PANTONOR 40mg Powder for solution for injection

What is PANTONOR 40mg

PANTONOR 40mg is a proton pump inhibitor (PPI) containing the active ingredient Pantoprazole. It is formulated as a powder for solution for injection and is typically used in hospital settings for patients who are unable to take oral medications. Each vial contains 40 mg of Pantoprazole, to be reconstituted before intravenous administration.

• Used to treat conditions involving excessive stomach acid such as gastric ulcers, duodenal ulcers, and gastroesophageal reflux disease (GERD).
• Effective in the prevention and treatment of stress ulcers in critically ill patients.
• Also used as part of a combination therapy for Helicobacter pylori eradication when oral treatment is not feasible.
• Reserved primarily for short-term use when oral administration is not possible or appropriate.

How to use PANTONOR 40mg

PANTONOR 40mg must be administered by a healthcare professional, typically in a hospital or clinical setting. It is given via slow intravenous injection or infusion after reconstitution.

• Reconstitute the powder in the vial with 10 ml of 0.9% sodium chloride solution.
• For intravenous injection, administer slowly over 2–15 minutes.
• For infusion, the reconstituted solution can be further diluted in 100 ml of 0.9% sodium chloride or 5% glucose solution and infused over 15 minutes.
• Use immediately after preparation; discard unused solution.
• Do not mix with solvents or infusions other than those recommended.
• Dosage and duration depend on the clinical indication and patient’s condition.

Mode of Action PANTONOR 40mg

PANTONOR 40mg works by targeting the final step in acid production within the stomach lining, making it effective in controlling gastric acidity.

• Pantoprazole irreversibly inhibits the H⁺/K⁺-ATPase enzyme system (proton pump) located in the gastric parietal cells.
• This leads to a profound and long-lasting reduction in gastric acid secretion, regardless of the stimulus (e.g., food, histamine).
• Onset of action typically occurs within 1 hour of administration, with maximum effect observed within 2–3 hours.
• The acid-suppressive effect persists for up to 24 hours, allowing once-daily dosing in most cases.
• The inhibitory effect is dose-dependent and cumulative over repeated doses.

PANTONOR 40mg Interactions PANTONOR 40mg

PANTONOR 40mg may interact with a number of medications, potentially affecting their absorption or metabolism. Caution is advised when co-administered with the following:

• Drugs requiring acidic pH for absorption (e.g., ketoconazole, itraconazole, erlotinib) – effectiveness may be reduced due to decreased gastric acidity.
• Anticoagulants (e.g., warfarin) – pantoprazole may alter INR and bleeding risk; close monitoring is required.
• HIV protease inhibitors (e.g., atazanavir, nelfinavir) – reduced absorption may decrease therapeutic effect.
• Clopidogrel – although controversial, PPIs like pantoprazole may reduce antiplatelet activity; use only if clinically necessary.
• Methotrexate – high-dose methotrexate levels may be elevated due to reduced renal clearance; monitor toxicity signs.
• Digoxin – pantoprazole may increase serum levels of digoxin; monitor as needed.

Dosage of PANTONOR 40mg

Dosage should be tailored based on the clinical indication, patient age, renal and hepatic function. Below is a general guideline:

• Adults with GERD or erosive esophagitis: 40 mg once daily via IV for up to 7 days.
• Zollinger-Ellison Syndrome and other pathological hypersecretory conditions: Initial dose of 80 mg daily; doses up to 240 mg/day may be used based on patient response, divided into two or three doses.
• Peptic ulcer bleeding prophylaxis in critically ill patients: 40 mg IV once daily.
• H. pylori eradication (when oral therapy is not possible): 40 mg IV in combination with antibiotics, as determined by the clinician.
• Renal impairment: No dosage adjustment necessary.
• Hepatic impairment: Caution is advised; liver function should be monitored.
• Children: Safety and efficacy not well established in pediatric populations.

Possible side effects of PANTONOR 40mg

Like all medications, PANTONOR 40mg may cause side effects, although not everyone experiences them. Most are mild and transient.

• Common side effects:
  • Headache
  • Diarrhea
  • Nausea or vomiting
  • Injection site reactions (pain, redness, or swelling)
• Uncommon side effects:
  • Dizziness
  • Fatigue
  • Abdominal pain or bloating
• Rare but serious side effects:
  • Severe allergic reactions (anaphylaxis, angioedema)
  • Stevens-Johnson syndrome or toxic epidermal necrolysis
  • Hepatic enzyme elevation or hepatitis
  • Hypomagnesemia with long-term use
  • Bone fracture (in cases of long-term/high-dose use)
• Laboratory abnormalities: Altered liver function tests, decreased magnesium levels, elevated creatinine kinase.

PANTONOR 40mg Contraindications PANTONOR 40mg

PANTONOR 40mg should not be used in the following situations:

• Known hypersensitivity to pantoprazole, substituted benzimidazoles, or any of the excipients.
• History of severe allergic reactions (e.g., Stevens-Johnson syndrome) to proton pump inhibitors.
• Concomitant use with rilpivirine or other drugs contraindicated with PPIs due to significant interaction and reduced efficacy.
• Severe hepatic dysfunction – use with caution; contraindicated in some severe liver failure cases unless benefit outweighs risk.
• Pediatric use: Not approved for use in children due to insufficient data for safety and efficacy in this formulation.

Storage of PANTONOR 40mg

Proper storage of PANTONOR 40mg is essential to ensure its effectiveness and safety.

• Store vials at room temperature (15°C to 25°C), protected from light and moisture.
• Do not freeze the powder or reconstituted solution.
• Once reconstituted, the solution should be used within 12 hours if stored at room temperature, or as per manufacturer’s guidance.
• Keep the vials in the original packaging until use to protect from light exposure.
• Keep out of reach of children.
• Discard any unused reconstituted solution appropriately, following hospital or local disposal protocols for injectable drugs.