Pantoprazole
Pantoprazole
Protonix
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Summary
Common uses
GERD0, Erosive esophagitis0, Zollinger-Ellison syndrome0, Stress ulcer prophylaxis0
Pharmacy
Starting dose
40 mg PO or IV once daily
Preparations
20 mg, 40 mg delayed-release tablets; 40 mg IV vial; oral suspension 40 mg/packet
US FDA Max
40 mg/d typical; up to 240 mg/d for Zollinger-Ellison
Pharmacology
Routes
Oral, IV
Onset
2-3 hours per dose; full acid suppression after 3-5 days
Duration
24+ hours (irreversible enzyme binding)
Half-life
~1 hour (plasma); pharmacodynamic effect persists 24+ hours[2]
Bioavailability
~77% (oral; not affected by food or antacids)[2]
Pregnancy
Generally considered safe; widely used in obstetric reflux.[citation needed]
Legal status
Rx-only in US
Purported mechanism
Pantoprazole is a prodrug irreversibly bound to the H+/K+ ATPase after acid-driven activation, blocking the final common step of gastric acid secretion.0 Compared with omeprazole, pantoprazole has a more linear pharmacokinetic profile and is metabolized predominantly via CYP2C19 with CYP3A4 contribution; less CYP2C19-driven drug interaction with clopidogrel than omeprazole[1].
References
- ↑ CPIC Guideline for CYP2C19 and Proton Pump Inhibitors, 2020. https://cpicpgx.org/guidelines/cpic-guideline-for-proton-pump-inhibitors-and-cyp2c19/
- ↑ 2.0 2.1 FDA Prescribing Information, Protonix (pantoprazole sodium), Pfizer, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020987s045,022020s016lbl.pdf