pantoprazole (Protonix)

Introduction

Tradename: Protonix.

Indications

• short-term erosive esophagitis associated with GERD
  • pyrosis
• peptic ulcer disease
• effective when used in combination therapy for H pylori
• prevention of upper GI bleed associated with gastric acidity
  • Zollinger-Ellison syndrome

Dosage

• 40 mg PO QD-BID (40 mg equivalent to 20 mg of omeprazole)
• 40 mg IV QD

Tabs: 40 mg enteric-coated tablets.

Injection: (Protonix IV)

Dosage adjustment in renal failure

none*

* has been associated with tubulointerstitial nephritis

Pharmacokinetics

• completely absorbed with or without food
• bioavailability is 77%
• 98% plasma protein bound
• metabolized by cyt P450 system in the liver
• metabolites excreted in the urine
• elimination 1/2life is 1 hour

elimination via liver

protein binding = 98 %

1/2life = 1 hour

Adverse effects

• uncommon (< 2%)
  • headache (1.3%)
  • diarrhea (1.5%)
  • dizziness
  • pruritus
  • asthenia
• tubulointerstitial nephritis

• drug adverse effects of proton pump inhibitors (PPI)

Drug interactions

none known

• drug interaction(s) of levothyroxine with proton pump inhibitors
• drug interaction(s) of palbociclib with proton pump inhibitors
• drug interaction(s) of methotrexate with proton pump inhibitors
• drug interaction(s) of bisphosphonates with proton pump inhibitors
• drug interaction(s) of aspirin with proton pump inhibitors
• drug interaction(s) of antiplatelet agents with proton pump inhibitors
• drug interaction(s) of clopidogrel with proton pump inhibitors
• drug interaction(s) of ginko biloba with proton pump inhibitors

Mechanism of action

• proton pump inhibitor
• interacts with sulfhydryl groups in proton pump
• inactive at neutral pH

Notes

Manufacturer: Wyeth-Ayerst

More general terms

• proton pump inhibitor
• pyrrole

Database

• PubChem: http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=4679