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