Hyperacidity, GERD, and ulcers:
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/deficiency of Vit. B12. Monitor magnesium levels during prolonged therapy. Increased risk of fundic gland polyps with long-term use (esp. >1yr) or osteoporosis-related fractures (hip, wrist or spine) with long-term (>1yr) and multiple daily dose PPI therapy. Use lowest dose for shortest duration appropriate to condition. Reevaluate periodically. IV: consider zinc supplementation in those prone to zinc deficiency. Pregnancy. Nursing mothers.
Proton pump inhibitor.
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.
Headache, diarrhea, nausea, abdominal pain, vomiting, flatulence, dizziness, arthralgia; possible C. difficile-associated diarrhea, inj site reactions (IV); rare: hypomagnesemia. Also children: URI, fever, rash.
Renal (primarily), fecal.
Tabs, IV (YES); oral soln (NO)
Tabs—90; Susp—30 pkts/carton; Vials (40mg)—1, 10, 25