• PO (Adults): GERD — 40 mg once daily; Gastric hypersecretory conditions — 40 mg twice daily, up to 120 mg twice daily.
• PO (Children): 0.5–1 mg/kg/day .
• IV (Adults): GERD — 40 mg once daily for 7–10 days. Gastric hypersecretory conditions — 80 mg q 12 hr (up to 240 mg/day).
Use Cautiously in:
CNS: Headache (9%); anxiety, asthenia, dizziness, hypertonia, migraine (1% or more); insomnia (1%); anterior ischemic optic neuropathy, confusion, hypokinesia, speech disorder, tinnitus, vertigo (postmarketing).
DERM: Rash (2%); severe dermatologic reactions (eg, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis) (postmarketing).
EENT: Pharyngitis, rhinitis (more than 1%); blurred vision (postmarketing).
GI: Diarrhea (6%); abdominal pain, flatulence (4%); nausea, vomiting (2%); constipation, dyspepsia, gastroenteritis, GI disorder, rectal disorder (1% or more); eructation (1%); increased salivation, pancreatitis (postmarketing).
GU: Urinary frequency, UTI (at least 1%); creatinine increased; interstitial nephritis (postmarketing).
HEMA/LYMPH: Pancytopenia (postmarketing).
HEPA: Abnormal LFTs (2%); increased ALT (1% or more); hepatocellular damage leading to jaundice and hepatic failure (postmarketing).
LABTESTABS: Elevated CPK (postmarketing).
LOCAL: Injection-site reactions (including abscess, thrombophlebitis) (more than 1%).
M/N: Hyperlipidemia (at least 1%); hyperglycemia (1%); hypercholesterolemia, hyperuricemia.
MUSC: Arthralgia, back pain, neck pain (at least 1%); rhabdomyolysis (postmarketing).
RESP: Bronchitis, cough increased, dyspnea, sinusitis, upper respiratory tract infection (at least 1%).
OTHER: Chest pain, flu syndrome, infection, pain (1% or more); anaphylaxis, angioedema (postmarketing).
Atazanavir, indinavir, nelfinavir
Plasma concentrations may be reduced by pantoprazole. Coadministration with atazanavir is not recommended.
Azole antifungals (eg, itraconazole, ketoconazole)
Plasma levels of certain azole antifungals may be reduced. Avoid this combination if possible.
Proton pump inhibitors may increase serum digoxin levels.
Drugs depending on gastric pH for bioavailability (eg, ampicillin, iron salts, itraconazole, ketoconazole)
Absorption of these drugs may be affected.
May reduce pantoprazole plasma concentrations. Avoid combination if possible.
Incompatible with IV pantoprazole.
Enteric-coated salicylates may dissolve more rapidly, increasing gastric adverse reactions.
Increased INR and PT have been reported. Monitor INR and PT.
Therapeutic Classification: antiulcer agents
Pharmacologic Classification: proton pump inhibitors
Absorption: Tablet is enteric-coated; absorption occurs only after tablet leaves the stomach.
Protein Binding: 98%.
Metabolism/Excretion: Mostly metabolized by the liver via the cytochrome P450 (CYP) system; inactive metabolites are excreted in urine (71%) and feces (18%).
Half-life: 1 hr.
Onset = 51% inhibition; duration = return to normal following discontinuation
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