Pantoprazole
Class: ulcer healing/prophylaxis – proton pump inhibitor
Indications: duodenal/benign gastric ulcer, reflux oesophagitis, dyspepsia, NSAID-associated gastro-duodenal ulcer
Contraindications/cautions: moderate to severe renal impairment; max dose 40 mg daily in mild impairment; maximum dose 20 mg daily in severe hepatic impairment
Adverse reactions: common: headache, GI disturbances (nausea/vomiting/diarrhoea) less common: abdominal pain, flatulence, insomnia, pruritus, dizziness, dry mouth, increased sweating, rash, pruritis
Metabolism/clearance: metabolised by metabolising enzyme CYP2C19 mainly in the liver
Interactions:
- increased clinical effect/toxicity of pantoprazole (due to increased blood concentrations) may occur with some CYP metabolising enzyme inhibitors (see above) e.g. fluconazole, fluoxetine, ketoconazole
- decreased clinical effect/toxicity of pantoprazole (due to decreased blood concentrations) may occur with some CYP metabolism enzyme inducers (see above) e.g. carbamazepine, phenytoin, rifampicin
- decreased absorption of ketoconazole, itraconazole may occur with pantoprazole
| Dosing: | |
|---|---|
| oral: | 20 to 40 mg once a day |
| subcut: | inj available but not usually used subcut |
| rectal: | not available |
Syringe driver: not usually used
Mechanism of action: inhibits gastric acid secretion via proton pump blockade
Onset: oral (antacid effect): 2 hours