Background pattern

Citrel 20 mg comprimidos gastrorresistentes efg

About the medicine

How to use Citrel 20 mg comprimidos gastrorresistentes efg

Introduction

Package Insert: Information for the Patient

Citrel 20 mg Gastrorresistant Tablets EFG

Pantoprazol

Read the entire package insert carefully before starting to take the medication, as it containsimportant information for you.

  • Keep this package insert, as you may need to refer to it again.
  • If you have any questions, consult your doctor or pharmacist.
  • This medication has been prescribed for you, and you should not give it to others, even if they have the same symptoms as you, as it may harm them.
  • If you experience any adverse effects,consult your doctor or pharmacist, even if they are not listed in this package insert. See section 4.

1.What Citrel is and for what it is used

2.What you need to know before starting to take Citrel

3.How to take Citrel

4.Adverse effects

5.Storage of Citrel

6.Contents of the package and additional information

1. What is Citrel and what is it used for

Citrel is a selective proton pump inhibitor, a medication that reduces the amount of acid produced in your stomach. It is used for the treatment of diseases related to stomach acid and intestine.

Citrel is used for:

Adults and adolescents 12 years and older:

  • Treatment of symptoms associated with gastroesophageal reflux disease (stomach burning, acid regurgitation, difficulty swallowing) caused by acid reflux from the stomach.
  • Long-term treatment and prevention of relapses of esophagitis caused by acid reflux (inflammation of the esophagus accompanied by acid regurgitation from the stomach).

Adults:

  • Prevention of gastroduodenal ulcers induced by nonsteroidal anti-inflammatory drugs (NSAIDs, for example, ibuprofen) in patients at risk who require continued treatment with this type of medication.

2. What you need to know before starting to take Citrel

Do not take Citrel

  • If you are allergic (hypersensitive) to pantoprazole or to any of the othercomponents ofCitrel (see section 6).
  • If you are allergic to medicines that contain other proton pump inhibitors (e.g., omeprazole, lansoprazole, rabeprazole, esomeprazole).

Warnings and precautions

Consult your doctor or pharmacist before starting to takeCitrel:

  • If you have severe liver problems. Inform your doctor if you have ever had liver problems. Your doctor will monitor your liver enzymes more frequently, especially when you are on long-term treatment with pantoprazole. If liver enzyme levels increase, treatment should be interrupted.
  • If you need to take non-steroidal anti-inflammatory drugs (NSAIDs) continuously and take pantoprazole, as there is a higher risk of developing complications in the stomach and intestine. Any increased risk will be assessed based on individual risk factors such as age (65 years or older), history of stomach or duodenal ulcers or gastrointestinal bleeding.
  • If you have decreased vitamin B12 reserves or risk factors for it and receive treatment with pantoprazole for a long period of time. Like all acid-reducing medications, pantoprazole may reduce vitamin B12 absorption.
  • Consult your doctor if you are taking any medication containing atazanavir (for HIV treatment) at the same time as pantoprazole.
  • Long-term use of a proton pump inhibitor like pantoprazole, especially for more than a year, may increase the risk of fractures of the hip, wrist, or spine.

Inform your doctor if you have osteoporosis (reduced bone density) or if you have been told you are at risk of developing osteoporosis (e.g., if you are taking corticosteroids).

  • If you take pantoprazole for more than three months, you may experience a decrease in magnesium levels in your blood. Symptoms of low magnesium levels may include fatigue, involuntary muscle contractions, disorientation, dizziness, or increased heart rate. If you experience any of these symptoms, inform your doctor immediately. Low magnesium levels can also cause a decrease in potassium and calcium levels in the blood. Your doctor will decide to perform regular blood tests to monitor magnesium levels.
  • If you have ever had a skin reaction after treatment with a similar medication to Citrel for reducing stomach acid.
  • If you experience a skin rash, especially in sun-exposed areas, consult your doctor as soon as possible, as it may be necessary to interrupt treatment with Citrel. Remember to mention any other symptoms you may notice, such as joint pain.
  • If you are scheduled to have a specific blood test (Cromogranin A)

Inform your doctor immediately if you notice any of the following symptoms:

-Unintentional weight loss

-Recurring vomiting

-Difficulty swallowing

-Blood in your vomit; it mayappear as a dark brown powder in your vomit

  • Blood in your stools, which may appear black or melena
  • Difficulty swallowing or pain when swallowing

-Pale appearance and feeling of weakness (anemia)

  • Chest pain
  • Abdominal pain
  • Severe or persistent diarrhea, as pantoprazole has been associated with a small increase in infectious diarrhea.

Your doctor will decide if you need additional tests to rule out a malignant disease, as pantoprazole may alleviate cancer symptoms and potentially delay diagnosis. If your symptoms persist despite treatment, further investigations will be performed.

