section name header

Pronunciation ⬇

pan-TOE-pra-zole

Classifications ⬆ ⬇

Therapeutic Classification: antiulcer agents

Pharmacologic Classification: proton pump inhibitors

Indications ⬆ ⬇

BEERS REMS

Unlabeled Use:

Action ⬆ ⬇

  • Binds to an enzyme in the presence of acidic gastric pH, preventing the final transport of hydrogen ions into the gastric lumen.
Therapeutic effects:
  • Diminished accumulation of acid in the gastric lumen, with lessened acid reflux.
  • Healing of duodenal ulcers and esophagitis.
  • Decreased acid secretion in hypersecretory conditions.

Pharmacokinetics ⬆ ⬇

Absorption: Tablet is enteric-coated; absorption occurs only after tablet leaves the stomach.

Distribution: Unknown.

Protein Binding: 98%.

Metabolism/Excretion: Primarily metabolized by the CYP2C19 and CYP3A4 isoenzymes in the liver; the CYP2C19 isoenzyme exhibits genetic polymorphism (15–20% of Asian patients and 3–5% of Caucasian and Black patients may be poor metabolizers and may have significantly ↑ pantoprazole concentrations and an ↑ risk of adverse effects); inactive metabolites are excreted in urine (71%) and feces (18%).

Half-Life: 1 hr.

Time/Action Profile ⬆ ⬇

(effect on acid secretion)

ROUTEONSET‡PEAKDURATION‡
PO2.5 hrunknown1 wk
IV15–30 min2 hrunknown



‡Onset = 51% inhibition; duration = return to normal following discontinuation.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects ⬆ ⬇

Derm: ACUTE GENERALIZED EXANTHEMATOUS PUSTULOSIS, cutaneous lupus erythematosus, DRUG REACTION WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS), STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS

Endo: hyperglycemia

F and E: hypocalcemia (especially if treatment duration ≥3 mo), hypokalemia (especially if treatment duration ≥3 mo), hypomagnesemia (especially if treatment duration ≥3 mo)

GI: abdominal pain, CLOSTRIDIOIDES DIFFICILE-ASSOCIATED DIARRHEA (CDAD), diarrhea, eructation, flatulence, fundic gland polyps

GU: acute tubulointerstitial nephritis

Hemat: vitamin B12 deficiency

MS: bone fracture

Neuro: headache

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS, ANGIOEDEMA, OR TUBULOINTERSTITIAL NEPHRITIS), systemic lupus erythematosis

Interactions ⬆ ⬇

Drug-drug:

Route/Dosage ⬆ ⬇

Gastroesophageal Reflux Disease

Gastric Hypersecretory Conditions

Availability ⬆ ⬇

(Generic available)

Assessment ⬆ ⬇

Lab Test Considerations:

Implementation ⬆ ⬇

IV Administration:

Patient/Family Teaching ⬆ ⬇

Evaluation/Desired Outcomes ⬆ ⬇

US Brand Names ⬆ ⬇

Protonix

Canadian Brand Names ⬆ ⬇

Pantoloc, Tecta

Code ⬆

NDC Code