down an overactive immune system

What Are Steroids Used For?

• Autoimmune diseases - rheumatoid arthritis, lupus, inflammatory bowel disease
• Allergic reactions - severe asthma, allergic skin conditions
• Kidney diseases - nephrotic syndrome (likely why you were prescribed it)
• Muscle diseases - Duchenne Muscular Dystrophy
• Lung diseases - asthma, COPD flare-ups
• Skin diseases - severe eczema, psoriasis
• Organ transplant - to prevent rejection

Forms of Steroids

• Tablets/oral - Defcort, prednisone (like your prescription)
• Inhalers - for asthma (budesonide, fluticasone)
• Injections - into joints, muscles, or veins
• Creams/ointments - for skin conditions
• Eye drops - for eye inflammation

Side Effects (Important!)

Why You Are Given Other Medicines Alongside Steroids

• Pantocid 40 & Veloz 20 - protect your stomach (steroids can cause ulcers)
• DVK Plus (Calcium + Vitamin D + K2) - protect your bones from steroid-induced osteoporosis
• TP Care (protein supplement) - support muscle mass, which steroids can reduce

Very Important Rules for Taking Steroids

1. Never stop suddenly - your body stops making its own cortisol while on steroids; stopping abruptly can cause a life-threatening "adrenal crisis" (collapse, low blood pressure, shock)
2. Always taper - the dose must be reduced slowly under your doctor's guidance
3. Take with food - reduces stomach irritation (that's why Defcort is prescribed after breakfast)
4. Avoid infections - your immune system is suppressed; stay away from sick people and report any fever to your doctor promptly
5. Carry a steroid card - in emergencies, doctors need to know you are on steroids

Omeprazole - Complete Guide

What Is It?

• It is in the same family as Pantocid (pantoprazole) and Veloz (rabeprazole) that were on your prescription
• Available as capsules, tablets, and IV injections
• Available both on prescription and over-the-counter (OTC) in many countries

How Does It Work? (Mechanism)

Normal:   Parietal cell → Proton Pump → Acid secreted into stomach
With PPI: Proton pump BLOCKED → Much less acid produced

• Effects begin within 1 hour of taking it
• Maximum effect at 2 hours
• Effects last up to 72 hours (3 days!) even after a single dose
• Acid returns to normal in 3-5 days after stopping
• Lippincott Illustrated Reviews Pharmacology, p. 1451

What Is It Used For?

Dosage (General Adult Doses)

Omeprazole vs. Other PPIs (Comparison)

Side Effects

• Headache
• Nausea, stomach pain, gas
• Diarrhea or constipation

Important Rules

1. Take before meals - 30 to 60 minutes before breakfast for best effect
2. Do not crush - it is a delayed-release capsule; crushing destroys the protection
3. Don't stop suddenly after long-term use - taper gradually to avoid acid rebound
4. Tell your doctor if you use it for more than 4 weeks continuously
5. Interactions - Omeprazole can reduce the effectiveness of clopidogrel (a blood thinner) - important if you take both

Connection to Your Prescription

• Protect your stomach from the Defcort (steroid) you are taking
• Prevent steroid-induced ulcers and gastritis