PANTOPRAZOLE

PANTOPRAZOLE
(Protonix®)

DOSING IN ADULTS

Erosive esophagitis associated with GERD
    Treatment: 40 mg once daily for up to 8 weeks; an additional 8 weeks may be used in patients who have not healed after an 8-week course
    Maintenance of healing: 40 mg once daily

DOSING IN RENAL IMPAIRMENT 

No adjustment is required. Pantoprazole is not removed by hemodialysis.

DOSING IN HEPATIC IMPAIRMENT 

No adjustment is required.

DOSAGE FORMS 

Tablet, delayed release, as sodium: 20 mg, 40 mg
  Protonix®: 20 mg, 40 mg
Granules for suspension, delayed release, enteric coated, as sodium, oral:
  Protonix®: 40 mg/packet (30s)

ADMINISTRATION

  Tablet: Should be swallowed whole, do not crush or chew. Best if taken before breakfast.
  Delayed-release oral suspension: Should only be administered in apple juice or applesauce and taken ~30 minutes before a meal. Do not administer with any other liquid (eg, water) or foods.
    Oral administration in applesauce: Sprinkle intact granules on 1 tablespoon of applesauce and swallow within 10 minutes of preparation.
    Oral administration in apple juice: Empty intact granules into 5 mL of apple juice (~1 teaspoonful), stir for 5 seconds, and swallow immediately after preparation. Rinse container once or twice with apple juice and swallow immediately.

SIGNIFICANT  ADVERSE REACTIONS
Abdominal pain
Diarrhea
Headache
Insomnia
Rash

CONTRAINDICATIONS — Hypersensitivity to pantoprazole, substituted benzamidazoles (eg, esomeprazole, lansoprazole, omeprazole, rabeprazole), or any component of the formulation

DRUG INTERACTIONS 

Antifungal agents (azole derivatives, systemic): Proton pump inhibitors may decrease the absorption of antifungal agents (azole derivatives, systemic).
Antiretrovirals: Proton pump inhibitors may decrease the absorption of atazanavir and Indinavir. Concurrent use is not recommended. Proton pump inhibitors may increase saquinavir concentrations.
Clopidogrel: Proton pump inhibitors may decrease conversion of clopidogrel to its active metabolite, possibly interfering with its antiplatelet effects.
CYP2C19 inducers: May decrease the levels/effects of pantoprazole. Example inducers include aminoglutethimide, carbamazepine, phenytoin, and rifampin.
Iron salts: Proton pump inhibitors may decrease the oral absorption of iron salts.
Methotrexate: Proton pump inhibitors may decrease the excretion of methotrexate. Antirheumatic doses of methotrexate probably hold minimal risk.

PREGNANCY RISK FACTOR — B

LACTATION — Enters breast milk/not recommended.