PANTOPRAZOLE is a proton pump inhibitor drug that inhibits gastric acid secretion.
Pantoprazole is used for short-term treatment of erosion and ulceration of the esophagus caused by gastroesophageal reflux disease. Initial treatment is generally of eight weeks' duration, after which another eight week course of treatment may be considered if necessary. It can be used as a maintenance therapy for long term use after initial response is obtained.
This medication may affect the results of certain lab tests, such as drug screenings (pantoprazole can cause a false positive for THC, the psychoactive component of cannabis.
PHARMACOLOGY :Pantoprazole is metabolized in the liver by the cytochrome P450 system. Metabolism mainly consists of demethylation by CYP2C19 followed by sulfation. Another metabolic pathway is oxidation by CYP3A4. Pantoprazole metabolites are not thought to have any pharmacological significance. Pantoprazole is relatively free of drug interactions; however, it may alter the absorption of other medications that depend on the amount of acid in the stomach, such as ketoconazole or digoxin. Generally inactive at acidic pH of stomach, thus it is usually given with a pro kinetic drug. Pantoprazole binds irreversibly to H+K+ATPase (proton pumps) and suppresses the secretion of acid. As it binds irreversibly to the pumps, new pumps have to be made before acid production can be resumed. The drug's plasma half-life is about 2 hours.
PHARMACOKINETICS : Absorption
Bioavailability: (oral, delayed release tablets), approximately 77%
Effect of food: (oral, delayed-release tablets), AUC an Cmax no effect, Tmax variable, absorption delayed, no net effect
Effect of food: (oral, for-delayed-release suspension), administer 30 minutes before a meal
Tmax, Oral, delayed-release suspension: 2 to 2.5 hr
Tmax, Oral, delayed-release tablets: 2.5 hr
Tmax, Oral, delayed-release tablets: 1.5 to 2 hours (pediatrics)
Protein binding: about 98% to primarily albumin
Vd, extensive metabolizers (IV): approximately 11 L to 23.6 L
Vd, pediatrics (oral): 0.21 to 0.43 L/kg .
Hepatic; cytochrome P450 CYP2C19; minor metabolism from CYP3A4, 2D6, and 2C9
Fecal: (oral or IV, normal metabolizers), 18%
Renal: (oral or IV, normal metabolizers), approximately 71%, none as unchanged
Dialyzable: no (hemodialysis)
Total body clearance: (IV) 7.6 to 14 L/hour .
Total body clearance: (oral, pediatrics) 0.18 to 2.08 L/hr/kg
Elimination Half Life
Oral or IV, 1 hour
Oral or IV, slow metabolizers, 3.5 to 10 hours
Pediatrics, 0.7 to 5.34 hours
Why is this medication prescribed?
Pantoprazole is used to treat gastroesophageal reflux disease (GERD), a condition in which backward flow of acid from the stomach causes heartburn and possible injury of the esophagus (the tube between the throat and stomach). Pantoprazole is used to treat the symptoms of GERD, allow the esophagus to heal, and prevent further damage to the esophagus. It is also used to treat conditions where the stomach produces too much acid, such as Zollinger-Ellison syndrome. Pantoprazole is in a class of medications called proton-pump inhibitors. It works by decreasing the amount of acid made in the stomach.
How should this medicine be used?
Pantoprazole comes as a delayed-release (long-acting) tablet to take by mouth and packets of delayed-release (long-acting) granules to be mixed with applesauce or apple juice and taken by mouth or given through a feeding tube. The tablet is usually taken with or without food one or two times a day. The oral suspension is usually taken 30 minutes before a meal one or two times a day. Take pantoprazole at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take pantoprazole exactly as directed. Do not take more or less of it or take it more often or for a longer period of time than prescribed by your doctor.
Swallow the tablets whole; do not split, chew, or crush them. If your doctor has prescribed the 40 mg tablet and it is too big for you to swallow, ask your doctor to prescribe two of the 20 mg tablets instead.
To take the powder for oral suspension, open the packet and sprinkle the granules onto one teaspoonful of applesauce or into a cup containing one teaspoonful of apple juice. Use all of the granules in the packet; do not divide the granules into smaller doses. If you sprinkle the granules into apple juice, stir the mixture for 5 seconds. Swallow the mixture of applesauce or apple juice and medication right away without chewing or crushing the granules. If you sprinkled the granules on applesauce, take several sips of water to wash the granules down to your stomach. If you sprinkled the granules into apple juice, rinse the cup once or twice with apple juice and drink the apple juice right away to be sure you swallow any leftover granules.
Pantoprazole powder mixed with apple juice may be given through a feeding tube. If you have a feeding tube, ask your doctor how you should take pantoprazole.
Continue to take pantoprazole even if you feel well. Do not stop taking pantoprazole without talking to your doctor. If your condition does not improve or gets worse, call your doctor.
Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
What special precautions should I follow?
Before taking pantoprazole,
tell your doctor and pharmacist if you are allergic to pantoprazole, dexlansoprazole (Dexilant), esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec, Zegerid), rabeprazole (AcipHex), any other medications, or any of the ingredients in pantoprazole tablets or powder.Ask your pharmacist for a list of the ingredients.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: certain antibiotics, including ampicillin (Principen), anticoagulants (blood thinners) such as warfarin (Coumadin), atazanavir (Reyataz), digoxin (Lanoxin, Lanoxicaps), diuretics ('water pills'), iron supplements, ketoconazole (Nizoral), methotrexate (Rheumatrex, Trexall), and nelfinavir (Viracept). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
tell your doctor if you have or have ever had a low level of magnesium in your blood.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking pantoprazole, call your doctor.
if you are 50 years of age or older, ask your doctor if it is safe for you to take pantoprazole. The risk that you may develop a severe form of diarrhea caused by bacteria or that you may fracture your wrist, hip, or spine may be higher if you are an older adult.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
What should I do if I forget a dose?
Take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed dose.
What side effects can this medication cause?
Pantoprazole may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
Some side effects may be serious. If you experience any of the following symptoms, call your doctor immediately, or get emergency medical help:
blistering or peeling skin
swelling of the eyes, face, lips, mouth, throat, or tongue
difficulty breathing or swallowing
irregular, fast, or pounding heartbeat
uncontrollable shaking of a part of the body
severe diarrhea with watery stools
stomach pain , fever
Pantoprazole may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
People who take proton pump inhibitors such as pantoprazole may be more likely to fracture their wrists, hips, or spine than people who do not take one of these medications. The risk is highest in people who take high doses of one of these medications or take them for one year or longer.
People who take pantoprazole for a long time may develop weakening of the stomach lining and a low level of vitamin B12 in the blood.
Talk to your doctor about the risks of taking pantoprazole.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].
What storage conditions are needed for this medicine?
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.
In case of emergency/overdose :
In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.
What other information should I know?Return to top
Keep all appointments with your doctor and the laboratory. Your doctor may order certain laboratory tests before and during your treatment, especially if you have severe diarrhea..
Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking pantoprazole.
Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.