PROTONIX I.V. Rx
Generic Name and Formulations:
Pantoprazole (as sodium) 40mg; per vial; pwd for IV infusion after reconstitution and dilution; contains edetate disodium.
Indications for PROTONIX I.V.:
Short-term treatment (7–10 days) of GERD associated with a history of erosive esophagitis. Pathological hypersecretory conditions (eg, Zollinger-Ellison syndrome).
Give by IV infusion over 2mins or 15mins (see full labeling). ≥18yrs: GERD: 40mg once daily for 7–10 days; switch to tabs or oral suspension as soon as possible. Hypersecretory conditions: 80mg every 8–12hrs; usual max 240mg/day or 6 days' treatment.
<18yrs: not established.
Concomitant rilpivirine-containing products.
Symptomatic response does not preclude gastric malignancy. Discontinue if acute interstitial nephritis, cutaneous/systemic lupus erythematosus occurs. Long-term therapy (eg, >3yrs) may lead to malabsorption or deficiency of Vit.B12. Increased risk of osteoporosis-related fractures (hip, wrist or spine) with long-term and multiple daily dose PPI therapy. Monitor magnesium levels with long-term therapy. Use lowest effective dose for shortest duration. Reevaluate periodically. IV: consider zinc supplementation in those prone to zinc deficiency. Pregnancy (Cat.C). Nursing mothers: not recommended.
See Contraindications. May antagonize atazanavir, nelfinavir (avoid). May potentiate saquinavir, methotrexate (at high doses, consider temporary withdrawal of the PPI); monitor. May alter absorption of gastric pH-dependent drugs (eg, iron salts, erlotinib, dasatinib, nilotinib, mycophenolate mofetil, ketoconazole, itraconazole). Caution with digoxin or drugs that may cause hypomagnesemia (eg, diuretics); monitor. Monitor warfarin. May cause false (+) results in diagnostic investigations for neuroendocrine tumors; discontinue pantoprazole 14 days prior to CgA level assessment. May cause false (+) urine THC test. IV: caution with concomitant other EDTA-containing products.
Proton pump inhibitor.
Headache, diarrhea, nausea, abdominal pain, vomiting, flatulence, dizziness, arthralgia; possible C. difficile-associated diarrhea, inj site reactions (IV); rare: hypomagnesemia (w. prolonged PPI therapy). Also children: URI, fever, rash.
Hepatic (CYP2C19, 3A4). 98% protein bound.
Renal (primarily), fecal.
Tabs, IV (YES); oral soln (NO)
Tabs—90; Susp—30 pkts/carton; Vials (40mg)—1, 10, 25