Pantonix 40 IV Injection

✔️ Uses of Pantonix 40 IV Injection

• Erosive Esophagitis
• Gastroesophageal Reflux Disease
• Helicobacter Pylori Infection
• Zollinger-Ellison Syndrome
• Other Forms Of Ulcers

✔️ Side Effects of Pantonix 40 IV Injection

Pantoprazole is well tolerated in both short-term and long-term treatment. Headache and diarrhea are the common side effects and rarely included side effects are abdominal pain, flatulence, rash, insomnia, and hyperglycemia.

✔️ How does Pantonix 40 IV Injection work?

Pantonix 40 IV Injection is a proton pump inhibitor. It reduces gastric acid secretion by blocking the actions of a protein membrane called H+K+Atpase (proton pump) across the stomach lining. As a result, it prevents the worsening of ulcers, heals the existing ulcers and esophageal lesions, and provides relief from the unpleasant symptoms of the GI tract (such as acidity, heartburn, and acid reflux).

✔️ Quick Suggestions:

• Avoid foods and drinks that can trigger acid reflux and heartburn, such as onions, peppermint, chocolate, citrus fruits or juices, tomatoes, caffeinated beverages, and high-fat or spicy foods.
• Elevate the head of your bed while sleeping by using a raised block to keep your head and chest higher than your feet. This position helps prevent stomach acid from flowing back into the food pipe. Avoid using multiple pillows, as it may strain your neck.
• Quit smoking and limit alcohol intake, as they can increase stomach acid production and weaken the valve that prevents acid reflux.
• Include high-fiber foods, berries, cherries, leafy green vegetables (like kale and spinach), and black peppers in your diet. These foods are rich in antioxidants, calcium, and vitamin B12, which can help counter the long-term effects of the medication. Fermented dairy products like miso, sauerkraut, and kimchi contain probiotics that can aid in reducing excess stomach acid.
• Avoid prolonged periods of sitting. Take short breaks every hour to engage in brisk walking or stretching, as it can help regulate stomach acid production.
• Follow the prescribed dosage and instructions for taking the medication. Preferably, take anti-reflux medicines in the morning on an empty stomach or with food for optimal effectiveness.
• Make necessary lifestyle modifications, such as limiting carbonated drinks and oily/fried food, engaging in regular exercise, and maintaining a healthy weight, to manage acidity.
• Reduce stress levels and prioritize getting adequate sleep each night, as stress and lack of sleep can exacerbate acidity symptoms.
• Inform your doctor if you have been using this medication for more than four weeks or if the symptoms persist despite taking the medicine as prescribed.
• Pantoprazole may interact with other medications. Inform your doctor about all the medicines you are taking.
• If you experience symptoms like nausea, fullness, and bloating, especially after meals, even after taking the medication, consult your doctor.
• If you are at risk for osteoporosis-related fractures, ensure an adequate intake of calcium and vitamin D.
• Regularly monitor your vitamin B12 levels, as long-term use of Pantonix 40 IV Injection may rarely cause vitamin B12 deficiency.
• Pantonix 40 IV injections may interfere with certain laboratory tests, potentially causing false results. Inform laboratory personnel and all your doctors that you are taking Pantonix 40 IV Injection.

✔️ Indication

Pantonix 40 IV Injection contains the active substance Pantoprazole which belongs to a group of medicines called "Proton pump inhibitors," medications that reduce the amount of acid produced in the stomach.

✔️ Pharmacology

Pantonix 40 IV Injection is a type of medication known as a proton pump inhibitor (PPI). It works by covalently binding to the H+/K+ATPase enzyme system found on the surface of gastric parietal cells. This binding action suppresses the final step in the production of gastric acid in the stomach. As a result, Pantonix 40 IV Injection inhibits the production of stomach acid, both under normal conditions and when stimulated, regardless of the duration of the stimulus, for more than 24 hours.

✔️ Dosage of Pantonix 40 IV Injection

Preparation and administration instructions for IV infusion/injection of Pantonix 40 are as follows:

• For GERD with a history of erosive esophagitis 15-minute infusion: Reconstitute each vial with 10 mL normal saline (NS), THEN further dilute the reconstituted solution with 100 mL of either 5% dextrose in water (D5W), normal saline (NS), or lactated Ringer's (LR) solution to achieve a final concentration of 0.4 mg/mL.
• For Zollinger-Ellison syndrome 15-minute infusion: Reconstitute each vial with 10 mL normal saline (NS), then combine two vials and further dilute the combined solution with 80 mL of either 5% dextrose in water (D5W), normal saline (NS), or lactated Ringer's (LR) solution to achieve a total volume of 100 mL with a concentration of 0.8 mg/mL.
• Duodenal ulcer and gastric ulcer: A single dose of 40 mg once daily for 7-10 days.
• Gastroesophageal reflux disease (GERD) with a history of erosive esophagitis: A single dose of 40 mg once daily for 7-10 days.
• Prevention of rebleeding in peptic ulcer: An initial IV dose of 80 mg, followed by a continuous infusion of 8 mg per hour for 72 hours.
• Prophylaxis of acid aspiration: An initial IV dose of 80 mg every 12 hours for 24 hours, followed by 40 mg every 12 hours.
• Long-term management of Zollinger-Ellison Syndrome and other pathological hypersecretory conditions: An initial IV dose of 80 mg every 12 hours. The dosage may be increased to 80 mg every 8 hours if needed, and further titration to higher doses can be done based on acid output.
• For a 2-minute injection: Reconstitute each vial with 10 mL normal saline (NS) to achieve a final concentration of 4 mg/mL.

