Pantoprazole i.v.: Mechanism, Indications, Dosage & Administration of Antacid | Summaries Clinical Medicine

PANTOZOL®i.v.

Active Ingredient: Pantoprazole sodium sesquihydrate

COMPOSITION

Each vial contains 42.3 mg Pantoprazole sodium sesquihydrate (equivalent to pantoprazole 40

mg)

MECHANISM OF ACTION

Pantoprazole is a substituted benzimidazole which inhibits the secretion of hydrochloric acid in

the stomach by specific action on the proton pumps of the parietal cells.

Pantoprazole is converted to its active form in the acidic environment in the parietal cells where

its inhibits the H+, K+ ATPase enzyme, i.e. the final stage in the production of hydrochloric acid

in the stomach. The inhibition is dose-dependent and affects both receptor inhibitors, treatment

with pantoprazole causes a reduced acidity in the stomachand thereby an increase in gastrin in

proportion to the reduction in acidity. The increase in gastrin is reversible. Since pantoprazole

binds to the enzyme distal to the cell receptor level, the substance can affect hydrochloric acid

secretion independently of stimulation by other substances (acetylcholine, histamine, gastrin).

The effect is the same whether the product is given orally or intravenously.

INDICATIONS

- Duodenal ulcer

- Gastric ulcer

- Moderate and severe cases of inflammation of the esophagus (reflux esophagitis)

- For the treatment of pathological hypersecretory conditions associated with Zollinger

Ellison Syndrome or other neoplastic conditions.

POSOLOGY AND METHOD OF ADMINISTRATIONS

The intravenous administration of Pantozol i.v. is recommended only if oral application is not

appropriate.

Recommended dosage

Duodenal ulcer, gastric ulcer, moderate and severe reflux esophagitis

The recommended intravenous dosage is one vial (40 mg pantoprazole) Pantozol i.v. per

day.

Long-term management of Zollinger-Ellison-Syndrome and other pathological

hypersecretory conditions

Patients should start their treatment with a daily dose of 80 mg Pantozol i.v.

Thereafter, the dosage can be titrated up or down as needed using measurements of

gastric acid secretion to guide. With doses above 80 mg daily, the dose should be divided

and given twice daily. A temporary increase of the dosage above 160 mg pantoprazole is

possible but should not be applied longer than required for adequate acid control.

In case a rapid acid control is required, a starting dose of 2 x 80 mg Pantozol i.v. is

sufficient to manage a decrease of acid output into the target range (< 10 mEq/h) within one

hour in the majority of patients. Transition from oral to i.v. and from i.v. to oral formulations of

gastric acid inhibitors should be performed in such manner to ensure continuity of effect of

suppression of acid secretion.

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PANTOZOL ®i.v. Active Ingredient: Pantoprazole sodium sesquihydrate COMPOSITION Each vial contains 42.3 mg Pantoprazole sodium sesquihydrate (equivalent to pantoprazole 40 mg) MECHANISM OF ACTION Pantoprazole is a substituted benzimidazole which inhibits the secretion of hydrochloric acid in the stomach by specific action on the proton pumps of the parietal cells. Pantoprazole is converted to its active form in the acidic environment in the parietal cells where its inhibits the H+, K+ ATPase enzyme, i.e. the final stage in the production of hydrochloric acid in the stomach. The inhibition is dose-dependent and affects both receptor inhibitors, treatment with pantoprazole causes a reduced acidity in the stomachand thereby an increase in gastrin in proportion to the reduction in acidity. The increase in gastrin is reversible. Since pantoprazole binds to the enzyme distal to the cell receptor level, the substance can affect hydrochloric acid secretion independently of stimulation by other substances (acetylcholine, histamine, gastrin). The effect is the same whether the product is given orally or intravenously. INDICATIONS

