Adult Dosing

Erosive esophagitis with GERD

• 40 mg IV for 2/15 min q24 hrs for 7-10 days; Max: 10 days

Pathological GI hypersecretory conditions viz Zollinger-Ellison syndrome

• 80 mg IV for 2/15 min q8-12 hrs; Max: 240 mg/d or 6 days
• Note: Resume to oral route as soon as the patient recovers

Pediatric Dosing

• Safety and efficacy in pediatric patients have not been established

[Outline]

• Adult Dosing
• Pediatric Dosing

• GERD with a history of erosive esophagitis
• Pathological hypersecretion associated with Zollinger-Ellison Syndrome or other neoplastic conditions

• Hypersensitivity to any of the ingredients of the product

• N/A

Renal Dose Adjustment

• Renal impairment: No dose adjustments

Hepatic Dose Adjustment

• Hepatic impairment: No dose adjustments

• Provide emergency medical treatment in case of immediate hypersensitivity reactions with IV administration of drug
• At the injection site thrombophlebitic reaction may occur
• Mild increase in liver transaminases have occurred
• Symptomatic relief with pantoprazole therapy does not exclude the presence of gastric malignancy
• Dose increment, multiple daily dose or long term on proton pump inhibitozinc (PPI) therapy can associate with an increased risk for osteoporosis-related fracture, this can be managed by lowering the dose or short term therapy
• Cautiously administer in patients who are prone to zinc deficiency as edetate disodium is a potent chelator of metal ion including zinc and zinc supplement; consider zinc supplementation
• PPI therapy including pantoprazole may increase risk of Clostridium difficile associated diarrhea, particularly in hospitalized patients
• Treatment should be resumed to oral route of administration as soon as the patient can take oral tablet
• Use of PPIs with high dose methotrexate may increase and prolong serum levels of methotrexate and its metabolite leading to methotrexate toxicities. Temporary withdrawal of the PPI must be consider in patients who are on high-dose of methotrexate

Cautions: Use cautiously in

• High dose
• Long term use of PPI
• Concomitant with EDTA containing products
• Zinc deficiency
• Risk of osteoporosis

Protonix IV interacts with :

	Acalabrutinib
	Anticancer doses
	Atazanavir
	Bosulif
	Bosutinib
	Calquence
	Cefditoren
	Cefpodoxime
	Ceftin
	Cefuroxime
	CellCept
	Crixivan
	Crizotinib
	Dabrafenib
	Dasatinib
	DiaBeta
	Edurant
	Erlotinib
	Extina
	Folotyn
	Gefitinib
	Glipizide
	Glucotrol
	Glucotrol XL
	Glucovance
	Glyburide
	Glynase
	Harvoni
	Indinavir
	Iressa
	Itraconazole
	Ketoconazole
	Lapatinib
	Ledipasvir
	Methotrexate
	Mycophenolate
	Myfortic
	Nelfinavir
	Neratinib
	Nerlynx
	Nexavar
	Nizoral
	Nizoral A-D Shampoo
	Nizoral Shampoo
	Noxafil
	Onmel
	Otrexup
	Posaconazole
	Pralatrexate
	Reyataz
	Rheumatrex Dose Pack
	Rilpivirine
	Sorafenib
	Spectracef
	Sporanox
	Sprycel
	Tafinlar
	Tarceva
	Trexall
	Tykerb
	Vantin
	Viracept
	Xalkori
	Xolegel
	Zinacef

Pregnancy Category:B

Breastfeeding: Limited information indicates that maternal pantoprazole doses of 40 mg daily produce low levels in milk and would not be expected to cause any adverse effects in breastfed infants. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 22nd November 2010). Pantoprazole and its metabolites are excreted in the milk of rats and in human milk in a study of a single nursing mother after a single 40 mg oral dose. The clinical relevance of this finding is not known. As many drugs are excreted in human milk, Pantoprazole has a potential for serious adverse reactions in nursing infants. Based on the potential for tumorigenicity shown for pantoprazole in rodent carcinogenicity studies, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the benefit of the drug to the mother.

• GI: Constipation, dyspepsia, nausea, vomiting, diarrhea, pancreatitis, flatulence, abdominal pain
• GU: Interstitial nephritis
• CNS: Insomnia, dizziness, headache
• RESP: Rhinitis
• DERM: Thrombophlebitis, Stevens-Johnson syndrome, epidermal necrolysis, erythema multiforme, angioedema, abscess
• HEPA: Elevated liver transaminases, hepatic impairment
• MISC: Anaphylaxis, bone fracture, pain
• HEMA: Blood dyscrasias

• Proton pump inhibitor; inhibit the gastric acid production by forming a covalent bond with (H+,K+ )- ATPase enzyme system at the secretory surface of the gastric parietal cell
• Metabolized by liver; CYP450; demethylation by CYP2C19 followed by sulfation, oxidation by CYP3A4
• Excreted in urine approximately 71%; Feces 18%
• Half-life: 1 hr

US Trade Name(s)

• Protonix IV

US Availability

Protonix IV

• PWDR for INJ: 40 mg/vial

Canadian Trade Name(s)

• Panto IV
• Protium IV

Canadian Availability

pantoprazole (generic)

• PWDR for INJ : 40 mg/vial

Panto IV

• PWDR for INJ: 40 mg/vial

Protium IV

• PWDR for INJ: 40 mg/vial

UK Trade Name(s)

• Protium IV

UK Availability

pantoprazole (generic)

• PWDR for INJ: 40 mg/vial

Protium IV

• PWDR for INJ: 40 mg/vial

Australian Trade Name(s)

• Somac

Australian Availability

pantoprazole (generic)

• PWDR for INJ: 40 mg/vial

Somac

• PWDR for INJ: 40 mg/vial

[Outline]

Gastrointestinal

Antiulcer Agents

Proton Pump Inhibitors