If you take pantoprazole for a prolonged period (more than a year), your doctor may monitor you regularly. You should inform your doctor of any new or unexpected symptoms and/or events each time you attend your appointment.

Children and adolescents

The use of Anagastra is not recommended in children as it has not been tested in children under 12 years.

Taking Citrel with other medicines

Inform your doctor or pharmacist if you are taking, have taken recently, or may need to take any other medication, including over-the-counter medications.

Citrel may affect the efficacy of other medications, inform your doctor if you are taking:

  • Medicines such as ketoconazole, itraconazole, and posaconazole (used to treat fungal infections) or erlotinib (used to treat certain types of cancer), as Citrel may make these and other medications not work correctly.
  • Warfarin and fenprocumon, which affect blood clotting. You may need additional monitoring.
  • Medicines used to treat HIV infection, such as atazanavir.
  • Methotrexate (used to treat rheumatoid arthritis, psoriasis, and cancer), if you are taking
  • methotrexate your doctor may temporarily interrupt treatment with Anagastra

because pantoprazole may increase methotrexate levels in the blood.

  • Fluvoxamine (used to treat depression and other psychiatric disorders) if you are taking fluvoxamine, your doctor may reduce your dose.
  • Rifampicin (used to treat infections).
  • St. John's Wort (Hypericum perforatum) (used to treat mild depression).

Pregnancy and breastfeeding

There is insufficient data on the use of pantoprazole in pregnant women.Pantoprazole is excreted in human breast milk.

If you are pregnant or breastfeeding, or think you may be pregnant or plan to become pregnant, consult your doctor or pharmacist before using this medication.

You should only use this medication if your doctor considers the benefits for you to be

greater than the potential risk to the fetus or baby.

Driving and operating machinery

Citrelhas no influence or this is insignificant on the ability to drive or operate machinery.

You should not drive or operate machinery if you experience side effects such as dizziness or blurred vision.

Citrel contains sodium.

This medication contains less than 23 mg of sodium (1 mmol) per tablet; this is, essentially “sodium-free”.

3. How to Take Citrel

Follow exactly the administration instructions of this medication as indicated by your doctor.In case of doubt, consult your doctor or pharmacist again.

When and how should you take Citrel?

Take the whole tablets, without chewing or crushing, with a little water, 1 hour before a meal.

Unless your doctor has indicated otherwise, theusual doseis:

Adults and adolescents 12 years and older:

For treating symptoms associated with gastroesophageal reflux disease(heartburn, acid regurgitation, difficulty swallowing)

The usual dose is 1 tablet per day.

This dose usually provides relief within 2-4 weeks, and if not, within a maximum of 4 weeks. Your doctor will tell you how long you should continue taking the medication. Subsequently, any recurring symptoms can be controlled as needed by taking1 tablet per day.

For long-term treatment and prevention of relapses of esophagitis due to reflux

The usual dose is 1 tablet per day. If the disease recurs, your doctor may double the dose, in which case you can take Pantoprazol 40 mg,onceper day. After recovery, you can reduce the dose again to1 tabletof 20 mg per day.

Adults:

For preventing duodenal and stomach ulcers in patients requiring long-term treatment with NSAIDs

The usual dose is 1 tablet per day.

Special patient groups:

- If you have severe liver problems,do not take more than1 tablet of 20 mg per day.

-Children under 12 years:This medication is not recommended for children under 12 years.

If you take more Citrel than you should

Inform your doctor or pharmacist or call the Toxicological Information Service, phone 91 562 04 20, indicating the medication and the amount ingested. No symptoms of overdose are known.

If you forget to take Citrel

Do not take a double dose to compensate for the missed doses. Take your next dose as usual.

If you interrupt treatment with Citrel

Do not stop taking these tabletswithout consulting your doctor or pharmacist first.

If you have any other questions about the use of this product, ask your doctor or pharmacist.

4. Possible Adverse Effects

Like all medicines, Citrel may cause side effects, although not everyone will experience them.

If you experience any of the following side effects, stop taking these tablets and inform your doctor immediately, or contact the emergency service at the nearest hospital:

  • Severe allergic reactions (rare; may affect up to 1 in 1,000 people): swelling of the tongue and/or throat, difficulty swallowing, hives (urticaria), difficulty breathing, swelling of the face due to an allergic reaction (Quincke's edema/angioedema), intense dizziness with very rapid heartbeats, and excessive sweating.
  • Severe skin changes (frequency unknown; cannot be estimated from available data): you may notice one or more of the followingblistering on the skin and a rapid deterioration of general conditions, erosion (including light bleeding) of eyes, nose, mouth/lips, or genitalsor skin sensitivity/eruption, particularly in areas of exposed skin to light/sun.You may also have joint pain or symptoms similar to the flu, fever, swollen lymph nodes (e.g., in the armpit), and blood tests may show changes in certain white blood cells or liver enzymes. (Stevens-Johnson syndrome, Lyell syndrome, Multiforme erythema, Acute cutaneous lupus erythematosus, Pharmacological reaction with eosinophilia and systemic symptoms (DRESS), Photosensitivity).
  • Other serious conditions (frequency unknown): yellowing of the skin and the white of the eyes (severe liver cell damage, jaundice), or fever, hives, increased kidney size with occasional pain while urinating, and lower back pain (severe kidney inflammation),possibly causing kidney failure.