Duodenal ulcer
Gastric ulcer
Moderate and severe cases of inflammation of the esophagus (reflux esophagitis)
For the treatment of pathological hypersecretory conditions associated with Zollinger Ellison Syndrome or other neoplastic conditions. POSOLOGY AND METHOD OF ADMINISTRATIONS The intravenous administration of Pantozol i.v. is recommended only if oral application is not appropriate. Recommended dosage Duodenal ulcer, gastric ulcer, moderate and severe reflux esophagitis The recommended intravenous dosage is one vial (40 mg pantoprazole) Pantozol i.v. per day. Long-term management of Zollinger-Ellison-Syndrome and other pathological hypersecretory conditions Patients should start their treatment with a daily dose of 80 mg Pantozol i.v. Thereafter, the dosage can be titrated up or down as needed using measurements of gastric acid secretion to guide. With doses above 80 mg daily, the dose should be divided and given twice daily. A temporary increase of the dosage above 160 mg pantoprazole is possible but should not be applied longer than required for adequate acid control. In case a rapid acid control is required, a starting dose of 2 x 80 mg Pantozol i.v. is sufficient to manage a decrease of acid output into the target range (< 10 mEq/h) within one hour in the majority of patients. Transition from oral to i.v. and from i.v. to oral formulations of gastric acid inhibitors should be performed in such manner to ensure continuity of effect of suppression of acid secretion.

Instruction for use/handling A ready-to-use solution is prepared by injecting 10 ml of physiological sodium chloride solution into the vial containing the dry substance. This solution may be administered directly or may be administered after mixing with 100 ml physiological sodium chloride solution or 5% Glucose. After preparation the solution must be used within 12 hours. From a microbiological point of view, the product should be used immediately. If not used immediately, in-use storage times and conditions prior to use are the responsibility of the user and would normally not be longer than 12 hours at not more than 25oC. Pantozol i.v. should not be manufactured or mixed with solvents other than those stated. As soon as oral therapy is possible, treatment with Pantozol i.v. should be discontinued and 40 mg pantoprazole p.o. should be administered instead. The drug should be administered intravenously over 2 – 15 minutes. Any product that has remained in the container or the visual appearance of which has changed (e.g if cloudiness or precipitation is observed) has to be discarded. The contacts of the vial is for single use only. CONTRAINDICATIONS Pantozol i.v should generally not be used in cases of known hypersensitivity to the constituent. WARNING AND PRECAUTIONS The intravenous administration of Pantozol i.v. is recommended only if oral application is not appropriate. Pantoprazole is not indicated for mild gastrointestinal complaints such as nervous dyspepsia. Prior to treatment the possibility of malignancy of gastric ulcer or a malignant disease of the esophagus should be excluded as the treatment with pantoprazole may alleviate the symptoms of malignant ulcers and can thus delay diagnosis. Diagnosis of reflux esophagitis should be confirmed by endoscopy. The daily dose of 40 mg pantoprazole should not be exceeded in elderly patients or in those with impaired renal function. In patients with severe liver impairment the daily dose has to be reduced to 20 mg pantoprazole. Furthermore, in these patients the liver enzymes should be monitored during Pantozol i.v. therapy. In case of a rise of the liver enzymes Pantozol i.v. should be discontinued. To date there has been no experience with treatment in children. Pregnancy and lactation Clinical experience in pregnant women is limited. In animal reproduction studies, signs of slight fetotoxicity were observed at doses above 5 mg/kg. There is no information on the excretion of pantoprazole into human breast milk. Pantoprazole should only be used when the benefit to the mother is considered greater than the potential risk to the foetus/baby. Effect on the ability to drive and to use machines There are no known effects on the ability to drive and use machines. INTERACTIONS

Hepatobiliary disorders Severe hepatocellular damage leading to jaundice with or without hepatic failure Immune system disorders Anaphylactic reactions including anaphylactic shock Investigations Increased liver enzymes (transaminases, γ- GT); Elevated triglycerides; Increased body temperature Musculoskeletal connective tissue disorders Arthralgia Myalgia Nervous system disorders Headache Dizziness; Disturbances in vision (blurred vision) Psychiatric disorders Mental depression Renal and urinary disorders Interstitial nephritis Skin and subcutaneous tissue disorders Allergic reactions such as pruritus and skin rash Urticaria; Angiodema; Severe skin reactions such as Steven-Johnson- Syndrome,Erythema multiforme, Lyell- Syndrome; Photosensitivity PRESENTATION PANTOZOL®i.v. Box, 1 vial Reg. No. DKI0253300344A

Do not store above 30oC Keep container in the outer carton On medical Prescription Only HARUS DENGAN RESEP DOKTER Keep medicament out of reach of children! Imported by PHAROS Jakarta – Indonesia Under license from and manufactured by: ALTANA Pharma AG D 78467 Konstanz Germany

Pantoprazole i.v.: Mechanism, Indications, Dosage & Administration of Antacid, Summaries of Clinical Medicine

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