Hyperacidity, GERD, and ulcers:
Indications for PROTONIX IV:
Short-term treatment (7–10 days) of GERD associated with a history of erosive esophagitis. Pathological hypersecretory conditions (eg, Zollinger-Ellison syndrome).
Give by IV infusion over 2mins or 15mins (see full labeling). ≥18yrs: GERD: 40mg once daily for 7–10 days; switch to tabs or oral suspension as soon as possible. Hypersecretory conditions: 80mg every 8–12hrs; usual max 240mg/day or 6 days' treatment.
<18yrs: not established.
PROTONIX IV Contraindications:
Concomitant rilpivirine-containing products.
PROTONIX IV Warnings/Precautions:
Symptomatic response does not preclude gastric malignancy. Discontinue and evaluate if acute tubulointerstitial nephritis, cutaneous/systemic lupus erythematosus occurs. Long-term therapy (eg, >3yrs) may lead to malabsorption/deficiency of Vit. B12. Monitor magnesium levels during prolonged therapy. Increased risk of fundic gland polyps with long-term use (esp. >1yr) or osteoporosis-related fractures (hip, wrist or spine) with long-term (>1yr) and multiple daily dose PPI therapy. Use lowest dose for shortest duration appropriate to condition. Reevaluate periodically. IV: consider zinc supplementation in those prone to zinc deficiency. Pregnancy. Nursing mothers.
PROTONIX IV Classification:
Proton pump inhibitor.
PROTONIX IV Interactions:
See Contraindications. May antagonize atazanavir, nelfinavir (avoid). May potentiate saquinavir, methotrexate (at high doses, consider temporary withdrawal of the PPI); monitor. May alter absorption of gastric pH-dependent drugs (eg, iron salts, erlotinib, dasatinib, nilotinib, mycophenolate mofetil, ketoconazole, itraconazole). Caution with digoxin or drugs that may cause hypomagnesemia (eg, diuretics); monitor. Monitor warfarin. May cause false (+) results in diagnostic investigations for neuroendocrine tumors; discontinue pantoprazole 14 days prior to CgA level assessment. May cause false (+) urine THC test. IV: caution with concomitant other EDTA-containing products.
Headache, diarrhea, nausea, abdominal pain, vomiting, flatulence, dizziness, arthralgia; possible C. difficile-associated diarrhea, inj site reactions (IV); rare: hypomagnesemia. Also children: URI, fever, rash.
Generic Drug Availability:
Tabs—90; Susp—30 packets; Vials—1, 10, 25