Pantoprazole
Mechanism :
Suppresses gastric acid secretion by inhibiting the parietal cell membrane cell h+ k+ ATPase or proton pump demonstrates antimicrobial activity against H. Pylori.
Indication :
- Gastro-esophageal reflux disease (GERD)
- Esophageal gastric varices bleeding prophylaxis, erosive esophagitis
- Acid peptic disease
- Helicobacter pylori eradication
Contraindications :
Hypersensitivity to drug/class/component.
Substituted benzimidazole PPI e.g. esomeprazole, omeprazole or any other component.
Dosing :
Oral:
0.6 to 1.2 mg/kg/day (Max: 2.5 mg/day PO for neonates; 15 mg/day PO for patients aged
1 year; 20 mg/day PO for children aged 2 to 5 years; 40 mg/day PO for children 5 years and older. For children >40 kg, up to 80 mg/day PO (up to 2.5 mg/kg/day) has been used off-label for H. pylori eradication).
Duration of treatment is 8 weeks for erosive esophagitis (erosive GERD), non-erosive GERD and for 14 days in H.pylori eradication with combination therapy.
IV:
Limited data available for off-label IV use.
Adverse Effect :
Blood dyscrasias, hepatic impairment, hypersensitivity reaction, anaphylaxis, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, pancreatitis, interstitial nephritis, rhabdomyolysis, fractures, hyponatremia, hypomagnesemia (long-term use), atrophic gastritis (long-term use), clostridium difficile associated diarrhea, headache, nausea/vomiting, diarrhea, thrombophlebitis (IV use), abdominal pain, fever, rash, dizziness, flatulence, arthralgia.
Interaction :
Interaction Characteristics:
CYP2C19 Substrate, Gastric Alkalinzers.
Contraindicated:
Nelfinavir, Rilpivirine.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Not dialysed. Dose as in normal renal function |
| HD | Not dialysed. Dose as in normal renal function |
| HDF/High flux | Unknown dialysability. Dose as in normal renal function |
| CAV/VVHD | Unknown dialysability. Dose as in normal renal function |
Hepatic Dose :
No dosage adjustments are recommended.