Parenteral Manual

Pantoprazole sodium

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
PANTO IV
Classification: 
Gastric acid secretion inhibitor
Original Date: 
August 2005
Revised Date: 
April 2017
Indications: 
  • Treatment of conditions where a rapid reduction of gastric acid secretion is required such as reflux esophagitis in patients who cannot tolerate oral medications or in patients with severe GI bleeding.
Reconstitution and Stability: 
  • Reconstitute vial with 10 mL of 0.9% NaCl for a final concentraton of 4 mg/mL
  • Reconstituted solution stable 48 hrs at room temperature, 96 hrs refrigerated
  • Further diluted to 0.8 mg/mL in 0.9% NaCl stable 24 hours at room temp, 20 days refrigerated
Compatibility: 

- Solutions Compatible: D5W, 0.9% NaCl, ringer's lactate

-Y-site  Compatible: ampicillin, dimenhydrinate, dopamine, fentanyl, furosemide, gentamicin,  insulin regular,  methylprednisolone, metronidazole, morphine, nitroglycerin, piperacillin, potassium chloride, sodium bicarbonate, vasopressin

- Incompatible: ciprofloxacin, clindamycin, dobutamine, esmolol, hydromorphone, labetolol, midazolam, octreotide, potassium phosphate, zinc

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct

YES
Usual dilution: 4 mg/mL

- 0.8 mg/mL for dose less than or equal to 4 mg
Infusion time: 2-5 minutes
IV Intermittent Infusion

YES
Usual dilution: 4 mg/mL

- 0.8 mg/mL for dose less than or equal to 4 mg
Infusion time: over 15 minutes
IV Continuous Infusion

YES
Usual dilution: 0.8 mg/mL

 

 

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

  • Treatment is short-term: 7-10 days

Pediatric:
- GERD:

  • 1-1.5 mg/kg/day IV once daily
  • Maximum: 40 mg/day

- GI Bleed:

  • 5-15 kg: 2 mg/kg/dose IV x 1 then 0.2 mg/kg/hr IV
  • >15-40 kg: 1.8 mg/kg/dose IV x 1 and then 0.18 mg/kg/hr IV
  • >40 kg: 80 mg/dose IV x 1 then 8 mg/hr IV
  • Maximum: 80 mg/dose
  • Maximum rate: 8 mg/hour

Adult:
- GERD:

  • 40 mg IV once daily

- GI Bleed:

  • 80 mg/day IV loading dose followed by 8 mg/hr continuous IV infusion for 24-72 hours
  • Maximum: 240 mg/day has been administered
Potential hazards of parenteral administration: 
  • Diarrhea, headache, dizziness
  • Pruritis
  • Thrombophlebitis, abscess
Notes: 
  • Extensively metabolized hepatically
  • In patients with severe hepatic dysfunction, liver enzymes should be checked regularly and if an increase is noted, pantoprazole should be discontinued
  • When switching to oral, the same dose mg per mg should be ordered
  • Other additives - Edetate disodium (1 mg/ 40 mg vial)

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