✔️ Direction for use of IV injection:

• Your doctor will decide the correct dose and duration of therapy for you depending on your age, body weight, and disease condition.
• Pantoprazole IV injection should be given as a slow intravenous injection.
• The solution for IV injection is obtained by adding 10 ml 0.9% Sodium Chloride Injection to the vial containing powder. After reconstitution, the injection should be given slowly over a period of at least 2 to 5 minutes.
• Use only freshly prepared solutions. The reconstituted solution may be stored at room temperature (up to 30° C) for a maximum of 4 hours.

✔️ Overdose Effects of Pantonix 40 IV Injection

There are no known symptoms of overdosage in humans. Since Pantoprazole is highly protein-bound, it is not readily dialyzable. Apart from symptomatic and supportive management, no specific therapy is recommended.

✔️ Interaction

When taking Pantonix 40, there are several drug interactions that you should be aware of:

• Increased risk of digoxin-induced cardiotoxic effects: Pantonix 40 may increase the risk of adverse effects associated with digoxin, a medication used to treat heart conditions. Close monitoring of digoxin levels is recommended when using Pantonix 40 concurrently.
• Increased risk of hypomagnesemia with diuretics: Pantonix 40 may increase the risk of low magnesium levels in the blood when used together with diuretic medications. Regular monitoring of magnesium levels is advised.
• May increase INR and prothrombin time of warfarin: Pantonix 40 can potentially increase the International Normalized Ratio (INR) and prothrombin time, leading to an increased risk of bleeding when used with warfarin, an anticoagulant medication. Close monitoring of INR and adjustment of warfarin dosage may be necessary.
• May increase the serum concentration of methotrexate and saquinavir: Pantonix 40 may increase the blood levels of methotrexate (a medication used in cancer treatment and autoimmune diseases) and saquinavir (an antiviral medication). Monitoring for increased side effects or toxicity is recommended when using these medications together.
• Delayed absorption and decreased bioavailability with sucralfate: Sucralfate, a medication used to treat ulcers, may interfere with the absorption and effectiveness of Pantonix 40. It is recommended to separate the administration of Pantonix 40 and sucralfate by at least 2 hours.
• Decreased absorption of ketoconazole and itraconazole: Pantonix 40 may decrease the absorption of ketoconazole and itraconazole, which are antifungal medications. Taking these medications at least 2 hours before or after Pantonix 40 is advised.
• Potentially fatal: Pantonix 40 may decrease the serum levels and pharmacological effects of rilpivirine, atazanavir, and nelfinavir, which are antiviral medications. It is crucial to consult with your healthcare provider to assess the potential risks and consider alternative treatment options if necessary.

It is important to inform your doctor about all the medications you are taking, including prescription drugs, over-the-counter medications, and herbal supplements, to avoid potential drug interactions. Your doctor can provide personalized guidance and adjust your treatment plan accordingly.

✔️ Contraindications

Pantoprazole is not recommended for those who have a known hypersensitivity to any of the formulation's ingredients.

✔️ Pregnancy & Lactation

Pantoprazole is classified as a pregnancy category B medication by the US Food and Drug Administration (FDA). This means that animal studies have not shown any direct harm to the fetus, but there are no well-controlled studies in pregnant women.

As with any medication, the use of pantoprazole during pregnancy should be carefully considered. It should only be taken if the potential benefits to the mother outweigh the potential risks to the fetus. It is important to discuss the use of pantoprazole with your healthcare provider if you are pregnant or planning to become pregnant.

Pantoprazole has been found to pass into human breast milk. Therefore, a decision should be made whether to discontinue breastfeeding or to discontinue the medication, taking into account the importance of the drug to the mother.

✔️ Precautions & Warnings

• Before initiating pantoprazole treatment, it is important to rule out gastric malignancy, as this medication is primarily indicated for the treatment of conditions related to excessive stomach acid production.
• In patients who may be prone to zinc deficiency, it may be necessary to consider zinc supplementation during intravenous therapy with pantoprazole.
• During pregnancy, the use of pantoprazole should be carefully evaluated. While animal studies have not shown direct harm to the fetus, there is limited data from well-controlled studies in pregnant women. The decision to use pantoprazole during pregnancy should be made after considering the potential benefits and risks.
• Monitoring magnesium levels is recommended prior to initiating pantoprazole therapy and periodically during prolonged use, as prolonged use of pantoprazole may lead to magnesium deficiency.
• Long-term use of pantoprazole may potentially interfere with the absorption of cyanocobalamin (Vitamin B12) and increase the risk of osteoporosis-related conditions. Regular monitoring and appropriate supplementation may be necessary in such cases.
• Pantoprazole has been detected in breast milk after a single oral dose. There have been no reported adverse effects on breastfed infants. However, the impact of pantoprazole on milk production is not well-established. The decision to continue breastfeeding should consider the benefits of breastfeeding along with the mother's clinical need for pantoprazole and any potential adverse effects on the infant.

✔️ Storage Conditions

• Keep Pantonix 40 IV Injection out of the sight and reach of children
• Store Pantonix 40 IV Injection at room temperature