Pantoprazole
Classification
Proton pump inhibitor
Indications
CCP: Erosive esophagitis, short term treatment of GERD, Zollinger-Ellison syndrome, peptic ulcer disease
Contraindications
- Hypersensitivity
- Concomitant use with rilpivirine.
Caution
- Long term use
- High dose
- Hypomagnesemia
- Patients 50 years and older.
- Concomitant use with Clopidogrel.
Adult dosages
CCP: All indications
- 40-80 mg IV
- 8 mg/hr IV infusion
Pediatric Considerations And Dosing
CCP: All indications
- 15-24 kg
- 20- 40 mg IV
- 24-34 kg
- 40-60 mg IV
- > 35 kg
- 60-80 mg IV
How Supplied
Not supplied by BCEHS
- 40 mg/vial
- 20 mg tablet
- 40 mg tablet
Mechanism Of Action
Inhibits gastric parietal cell hydrogen-potassium ATPase. This results in the blocking of acid secretion in the stomach.
Pharmacokinetics
Onset: PO 2.5 hours, IV 15-30 minutes
Duration: 7 days
Peak plasma time: 2.8 hours.
Half-life: 1 hour
Adverse Effects
- Headache
- Abdominal pain
- Facial edema
- Generalized edma
- Chest pain
- Diarrhea
- Constipation
- Pruritus
- Rash
- Hyperglycemia
- Nausea and vomiting
Warning And Precautions
- PPI’s are possibly associated with increased incidence of CDAD.
- Cutaneous lupus erythematosus and systemic lupus erythematosus reported with PPI’s.
- Caution with severe hepatic impairment.
- PPI’s may be associated with an increased risk of osteoporosis related fractures.
- PPI’s may decrease the effectiveness of Plavix.
- Hypomagnesemia may occur with prolonged use.
- Therapy increases risk of Salmonella, Campylobacter, and other infections.
- Infusion thrombophlebitis
- Acute interstitial nephritis
- Acute tubulointerstitial nephritis
- Increased risk of fundic gland polyps.
- May elevate or prolong serum methotrexate.
Drug Interactions
- Nelfinavir
- Rilpivirine
- Acalabrutinib
- Atazanavir
- Bosutinib
- Captopril
- Cefditoren pivoxil
- Cefpodoxime proxetil
- Cefuroxime axetil
- Dacomitinib
- Dasatinib
- Dextroamphetamine
- Erlotinib
- Ferrous gluconate
- Ferrous sulfate
- Fosinipril
- Gefitinib
- Ketoconazole
- Levothyroxine
- Mefenamic acid
- Mesalamine
- Methylphenidate
- Neratinib
- Nilotinib
- Pazopanib
- Pexidartinib
- Posaconazole
- Selpercatinib
- Triazolam
- Velpatasvir