Pantoprazole
Antipeptic Ulcerant · Proton pump inhibitor
Indications
Duodenal ulcer. Benign gastric ulcer. Prevention of NSAID-induced ulceration. Zollinger-Ellison syndrome. Treatment and prevention of reflux oesophagitis. With antibiotics for the eradication of Helicobacter pylori in patients with duodenal ulcer or gastritis.
Dosage
ORAL: Adults: Duodenal ulcer: 40 mg daily in the morning for 4 wk. In severe cases, increase up to 80 mg daily. Gastric ulcer: 40 mg daily in the morning for 8 wk. In severe cases, increase up to 80 mg daily. NSAID ulceration: 20 mg daily. Zollinger-Ellison syndrome: Initially 80 mg daily, adjust dose according to response. Elderly: 40 mg daily. GERD: 20-40 mg daily in the morning for 2-4 wk. Extend for a further 4 wk if not healed. Maintenance, 20 mg daily; reassess risk/benefit if treatment exceeds 1 yr. Control of recurring symptoms in healed reflux disease: 20 mg once daily when required. Triple therapy vs H. Pylori: 40 mg twice daily with either clarithromycin 250 mg and metronidazole 400 mg both twice daily for one wk or clarithromycin 500 mg and amoxicillin 1 gm both twice daily for one wk. Children: Not recommended. INJECTION: Adults: Duodenal ulcer, gastric ulcer, reflux…
Administration
IV: Infuse over 15 min at a rate not to exceed 3 mg/min. Use in-line filter (positioned below Y-site if use). Flush IV line with D5W, NS, or lactated Ringer’s injection before and after giving drug. Reconstitution: Reconstitute each 40 mg vial with 10 mL 0.9% NaCl and dilute with 100 mL infusion fluid, give 40 mg over 15 min. Use within 12 hrs. Compatibility: Intermittent infusion in 5% Glucose or 0.9% NaCl. Y-site administration: Drug to Drug IV Compatibility: Azithromycin, bumetanide, ceftriaxone, imipenem, phenylephrine, vasopressin. Drug to Drug IV Incompatibility: Aztreonam, cefepime, ciprofloxacin, dexamethasone, diltiazem, diphenhydramine, dobutamine, esmolol, famotidine, fentanyl, fluconazole, labetalol, levofloxacin, linezolid, lorazepam, methylprednisolone, metronidazole, midazolam, ondansetron. Stability: Store at 2°C-8°C. Solution may be stored up to 2 hours before further…
Adverse Effects
Nausea, headache, diarrhoea, constipation, skin rashes, fundic gland polyps. Report of subacute cutaneous lupus erythematosus.
Risk Factor (Pregnancy/Lactation)
Pregnancy: No evidence of risk in humans. Lactation: Contraindicated or not recommended. Precautions: Exclude malignancy before and during treatment. Monitor liver enzyme, discontinue if elevated. Possible increased risk of GI infection. Long term therapy; risk of hypomagnesaemia, reduced vit B12 absorption and fractures.
Interactions
Drugs whose absorption is pH dependent e.g. Ketoconazole. Anticoagulants, atazanavir, erlotinib, methotrexate, inducers or inhibitors of CYP2C19, inducers of CYP3A4.
Advice to Patient
Take tablets with or without meals. Do not chew or crush tablet, swallow whole. Take at same time each day. Take oral granules for suspension 30 minutes before a meal. For oral suspension, mix granules with applesauce or apple juice. Do not use any other type of liquid or soft food. Sprinkle the granules directly onto a teaspoon of applesauce and swallow this mixture without chewing or pour the granules into a cup with 1 teaspoon of apple juice, mix for 5 seconds and swallow. Add a little more apple juice to the same glass, mix gently and drink. Do not save the granules mixture for later use. Contact prescriber immediately if bleeding occurs. Report constant abdominal discomfort, chest pain or palpitation, acute headache, unrelieved diarrhoea, excessive fatigue, increased muscle/joint/body pain, shortness of breath or wheezing, cold or flu symptoms, changes in urinary pattern. Patients…
Pharmacokinetics
Onset of action: Oral: 2.5 hrs. IV: 15-30 min. Maximum effect: IV: 2 hrs. Absorption: Rapid, well absorbed. Duration: Oral, IV: 24 hrs. Metabolism: Extensively hepatic. Bioavailability: Approx. 77%. Half-life elimination: Neonates: Approx. 3 hrs. Children: Oral: 5-16 yrs: 1.27 ± 1.29 hrs. IV: 2-16 yrs: 1.22 ± 0.68 hrs. Adults: 1 hr. Time to peak: Children: Oral: 5-16 yrs: 2.54 ± 0.72 hrs. IV: 2-16 yrs: 0.34 ± 0.12 hrs. Adults: Oral: 2.5 hrs. Excretion: Urine(71%), faeces(18%).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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