Pantoprazole

Information about Pantoprazole

Pantoprazole is a proton pump inhibitor (PPI) and a potent inhibitor of gastric acidity which is widely used in the therapy of gastroesophageal reflux and peptic ulcer disease. 

Liver safety of Pantoprazole

Pantoprazole therapy is associated with a low rate of transient and asymptomatic serum aminotransferase elevations and is a rare cause of clinically apparent liver injury.

Mechanism of action of Pantoprazole

Pantoprazole, (pan toe' pra zole) like other PPIs, blocks gastric acid production by binding to and inactivating the H+/K+-ATPase of gastric parietal cells, causing inhibition of the proton pump that transports H+ into the gastric lumen, the final common step in gastric acid production.  Pantoprazole is a prodrug and is converted to the active form in the acidic secretory canaliculi of parietal cells.  Because the inhibition is irreversible, acid secretion is suppressed for 24 to 48 hours, until new proton pump molecules have been synthesized and transported to the cell membrane. 

FDA approval information for Pantoprazole

Pantoprazole was the fourth PPI approved for use in the United States (2000) and now is in wide use. 

Dosage and administration for Pantoprazole

Pantoprazole is available as delayed release tablets of 20 and 40 mg, and in 40 mg vials for parenteral use generically and under the brand name of Protonix.  The typical dose of pantoprazole for peptic ulcer disease is 40 mg once daily for 4 to 8 weeks with similar long term maintenance doses.  Twice daily doses are recommended for more severe cases of gastrointestinal reflux and peptic ulcer disease, and doses of up to 240 mg daily for Zollinger-Ellison syndrome. 

Side effects of Pantoprazole

Pantoprazole is very well tolerated.  Side effects are uncommon and usually mild, and include diarrhea, nausea, vomiting, abdominal discomfort, flatulence, skin rash, headaches and dizziness. Severe adverse events are rare but can include hypersensitivity reactions.  Long-term use may be associated with bone fractures, acute interstitial nephritis, lupus erythematosus, vitamin B12 deficiency and hypomagnesemia.

The antiulcer agents in clinical use

Proton Pump Inhibitors

• Dexlansoprazole
• Esomeprazole
• Lansoprazole
• Omeprazole
• Pantoprazole
• Rabeprazole

Selective Histamine Type 2 Receptor Antagonists or H2 Blockers

• Cimetidine
• Famotidine
• Nizatidine
• Ranitidine

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