What is pantoprazole used for?

• Erosive esophagitis — the damage of the esophagus from exposure to stomach acid caused by GERD (gastroesophageal reflux disease).
• The esophagus is the tube that carries food and liquid from your throat to your stomach.
• Zollinger-Ellison syndrome—a rare condition where tumors in the pancreas or the duodenum (the upper part of the small intestines) secrete large amounts of the hormone gastrin; gastrin, then, signals the stomach to produce excessive acid. 
• Other gastrointestinal conditions that are caused by excess stomach acid.

There may be other uses of pantoprazole—your pharmacist or physician can give you further information and assistance.

How does pantoprazole work?

• GERD (gastroesophageal reflux disease) is a condition where the backflow of acid from the stomach causes heartburn and injury of the esophagus (the tube between the throat and the stomach). 
• Pantoprazole works by blocking the action of the parietal cells in the stomach. The parietal cell is the gastric acid pump responsible for stomach acid production. Specifically, pantoprazole inhibits an enzyme essential for the final step in the acid secretion pathway. 
• Pantoprazole administration leads to long-lasting inhibition of gastric acid secretion.
• By blocking these cells, pantoprazole tablets and granules decrease gastric acid production; thus, relieving symptoms of heartburn, difficulty swallowing, and persistent cough. 
• Pantoprazole metabolism is independent of the route of administration (oral or intravenous dose). Meaning, pantoprazole gets broken down the same way whether given by mouth or intravenously. After hepatic metabolism, approximately 80% of the intravenous or oral dose is excreted as metabolites in urine.
• Pantoprazole is usually taken for up to 8 weeks while the esophagus heals. 
• Pantoprazole also prevents stomach ulcers and may prevent esophageal cancer.

 What is the suggested dosing for pantoprazole?

Pantoprazole is typically safe for various high-risk populations such as elderly patients and those with renal failure or moderate hepatic dysfunction. 

Pantoprazole doses higher than 40 mg per day have not been studied in patients with hepatic impairment.

Typical adult dosing for erosive esophagitis associated with GERD:

Treatment dosing of erosive esophagitis: 

• Take 40 mg by mouth once daily for up to 8 weeks
• An additional 8 weeks may be considered for patients who have not healed from the initial treatment

Maintenance dosing for healing of erosive esophagitis: 

• Take 40 mg by mouth once daily for up to 12 months
• Your doctor may recommend you continue to take pantoprazole for  the maintenance of healing erosive esophagitis and to easedaytime and nighttime heartburn symptoms.

Typical adult dosing for gastroesophageal reflux disease (GERD):

Parenteral (non-oral route of administration):

• Administer 40 mg intravenously over 15 minutes once daily for 7 to 10 days
• Switch to oral pantoprazole as soon as patients can swallow

Oral:

• Take 40 mg by mouth once daily for up to 8 weeks
• An additional 8 weeks may be considered for patients who have not healed from the initial treatment.
• There is no data regarding the safety and efficacy beyond 16 weeks of therapy.

Typical adult dosing for Zollinger-Ellison Syndrome:

Parenteral (non-oral route of administration):

• Administer 80 mg intravenously over 15 minutes every 12 hours 
• There is no data regarding the safety and efficacy of daily doses higher than 240 mg administered in equally divided doses or duration of therapy of more than 6 days.

Oral:

• Take 40 mg by mouth twice daily
• The maximum daily dose is 240 mg.

Typical adult dosing for peptic ulcer disease (PUD) — off-label:

Duodenal ulcer:

• Take 40 mg by mouth once daily
• The dose may be increased every 12 weeks by 40 mg increments. 
• The maximum daily dose is 120 mg.
• The duration of therapy is 28 weeks.

Gastric ulcer:

• Take 40 mg by mouth once daily
• The duration of therapy is 4 to 8 weeks depending on clinical response.

Typical adult dosing for Helicobacter pylori infection (H.pylori infection):

Triple therapy:

• Take pantoprazole 40 mg by mouth twice daily for 7 days, in conjunction with clarithromycin and amoxicillin or metronidazole. 
• After the first 7 days, take pantoprazole 40 mg by mouth once daily for 28 days.

Quadruple therapy:

• Take pantoprazole 40 mg by mouth twice daily for 7 days, in conjunction with bismuth subcitrate or tetracycline and metronidazole. 
• Bismuth subcitrate or tetracycline are to be taken by mouth four times daily. 
• Metronidazole 200 mg is to be taken three times daily, in addition to metronidazole 400 mg to be taken at bedtime.