Pantoprazole (Intravenous)

Pantoprazole is an injected medication that doctors prescribe for the short-term treatment of GERD that is causing erosive, ulcerated esophagitis symptoms.

Overview

Discovered in 1985, the compound that makes up Pantoprazole was a byproduct of other chemical research. It was eventually developed to the point that it was marketed in the US under the name Protonix beginning in 2000 and sold worldwide by 2004.

Pantoprazole is most often prescribed to patients who suffer from gastroesophageal reflux disease, also known as GERD. GERD can cause the erosion and ulceration of the esophagus if left untreated. Pantoprazole is a proton pump inhibition drug that reduces the acid secreted in the stomach, which effectively stops the GERD symptoms and the erosion of the esophagus.

In the injected format, Pantoprazole is used during emergency situations or those that are deemed urgent to the health of the patient and is replaced by longer term oral type medications once the symptoms are alleviated. The maximum period of time that a patient should be treated with Pantoprazole is 16 weeks.

GERD is also commonly called acid reflux and is considered a long-term condition. Patients with GERD experience a back-up of the contents of the stomach into the esophagus, which gives them symptoms including chest pain, vomiting, heartburn, difficulty breathing and tooth erosion. The acid can also erode the esophagus, causing esophagitis.

Esophagitis is a condition in which the esophagus, the tube that passes food from mouth to stomach, has become inflamed due to exposure to stomach acid. This is a painful disease that can, over time, make the patient susceptible to esophageal cancer.

Conditions Treated

  • GERD
  • Erosive esophagitis
  • Zollinger-Ellison syndrome

Type Of Medication

  • Proton pump inhibitor
  • Gastric acid suppressor

Side Effects

Through its work to prevent excess stomach acid by stopping the production, Pantoprazole may cause unwanted effects on health. Some of these symptoms can be the sign of long term health issues and should be reported to your physician right away. They include:

  • Pus accumulation
  • Injection site infection, numbness, stinging, swelling, blistering, bleeding or other symptoms
  • Skin color changes
  • Elevated body temperature
  • Swollen, tender, painful leg or foot
  • Pain in stomach
  • Tender, red, swollen infected areas
  • Drowsiness
  • Appetite loss
  • Changes to mood or mental state
  • Twitching or spasms in muscles
  • Vomiting
  • Nausea
  • Seizures
  • Fatigue
  • Trembling
  • Weak muscles
  • Tender stomach or abdomen
  • Partial paralysis
  • Vision changes, blurriness or loss
  • Skin peeling, loosening or blistering
  • Bloated stomach or abdomen
  • Urine that is cloudy or has signs of blood
  • Stools appear tar-like or bloody
  • Chills
  • Difficulty having a bowel movement
  • Buzzing or ringing in ears
  • Coughing
  • Urine is dark in color
  • Diarrhea
  • Difficulty swallowing or speaking
  • Dizzy, lightheaded
  • Rapid heart rhythm
  • Vertigo
  • Decrease in amount or frequency of urine
  • Loss of hearing
  • Itching, rash on skin or hives
  • Increased saliva production
  • Indigestion
  • Pain in joints or muscles
  • Swollen patches on eyelids, face, lips, throat, tongue, sex organs, legs, hands or feet
  • Stools are light in color
  • Pain, cramping or stiffness in muscles
  • Stomach, abdomen, side or pains radiate to back
  • Skin paleness
  • Swollen eyes, lips, tongue or face
  • Red spots on skin with purple middles
  • Bloodshot eyes
  • Eye irritation
  • Spinning sensation
  • Severe cramps in stomach or abdomen
  • Throat soreness
  • Ulcerated, sore white spots on mouth or lips
  • Swollen lower legs or feet
  • Glands are swollen
  • Chest feels tight
  • Bruising or bleeding for no reason
  • Diarrhea, severe, bloody or watery
  • Yellow tinge to skin or eyes

Some patients experience temporary health symptoms that go away in a relatively short amount of time with continued treatment. If you do have these symptoms, let you physician know:

  • Headache
  • Sour, acid stomach feeling
  • Excess gas
  • Dizzy
  • Feeling full

Any changes to your overall health or demeanor with treatment of Pantoprazole should be reported to your physician for your own safety.

Dosage

Pantoprazole is an intravenous route drug, meaning you will be given your dosage in a professional medical setting by a doctor or nurse who will inject it into your veins. It will take a few days before you experience any relief in your stomach pain and, in the meantime, you will be given other medications including antacid drugs, pain relievers and antibiotics.

