Medical Description
Proton pump inhibitor used in the treatment of dyspepsia, gastroesophageal reflux disease, Helicobacter pylori eradication, primary prevention of nonsteroidal anti-inflammatory drugs-induced ulcers, treatment and prevention of peptic ulcer disease.
Indication & Usage
-Dyspepsia: Oral: 20 to 40 mg once daily for a 4- to 8-week; can be continued for a longer duration in patients with symptom improvement.
-Gastroesophageal reflux disease: Initial therapy: Mild/intermittent disease (<2 episodes/week) and no evidence of erosive esophagitis: Oral: 20 mg once daily, can increase to 40 mg once daily after 4 to 8 weeks if necessary. Discontinue once asymptomatic for 8 weeks. Severe and/or frequent symptoms (≥2 episodes/week), and/or erosive esophagitis: Oral: 40 mg once daily; once symptoms are controlled, continue for at least 8 weeks.
-Helicobacter pylori eradication: Oral: 40 mg or 80 mg twice daily as part of an appropriate combination regimen with antibiotics.
-Nonsteroidal anti-inflammatory drugs (including aspirin)-induced ulcers, primary prevention: Oral: 20 to 40 mg once daily for the duration of high-risk NSAID use.
-Treatment and secondary prevention of peptic ulcer disease: Uncomplicated ulcer: Oral: 40 mg once daily. Duration depends on the size, location, and cause of ulcer and ranges from 4 to 8 weeks, Complicated ulcer (perforation, penetration, or gastric outlet obstruction): Oral, IV: 40 mg twice daily for 4 weeks, followed by 40 mg once daily. Duration depends on the location and etiology of ulcer, Bleeding ulcer: IV: Continuous infusion: Loading dose of 80 mg, followed by 8 mg/hour continuous infusion for a total of 72 hours, IV: Intermittent dosing: Loading dose of 80 mg, followed by 40 mg every 12 hours.
-Stress ulcer prophylaxis in critically ill patients: IV: 40 mg once daily : Oral or via nasogastric tube: 40 mg once daily.
-Pediatric Gastroesophageal reflux disease (GERD): Infants, Children, and Adolescents: Oral: 1 to 2 mg/kg/day once daily; maximum daily dose: 40 mg/day.
Active Ingredients
Pantoprazole
Dosage & Administration
-Tablet: Should be swallowed whole, do not split, crush, or chew. For most indications, administer 30 to 60 minutes before a meal (preferably); best if taken before breakfast If administering twice daily, first dose should be administered before breakfast and the second dose before dinner.
-15-minute infusion: 40 mg dose: Reconstitute 1 vial with 10 mL of normal saline; further dilute with 100 mL of D5W, NS, or LR to a final concentration of ~0.4 mg/ml. 80 mg dose: Reconstitute 2 vials each with 10 mL of NS; combine the content of both vials and further dilute with 80 mL of D5W, NS, or LR to a final concentration of ~0.8 mg/ml.
-2-minute infusion: Reconstitute with 10 mL of NS to a final concentration of ~4 mg/ml.
Side Effects
Edema, facial edema, thrombophlebitis, pruritus, skin photosensitivity, skin rash, urticaria, increased serum triglycerides, abdominal pain, constipation, diarrhea, flatulence, nausea, vomiting, xerostomia, leukopenia, thrombocytopenia, hepatitis, increased liver enzymes, hypersensitivity reaction, depression, dizziness, vertigo, arthralgia, increased creatine phosphokinase in blood, myalgia, blurred vision, fever.
Safety Advice
-In patients who have received continuous therapy for >6 months, gradually taper therapy until discontinuation to avoid worsening or rebound symptoms. If the patient is receiving 40 mg once or twice daily, some experts decrease the dose by 50% every week. For patients receiving twice-daily dosing, the first dose reduction can be achieved by decreasing to once-daily AM dosing. Once patients are on the lowest dose for 1 week, discontinue therapy.
-Incase of over dose be ready to tell or show what was taken, how much and when it happened, and seek immediate medical attention. For additional information call us on 16676. Always tell your physician your detailed medical history.
Storage
Store at room temperature.
Drug Interactions
-Bisphosphonate Derivatives: Inhibitors of the Proton Pump (PPIs and PCABs) may diminish the therapeutic effect of Bisphosphonate Derivatives.
-Cefpodoxime: Inhibitors of the Proton Pump (PPIs and PCABs) may decrease the serum concentration of Cefpodoxime.
-Cefuroxime: Inhibitors of the Proton Pump (PPIs and PCABs) may decrease the absorption of Cefuroxime.
-Clopidogrel: Pantoprazole may decrease serum concentrations of the active metabolite(s) of Clopidogrel.
-Itraconazole: Inhibitors of the Proton Pump (PPIs and PCABs) may increase the serum concentration of Itraconazole.
-Methotrexate: Inhibitors of the Proton Pump (PPIs and PCABs) may increase the serum concentration of Methotrexate.
-Multivitamins/Minerals (with vitamins ADEK, Folate, Iron): Inhibitors of the Proton Pump (PPIs and PCABs) may decrease the serum concentration of Multivitamins/Minerals.
Pregnancy & Lactation
-Ask your physician before taking any medication during pregnancy or lactation.
-Based on available data, PPIs may be used when clinically indicated.
-The relative infant dose (RID) of pantoprazole was determined to be 0.14. In general, breastfeeding is considered acceptable when the RID is <10%.