Top 300 Pharmacy Drug Cards

PANTOPRAZOLE: Protonix, Various

Class: Proton Pump Inhibitor

Dosage Forms. Tablet, Delayed Release: 20 mg, 40 mg; Packet: 40 mg

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Common FDA Label Indication, Dosing, and Titration.

1. Erosive esophagitis, gastroesophageal reflux disease: Children 5 y and older and 15-40 kg, 20 mg po daily × up to 8 wk; Adults and Children 5 y and older and >40 kg, 40 mg po daily

2. Gastric hypersecretion: 40 mg po bid, titrate to 240 mg/d po

3. Zollinger-Ellison syndrome: 40 mg po bid, titrate to 240 mg/d po

Off-Label Uses.

1. Helicobacter pylori GI tract infection: 40 mg po bid × 10-14 d in combination with amoxicillin 1000 mg and clarithromycin 500 mg po bid

2. Duodenal ulcer disease: 40-80 mg po daily × up to 4-8 wk

MOA. Pantoprazole is a proton pump inhibitor that, when protonated in the secretory canaliculi of the parietal cells, covalently binds to H+/K+-ATPase (proton pump), which is the final pathway for acid secretion. Produces a profound and prolonged antisecretory effect and inhibits basal, nocturnal, pentagastrin-stimulated, and food-stimulated gastric acid secretion.

Drug Characteristics: Pantoprazole

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Medication Safety Issues: Pantoprazole

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Drug Interactions: Pantoprazole

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Adverse Reactions: Pantoprazole

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Efficacy Monitoring Parameters. Resolution of gastrointestinal discomfort, resolution of ulcers shown on endoscopy; for treatment of H pylori, negative urea breath test.

Toxicity Monitoring Parameters. Seek care for severe headache or blistering skin rash.

Key Patient Counseling Points. Can be taken with or without food.

Clinical Pearls. When the intravenous route is used, converted to oral route as soon as possible to avoid cost and risks of intravenous therapy. Multiple H pylori regimens exist that include different combinations of PPIs and antibiotics; council patient to complete full regimen if prescribed for H pylori management. Other PPI and H2 antagonists are available OTC; do not take multiple products concurrently to avoid additive risk of adverse effects. Also available as IV formulation. Packet formulation is delayed release; sprinkle into apple sauce or apple juice only, swallow immediately. Take on an empty stomach.