II. Indications

  1. Peptic Ulcer Disease
  2. Gastroesophageal Reflux
  3. Erosive Esophagitis
  4. Zollinger-Ellison Syndrome

III. Contraindications

  1. Hypersensitivity to Proton Pump Inhibitors
  2. Use with caution in severe liver disease

IV. Dosing: Adult

  1. See Helicobacter Pylori Treatment
  2. Background
    1. Take suspension 30 minutes prior to a meal
      1. Tablets may be taken regardless of food intake
    2. Suspension may be given via NG tube or G-Tube
    3. Intravenous dosing available
  3. Duodenal Ulcer or erosive Esophagitis
    1. Take 40 mg orally daily
  4. Zollinger Ellison Syndrome
    1. Take 40 mg orally twice daily OR
    2. Administer 80 mg IV every 8 to 12 hours until taking oral medications

V. Dosing: Child

  1. Indicated in GERD with erosive eosphagitis
  2. Weight <15 kg (off-label)
    1. Give 0.5 to 1 mg/kg/day
  3. Weight 15 to 40 kg
    1. Give 20 mg orally daily for up to 8 weeks
  4. Weight >=40 kg
    1. Give 40 mg orally daily for up to 8 weeks

VI. Pharmacokinetics

  1. All PPIs have short plasma half life of 1-2 hours
  2. Effect is delayed 5-7 days until proton pumps are fully blocked
  3. Metabolized by CYP2C19

VII. Mechanism

VIII. Adverse Effects:

IX. Precautions

X. Safety

  1. Pregnancy Category B
  2. Unknown safety in Lactation

XI. Efficacy

XII. Drug Interactions

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Related Studies

Cost: Medications

pantoprazole (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
PANTOPRAZOLE 40 MG SUSPENSION Generic $9.18 each
PANTOPRAZOLE DR 40 MG SUSP PKT Generic $10.58 each
PANTOPRAZOLE SOD DR 20 MG TAB Generic $0.05 each
PANTOPRAZOLE SOD DR 40 MG TAB Generic $0.06 each
protonix (on 1/1/2023 at Medicaid.Gov Survey of pharmacy drug pricing)
PROTONIX 40 MG SUSPENSION Generic $11.98 each
PROTONIX DR 40 MG TABLET Generic $0.06 each

Ontology: pantoprazole (C0081876)

Definition (NCI) A substituted benzimidazole and proton pump inhibitor with antacid activity. Pantoprazole is a lipophilic weak base that crosses the parietal cell membrane and enters the acidic parietal cell canaliculus where it becomes protonated, producing the active metabolite sulphenamide, which forms an irreversible covalent bond with two sites of the H+/K+-ATPase enzyme located on the gastric parietal cell, thereby inhibiting both basal and stimulated gastric acid production.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C064276
SnomedCT 317317009, 395821003
LNC LP171628-3
English 1H-Benzimidazole, 5-(difluoromethoxy)-2-(((3,4-dimethoxy-2-pyridinyl)methyl)sulfinyl)-, pantoprazole, pantoprazole (medication), pantoprazole [Chemical/Ingredient], PANTOPRAZOLE, Pantoprazole, Pantoprazole (product), Pantoprazole (substance)
Spanish pantoprazol (producto), pantoprazol (sustancia), pantoprazol

Ontology: Protonix (C0876139)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH C064276
English Protonix, pantoprazole (Protonix), protonix