Pantex 20 | 10'S

✔️ Side Effects | Pantoprazole

Common (1–10%):

Headache, abdominal pain, diarrhea, constipation, flatulence

Nausea, vomiting, rash, pruritus, edema

Less common / rare but serious:

Angioedema, atrophic gastritis, hepatic damage/failure, interstitial nephritis, pancreatitis, pancytopenia

Severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis, erythema multiforme)

Anaphylaxis, rhabdomyolysis, optic neuropathy

✔️ Administration

Controlled-release: Take on an empty stomach, at least 1 hour before meals. Swallow whole, do not chew or crush.

Normal-release: May be taken with or without food.

IV preparation:

GERD with erosive esophagitis: Reconstitute with 10 mL NS, then further dilute with 100 mL D5W, NS, or LR to 0.4 mg/mL; infuse over 15 minutes.

Zollinger-Ellison syndrome: Reconstitute each vial with 10 mL NS, combine 2 vials, then dilute with 80 mL D5W, NS, or LR to total 100 mL (0.8 mg/mL); infuse over 15 minutes.

Rapid IV injection: Reconstitute with 10 mL NS to a final concentration of 4 mg/mL; infuse slowly over 2 minutes.

✔️ Drug Interactions

↑ Risk of digoxin toxicity.

↑ Risk of hypomagnesemia with diuretics.

May ↑ INR/prothrombin time with warfarin.

↑ Levels of methotrexate, saquinavir.

↓ Absorption of ketoconazole, itraconazole.

✔️ Dosage & Administration | Pantoprazole

Adults

GERD / Erosive Esophagitis:

40 mg orally once daily for 8–16 weeks.

Maintenance: 40 mg once daily.

IV: 40 mg daily for 7–10 days, then switch to oral when possible.

Zollinger-Ellison syndrome:

40 mg orally once daily (up to 240 mg/day in some cases).

IV: 80 mg every 8–12 hours for up to 7 days.

Peptic Ulcer Disease:

Duodenal ulcer: 40 mg once daily for 2–4 weeks.

Gastric ulcer: 40 mg once daily for 4–8 weeks.

Elderly: No adjustment needed.

Hepatic impairment: Max 20 mg/day or 40 mg on alternate days.

Children

Erosive Esophagitis associated with GERD:

<5 years: Safety not established.

5–12 years, weight 15–40 kg: 20 mg once daily (up to 8 weeks).

≥40 kg: 40 mg once daily (up to 8 weeks).

Renal Impairment

No dose adjustment required.

✔️ Pregnancy & Lactation

Pregnancy: Available human data do not show increased risk of malformations. Animal studies show no adverse developmental effects.

Lactation: Detected in breast milk, but no known harmful effects in infants. Use only if clinically justified.

✔️ Precautions

Rule out gastric malignancy before starting therapy.

Consider zinc supplementation during prolonged IV therapy in patients at risk of deficiency.

Use with caution in pregnancy and lactation.

Monitoring: Check magnesium levels before and during long-term treatment.

✔️ Storage:

Keep in a dry place, away from light and heat. Keep out of the reach of children.