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Pantoprazole
📖 About
Always check the BNF link here for the most up-to-date guidance. Pantoprazole is a proton pump inhibitor (PPI) used in the management of peptic ulcer disease, gastro-oesophageal reflux, oesophagitis, and in acute upper GI bleeding.
⚙️ Mode of Action
- 🔒 Irreversibly inhibits the gastric H⁺/K⁺ ATPase (proton pump) in parietal cells.
- ⬇️ Suppresses both basal and stimulated gastric acid secretion.
- Provides prolonged acid suppression compared to H₂ receptor antagonists.
💊 Indications / Dose
- Upper GI bleed 🩸: 80 mg IV over 1 hour, then 8 mg/hour IV infusion for 72 hours in glucose 5% or 0.9% NaCl → reduces rebleeding rate.
- Peptic ulcer disease / GORD / oesophagitis 🫀:
- Oral: 20–40 mg once daily (max 80 mg/day).
- IV: 40 mg slow IV once daily (if oral route not possible).
- NSAID-associated ulcer prophylaxis 💊: 20–40 mg once daily.
🔗 Interactions
- ⚠️ PPIs may reduce the effectiveness of clopidogrel (due to CYP2C19 inhibition).
- May increase serum levels of drugs dependent on gastric pH for absorption (e.g., ketoconazole, atazanavir).
⚠️ Cautions
- 🩺 Use with care in liver disease (dose adjustment may be required).
- 🦴 Long-term use: risk of osteoporosis-related fractures, hypomagnesaemia, and vitamin B12 deficiency.
- 🦠 May increase risk of GI infections (e.g., C. difficile).
⛔ Contraindications
- 🚫 Hypersensitivity to pantoprazole or other PPIs.
- 📖 See BNF for full details.
😬 Side Effects
- 🤢 GI: Abdominal pain, constipation, diarrhoea, nausea, vomiting.
- 🤕 CNS: Headache, dizziness.
- 🦠 Infections: Risk of pneumonia and C. difficile diarrhoea with prolonged use.
- 🦴 Long-term: Bone fractures, hypomagnesaemia, vitamin B12 deficiency.
📚 References
- Pantoprazole – BNF
- NICE guidance on dyspepsia and GORD.
📝 Revisions
- Updated September 2025
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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