Pantoprazole - Comprehensive Drug Information
Drug Name
Generic Name
Pantoprazole
Brand Name(s)
In Pakistan: Pantozol, Pansec
In India: Pantocid, Pantodac
In the US: Protonix
In the UK: Pantoloc
Pharmacological Class
Class
Proton Pump Inhibitor (PPI)
Subclass
Benzimidazole
Mechanism of Action
Pantoprazole works by irreversibly binding to the H+/K+ ATPase enzyme system (proton pump) on the gastric parietal cells. This action inhibits the final step of gastric acid production, thereby reducing gastric acidity.
Indications
Primary Indications
- Gastroesophageal reflux disease (GERD)
- Erosive esophagitis
- Zollinger-Ellison syndrome
Off-label Uses
- Peptic ulcer disease
- Helicobacter pylori eradication (part of combination therapy)
Dosage and Administration
Standard Dosage
For GERD: 40 mg once daily for up to 8 weeks.
Route of Administration
Oral or intravenous
Special Populations
Pediatric: Safety and efficacy not established for children under 5 years. Adjust dose for older children based on weight.
Geriatric: No specific dosage adjustments, but monitor for increased sensitivity.
Pharmacokinetics
Absorption
Absorbed rapidly; peak plasma concentrations reached within 2.5 hours.
Distribution
Widely distributed; protein binding is about 98%.
Metabolism
Metabolized in the liver via the cytochrome P450 system, primarily CYP2C19.
Excretion
Excreted primarily in the urine (about 71%) as metabolites.
Half-life
Approximately 1 hour, but prolonged in hepatic impairment.
Contraindications
Hypersensitivity to pantoprazole or other proton pump inhibitors.
Warnings and Precautions
Monitor for symptoms of Clostridium difficile-associated diarrhea. Use with caution in patients with severe hepatic impairment. Long-term use may lead to vitamin B12 deficiency and osteoporosis-related fractures.
Side Effects
Common Side Effects
- Headache
- Diarrhea
- Nausea
- Abdominal pain
Serious Side Effects
- Severe allergic reactions (anaphylaxis)
- Clostridium difficile infection
- Hepatotoxicity
Drug Interactions
Major Interactions
- Warfarin: May increase risk of bleeding.
- Clopidogrel: May reduce efficacy of clopidogrel.
Moderate Interactions
- Methotrexate: May increase methotrexate levels.
Minor Interactions
- Iron supplements: May decrease absorption of iron.
Pregnancy and Lactation
Pregnancy Category
Category B: No adequate and well-controlled studies in pregnant women.
Breastfeeding Considerations
Pantoprazole is excreted in human milk; caution should be exercised when administered to a nursing woman.
Patient Counseling Information
Key Points for Patients
- Take pantoprazole as directed by your healthcare provider.
- Do not crush or chew the tablets; swallow them whole.
- Report any severe or persistent side effects to your doctor.
Administration Tips
- Take the medication at the same time each day.
- Can be taken with or without food.