Other side effects are:

  • Frequent(may affect up to 1 in 10 patients)

benign polyps in the stomach.

  • Infrequent(may affect up to 1 in 100 patients)

headache; dizziness; diarrhea; sensation of dizziness, vomiting; swelling and flatulence (gas); constipation; dry mouth; abdominal pain and discomfort; hives on the skin, exanthema, rash; tingling; feeling of weakness, fatigue, or general discomfort; sleep disturbances;hip fracture, wrist fracture, and spinal column fracture.

  • Rare(may affect up to 1 in 1,000 patients)

alterationor complete loss of taste;vision changes such as blurred vision; urticaria; joint pain; muscle pain; weight changes; increased body temperature; swelling in the extremities (peripheral edema); allergic reactions; depression; gynecomastia in men.

  • Very rare(may affect up to 1 in 10,000 patients)

disorientation

  • Frequency unknown(cannot be estimated from available data)

hallucination, confusion (especially in patients with a history of these symptoms),sensation of tingling, pinching, numbness, burning, or numbness, skin rash, possibly with joint pain, inflammatory bowel disease causing persistent watery diarrhea.

Side effects identified through blood tests:

  • Infrequent(may affect up to 1 in 100 patients)

increase in liver enzymes.

  • Rare(may affect up to 1 in 1,000 patients)

increase in bilirubin; increase in blood lipid levels;brusque drop in granular white blood cells in circulation, associated with high fever.

  • Very rare(may affect up to 1 in 10,000 patients)

reduction in the number of platelets that could cause bleeding or more frequent bruising; reduction in the number of white blood cells that could lead to more frequent infections;abnormal reduction in the balance between the number of red and white blood cells, as well as platelets.

  • Frequency unknown(cannot be estimated from available data) reduction in the level of sodium, magnesium, calcium, or potassium in the blood (see section 2).

Reporting of side effects

If you experience any type of side effect, consult your doctor or pharmacist, even if it is a possible side effect that does not appear in this leaflet. You can also report them directly through theSpanish System for the Pharmacovigilance of Medicinal Products for Human Use:www.notificaRAM.es.By reporting side effects, you can contribute to providing more information on the safety of this medication.

5. Citrel Storage

Keep this medication out of the sight and reach of children.

Do not use Citrel after the expiration date that appears on the packaging after CAD. The expiration date is the last day of the month indicated.

Store in the original packaging.

Medicines should not be disposed of through drains or trash. Dispose of packaging and unused medicines at the SIGRE collection point of the pharmacy. If in doubt, ask your pharmacist how to dispose of packaging and unused medicines. By doing so, you will help protect the environment.

6. Content of the packaging and additional information

Composition of Citrel

The active ingredient is pantoprazole.Each gastro-resistant tablet contains 20 mg of pantoprazole (in the form of sodium sesquihydrate).

Theother components(excipients) are:

Core:mannitol (E-421), sodium carbonate, pregelatinized cornstarch, crospovidone, calcium stearate.

Coating:hypromellose, triacetin, titanium dioxide, copolymer of methacrylic acid and ethyl acrylate (1:1), dispersion at 30%, talc, citrate of triethyl, red iron oxide (E-172), yellow iron oxide (E-172).

Appearance of the product and content of the packaging

Gastro-resistant tablet of yellow-orange color and round shape.

Packaging:

Each package contains 28 or 56 gastro-resistant tablets in a Poliamida/Al/PVC-Al blister.

Holder of the marketing authorization and responsible for manufacturing

Laboratorios Alter, S.A.

Mateo Inurria, 30

28036 Madrid.

Spain

Last review date of this leaflet: February 2024

The detailed and updated information on this medicine is available on the website of the Spanish Agency for Medicines and Medical Devices (AEMPS)http://www.aemps.gob.es/

About the medicine

How much does Citrel 20 mg comprimidos gastrorresistentes efg cost in Spain in 2025?

The average price of Citrel 20 mg comprimidos gastrorresistentes efg in July, 2025 is around 8.74 EUR. Prices may vary depending on the region, pharmacy, and whether a prescription is required. Always check with a local pharmacy or online source for the most accurate information.

Talk to a doctor online

Have questions about this medication or your symptoms? Connect with a licensed doctor for guidance and personalized care.