After your condition improves, typically with a few doses of Pantoprazole over time, you will be prescribed an oral medication to take at home for further treatment and prevention of symptoms.

Adults with GERD will most often be given 40 milligram infusions through an intravenous method for a seven to ten day period.

Adults with Zollinger-Ellison syndrome will initially be given an 80 milligram IV infusion twice daily. A great percentage of these patients will require an increase to 80 milligrams every 8 hours to effectively treat their condition, with the dosage at a maximum of 240 milligrams per day. These patients should not be treated with Pantoprazole for longer than ten days.

Critically ill patients who are suffering from stress gastritis prophylaxis will be given 40 milligrams per day via their intravenous medication route. It is possible to increase this dosage, but caution should be taken to prevent gastrointestinal bleeding risks associated with other life-saving measures these patients are on.

Patients who have had therapeutic endoscopy procedures and are experiencing bleeding and other symptoms post procedure can be infused with 80 milligrams of Pantoprazole in a 30 minute span of time followed by a longer infusion of 8 milligrams per hour for 72 hours. Oral therapy should be prescribed for these patients as soon as possible.

Dosage for children and infants are to be adjusted for body mass per the manufacturer's indications. Patients with liver problems should also have their dosage adjusted for safety and be monitored for any affects on their condition that Pantoprazole may cause.

Interactions

Hypersensitivity symptoms that you have experienced when taking other medications should be reported to your doctor prior to you receiving Pantoprazole injection. Mention any reactions to animals, foods, dyes, perfumes or preservatives that you've had as well.

Pediatric patients have not been the subject of any study that provided data on how effectively Pantoprazole worked in this age group or if they experienced any increase in adverse health effects. Use of this medication for children and infants is up to the doctor in charge of the case and should be done with cautious adjustment to dosage amounts.

Geriatric patients should have the same safety and effectiveness experience that their adult counterparts do with the exception of those that have age-related liver disease or low levels of zinc in their blood. Geriatric patients with these conditions should have their dosage of Pantoprazole adjusted for safety.

Women who are pregnant and those who are breastfeeding have not been determined to safely be able to have treatment of Pantoprazole on their stomach conditions. Use in these two groups is not recommended for safety reasons related to fetal and infant development.

Patients who are currently taking Rilpivirine should not be medicated with Pantoprazole and should let their physician know they are taking this drug. Your doctor may choose another treatment for you, as the two drugs combined is not safe for your health.

If you are taking the following medications, be aware that they may interact poorly with Pantoprazole, but your doctor will be able to adjust your prescriptions so that you are safe to take both. Alert your physician if you currently take:

  • Bosutinib
  • Atazanavir
  • Citalopram
  • Cilostazol
  • Erlotinib
  • Dasatinib
  • Gefitinib
  • Eslicarbazepine Acetate
  • Ledipasvir
  • Ketoconazole
  • Mycophenolate Mofetil
  • Methotrexate
  • Nilotinib
  • Nelfinavir
  • Saquinavir
  • Pazopanib
  • Vismodegib
  • Velpatasvir

Certain ill effects on your health could be at a greater risk if you are taking the following drugs:

  • Warfarin
  • Levothyroxine

If possible, avoid taking other medications while you are being treated with Pantoprazole. This includes any prescription, non-prescription, herbal, holistic or vitamin supplements. Let your physician know of any and all medications you are taking prior to your treatment.

Use of tobacco products and consumption of alcoholic beverages during your treatment with Pantoprazole may cause adverse reactions and endanger your health. Your doctor will potentially place you on a special diet when you are being treated with Pantoprazole. In particular, avoid food products containing cranberries or cranberries themselves during your treatment.

The following medical problems may become worse with treatment of Pantoprazole, so be sure to disclose your complete medical history to your physician prior to your treatment, especially if you have been diagnosed with:

  • Hypomagnesemia
  • Diarrhea
  • Kidney disease
  • SLEĀ ' Systemic lupus erythematosus
  • Osteoporosis
  • Deficiency of zinc in your blood
  • Liver diseases

Warnings

Your physician will most likely order regular tests of your urine and blood to make sure you aren't experiencing any ill effects on your health as the result of treatment with Pantoprazole. Keep all visit appointments and let your doctor know if your condition has not improved over time.

