Pantoprol Drug Interactions

Gastric pH-Dependent Drugs: Pharmacokinetic interaction theoretically possible when pantoprazole is used concomitantly with gastric pH-dependent drugs (e.g., ampicillin esters, iron salts, ketoconazole); increased or decreased drug absorption at increased gastric pH values.
Drugs Affecting Hepatic Microsomal Isoenzymes: Pharmacokinetic interaction unlikely.
Warfarin: Potential increased international normalized ratio (INR) and prothrombin time when warfarin is used concomitantly with proton-pump inhibitors, including pantoprazole. Potential for abnormal bleeding and death; monitor for INR and prothrombin time increase when Pantoprol is used concomitantly with warfarin.
Sucralfate: Potential delayed absorption and decreased bioavailability of proton-pump inhibitor (e.g., lansoprazole, omeprazole); administer proton-pump inhibitor at least 30 minutes before sucralfate.
General Advice: For the treatment of gastroesophageal reflux disease (GERD), one vial of Pantoprol injection should be reconstituted with 10 mL of 0.9% sodium chloride injection to provide a solution containing about 4 mg/mL of Pantoprol; the reconstituted solution may be injected IV over not less than 2 minutes. Alternatively, the reconstituted solution may be diluted with 100 mL of 0.9% sodium chloride injection or 5% dextrose injection, to provide a final concentration of about 0.4 mg/mL. The diluted solution may be infused IV over a period of about 15 minutes (about 2.7 mg of the drug or 7 mL of solution per minute).
For the treatment of hypersecretory conditions, each of two 40-mg (of pantoprazole) vials of Pantoprol injection should be reconstituted with 10 mL of 0.9% sodium chloride injection: the total volume (approximately 20 mL) of reconstituted solution may be injected IV over not less than 2 minutes. Alternatively, the contents of both vials may be combined and diluted with 80 mL of 0.9% sodium chloride injection or 5% dextrose injection to a final volume of about 100 mL, providing a final concentration of about 0.8 mg/mL. The diluted solution may be infused IV over a period of about 15 minutes (about 5.3 mg of the drug or 7 mL of solution per minute ).
Reconstituted solutions may be stored for up to 2 hours at room temperature before further dilution, and diluted solutions may be stored for up to 12 hours at room temperature. Neither reconstituted nor diluted solutions need to be protected from light.
Health-care personnel (e.g., pharmacists, nurses) preparing reconstituted solutions using spiked IV system adapters should use caution because of the potential for breakage of the glass vial.
Pantoprol should be administered IV through a dedicated IV line or via a Y-site. Parenteral pantoprazole sodium solutions should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Pantoprol for injection is incompatible by Y-site administration with midazolam hydrochloride injection and may be incompatible with solutions containing zinc. Y-site administration of Pantoprol IV should be discontinued immediately if precipitation or discoloration occurs.
For the treatment of pathologic hypersecretory conditions associated with Zollinger-Ellison syndrome or other neoplastic conditions, pantoprazole sodium for injection is administered IV every 8 or 12 hours. The frequency of administration may be individualized based on acid output measurements. Patients with Zollinger-Ellison syndrome may be vulnerable to serious complications of increased gastric acid secretion, even after a brief loss of gastric acid suppression.Therefore, transition from oral to IV and IV to oral formulations of gastric acid inhibitors should be performed in such a manner to ensure continuity of gastric acid suppression effects.