5.07 reviews
Doctor

Anna Moret

Dermatology18 years of experience

Dr. Anna Moret is a board-certified dermatologist and dermatovenereologist. She specialises in adult and pediatric dermatology, venereology, aesthetic skin care, and general medicine. Her consultations are evidence-based and tailored to each patient’s dermatological needs.

Dr. Moret provides expert evaluation and treatment for: • Skin conditions such as eczema, acne, rosacea, dermatitis, and psoriasis • Hair and scalp issues including hair loss, dandruff, and seborrheic dermatitis • Pediatric skin problems — from newborns to adolescents • Sexually transmitted infections (STIs) and dermatovenereology • Aesthetic concerns: skin ageing, non-invasive cosmetic treatments • Skin allergies and hypersensitivity reactions • Mole checks, lesion evaluation, and skin cancer screening • Skincare advice and personalised cosmeceutical routines

Combining dermatology with general medical knowledge, Dr. Moret offers comprehensive care that addresses both skin health and underlying conditions. She also holds certification from the Canadian Board of Aesthetic Medicine, ensuring an internationally aligned approach to aesthetic dermatology.

CameraBook a video appointment
5.043 reviews
Doctor

Alina Tsurkan

Family medicine12 years of experience

Dr. Alina Tsurkan is a licensed family medicine physician based in Portugal, offering online consultations for adults and children. She provides professional primary care, with a focus on prevention, accurate diagnosis, and long-term management of acute and chronic conditions.

Dr. Tsurkan supports patients with a wide range of health issues, including: • Respiratory infections: cold, flu, bronchitis, pneumonia, and lingering coughs • ENT conditions: sinusitis, tonsillitis, otitis (ear infections), sore throat, allergic rhinitis • Eye conditions: allergic or infectious conjunctivitis, red eyes, irritation • Digestive issues: acid reflux (GERD), gastritis, irritable bowel syndrome (IBS), constipation, bloating, nausea • Urinary and reproductive health: urinary tract infections (UTIs), cystitis, prevention of recurrent infections • Chronic diseases: hypertension, diabetes, thyroid disorders, elevated cholesterol, weight management • Neurological complaints: headaches, migraines, sleep disturbances, fatigue, general weakness • Women’s health: menstrual irregularities, perimenopausal symptoms, preventive screening • Children’s health: fever, infections, digestive issues, follow-ups, vaccination guidance

She also provides: • IMT medical certificates for driving licence exchange in Portugal • Personalised preventive care and wellness consultations • Interpretation of test results and medical reports • Follow-up care and medication review • Support in managing multiple coexisting conditions • Remote prescription management and medical documentation

Dr. Tsurkan’s approach is evidence-based and holistic. She works closely with each patient to develop an individualised care plan that addresses both symptoms and root causes. Her goal is to empower patients to take control of their health and maintain well-being through lifestyle adjustments, routine check-ups, and early intervention.

CameraBook a video appointment
5.078 reviews
Doctor

Andrei Popov

General medicine6 years of experience

Dr. Andrei Popov is a licensed pain management specialist and general practitioner based in Spain. He provides expert online care for adults dealing with both chronic and acute pain, as well as a wide range of everyday health concerns.

He specialises in diagnosing and treating pain conditions that affect quality of life, including: • Chronic pain lasting more than 3 months • Migraines and recurring headaches • Neck, back, lower back, and joint pain • Post-traumatic pain following injury or surgery • Nerve-related pain, fibromyalgia, and neuralgia In addition to pain management, Dr. Popov helps patients with: • Respiratory infections (colds, bronchitis, pneumonia) • High blood pressure and metabolic conditions such as diabetes • Preventive care and routine health check-ups

Online consultations last up to 30 minutes and include a detailed symptom review, personalised treatment planning, and medical follow-up when needed.

Dr. Popov’s approach is rooted in evidence-based medicine, combined with individualised care tailored to each patient’s history, lifestyle, and clinical needs.

CameraBook a video appointment
5.017 reviews
Doctor

Yevgen Yakovenko

General surgery11 years of experience

Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise: • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan. • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions. • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies. • General and paediatric surgery: hernias, appendicitis, congenital conditions, both planned and urgent surgeries. • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required. • Oncological surgery: diagnosis review, treatment planning, and long-term follow-up. • Imaging interpretation: analysis of ultrasound, CT, MRI, and X-ray results, surgical planning based on imaging data. • Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications: • 12+ years of clinical experience in university hospitals in Germany and Spain • International education: Ukraine – Germany – Spain • Member of the German Society of Surgeons (BDC) • Certified in radiological diagnostics and robotic surgery • Active participant in international medical conferences and research

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

CameraBook a video appointment
See all doctors

Stay informed and save on care

Get health tips, platform updates, and exclusive promos for subscribers.

Follow us on social media
FacebookInstagramTikTok