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PROTONIX I.V.
Hyperacidity, GERD, and ulcers
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Drug Name:

PROTONIX I.V. Rx

Generic Name and Formulations:
Pantoprazole (as sodium) 40mg; per vial; pwd for IV infusion after reconstitution and dilution; contains edetate disodium.

Company:
Pfizer Inc.

Therapeutic Use:

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).

Adult:

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.

Children:

<18yrs: not established.

Contraindications:

Concomitant rilpivirine-containing products.

Warnings/Precautions:

Symptomatic response does not preclude gastric malignancy. Discontinue if acute interstitial nephritis, cutaneous/systemic lupus erythematosus occurs. Long-term therapy may lead to malabsorption/deficiency of Vit. B12. Increased risk of osteoporosis-related fractures (hip, wrist or spine) with long-term and multiple daily dose PPI therapy. Monitor magnesium levels with long-term therapy. Use lowest effective dose for shortest duration. Reevaluate periodically. IV: consider zinc supplementation in those prone to zinc deficiency. Pregnancy (Cat.C). Nursing mothers: not recommended.

Interactions:

See Contraindications. May antagonize atazanavir, nelfinavir (avoid). May potentiate saquinavir, digoxin, methotrexate (consider temporary withdrawal of the PPI); monitor. May alter absorption of gastric pH-dependent drugs (eg, iron, erlotinib, dasatinib, nilotinib, mycophenolate mofetil, ketoconazole). Caution with digoxin or drugs that may cause hypomagnesemia (eg, diuretics); monitor. Monitor warfarin. May cause false (+) urine THC test. IV: caution with concomitant other EDTA-containing products.

See Also:

PROTONIX TABLETS

PROTONIX for ORAL SUSP

Pharmacological Class:

Proton pump inhibitor.

Adverse Reactions:

Headache, diarrhea, nausea, abdominal pain, vomiting, flatulence, dizziness, arthralgia; possible C. difficile-associated diarrhea, inj site reactions (IV); rare: hypomagnesemia (w. prolonged PPI therapy). Also children: URI, fever, rash.

Metabolism:

Hepatic (CYP2C19, 3A4). 98% protein bound.

Elimination:

Renal (primarily), fecal.

Generic Availability:

Tabs, IV (YES); oral soln (NO)

How Supplied:

Tabs—90; Susp—30 pkts/box; Vials (40mg)—1, 10, 25

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