Anaphylaxis is a life-threatening hypersensitive reaction that is at a high risk with use of an intravenous drug such as Pantoprazole. Report any symptoms such as a skin rash, hoarse voice, itching, difficulty swallowing or breathing and swelling in your mouth, face or hands to your doctor immediately.

Pantoprazole may affect your skin in a serious way, with reactions such as peeling, loosening or blistering skin, lesions, acne or sores, rashes and ulcers on your skin. If you have any of these symptoms, which may be accompanied by chills and fever, alert your physician right away.

Thrombophlebitis, a severe reaction at the site of your injection, may be at a higher risk for some patients who are given Pantoprazole. If the site where you have been injected is swollen or changes in color, if it is tender or painful or if your foot or leg swells, alert your medical team to this right away.

Pain in your joints, elevated body temperature, swelling in the ankles, feet or body or unusual weight gain and skin rashes can be signs of a condition known as acute interstitial nephritis. Alert your doctor to these conditions right away.

If, after a dose of Pantoprazole, you experience watery diarrhea that becomes chronic, pain in your stomach and an elevation in your body temperature, these should be reported to your physician.

Pantoprazole may increase your risk for bone fractures especially in your wrists, hips or spinal column. If you are older than 50 years of age and have received a dosage that is considered high or have been on this medication for longer than 12 months, you are at an even more increased risk. Your doctor will alert you of this risk and share cautionary measures you can follow to prevent fractures or help you detect them if they occur.

Pantoprazole may lower the amount of magnesium, an essential mineral that is found naturally in your system. Patients who are being treated for longer than 12 months and those who are combining this medication with digoxin or water pills are at a higher risk for this condition. Your doctor should be informed if you have convulsions or seizures or if your heart rhythm is abnormal, racing or uneven and if you have spasms, tremors or weakness in your muscles accompanied by fatigue.

Patients with systemic lupus erythematosus may experience a worsening of their symptoms with treatment of Pantoprazole. Inform your doctor if you have this condition and be alert for symptoms such as skin rashes that worsen with sun exposure, as this is a sign of an onset of this disease.

Inform any doctor or dentist who provides you treatment or gives you tests that you have been injected with Pantoprazole, as it could affect how certain tests work on your body.

Avoid taking other medications unless they are specifically prescribed for you by your doctor with knowledge of your injection of Pantoprazole. This includes any over-the-counter, herbal, holistic or vitamin supplements or treatments.

Storage

Pantoprazole is an injected medication given only by health care professionals in a medical setting. Responsibility for storage and administration of this medication is under their control as advised by the manufacturer.

Reconstituted Pantoprazole solution can be kept at room temperature for up to 6 hours, but must be used within 24 hours. Pantoprazole should not be frozen.

Summary

Pantoprazole is an injected proton pump inhibitor type of medication that prevents the production of acid in the stomach. This medication is most often prescribed for patients who suffer from a condition known as GERD, which is causing severe erosive esophagitis symptoms. These symptoms can include severe abdominal pain, heartburn, chest pain, vomiting, difficulty breathing and other painful effects. If left untreated GERD and the erosion caused by the stomach acid can lead to esophageal cancers and other severe health issues.

You will most likely be given this medication in a hospital setting by a doctor or nurse. Adult patients are typically given 40 milligrams administered through an IV line for a seven to ten day period, with adjustments in size of dose and duration depending on their health conditions. Pediatric patients may be given this medication if the doctor in charge determines that it is appropriate. Patients receiving this medication will be monitored for effectiveness as well as any adverse health risks they are showing signs of.

Patients are urged to avoid taking other medications of any kind while they are on this drug and should disclose any hypersensitivity they have experienced in the past to the medical staff treating them. Patients with blood, bone and liver diseases and those deficient in zinc should let their doctors know ahead of time that they have these conditions. Patients with SLE are at a higher risk for making their symptoms worse and should inform their physician that they have this condition as well as be on the alert for any signs of symptoms becoming worse.

Report any ill effects on your health that may occur with your treatment of Pantoprazole, which may include headache, excess gas, abdominal pain or dizziness. Severe or prolonged symptoms such as mood changes, heart rhythm abnormalities or digestive issues such as diarrhea, constipation, indigestion or blood in urine or stools should be reported to your doctor immediately.

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Last Reviewed:
March 26, 2018
Last Updated:
April 13, 2018
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