PANOM

Pantoprazole's mechanism of action involves the permanent inhibition of proton pumps in the stomach, which are responsible for gastric acid production. It is a prodrug - in the acid environment of the parietal cells, Pantoprazole inhibits the H⁺, K⁺ATPase of the coating gastric cells and gastric acid secretion is suppressed.

Indications

Gastro esophageal reflux disease (GERD)
Heartburn
NSAID induced gastritis
Duodenal and Gastric ulcer
Stress ulcer
Zollinger-Ellison (ZE) Syndrome
Hyper secretory Conditions

Dosage

Route of administration: Oral

GERD: 40 mg orally once a day 8 weeks
Reflux esophagitis: 40 mg orally once a day for up to 8 weeks
Gastric(stomach) Ulcer: 40 mg orally once a day for 4-8 weeks
Duodenal(intestinal) Ulcer: 40 mg orally once a day for 12 weeks
Zollinger Ellison Syndrome: 40 mg twice daily, to a maximum of 240 mg per day.

Better efficacy if taken 30 minutes before meal.

Pharmacokinetics

Absorption: Absolute bioavailability is approximately 77%.
Protein binding: 98% (bound to human plasma proteins)
Metabolism: Hepatic
Route of elimination: Approximately 71% of the dose was excreted in the urine with 18% excreted in the feces through biliary excretion
Half-life: 1 hour

Adverse Effects

Gastrointestinal: abdominal pain, diarrhea, flatulence, nausea, vomiting
Neurologic: headache, dizziness
Neuromuscular and skeletal: arthralgia

Drug Interactions

Acidity: Due to its effect of reducing stomach acidity, use of pantoprazole can affect absorption of drugs that are pH-sensitive such as ampicillin esters, ketoconazole, atazanavir, iron salts, amphetamine and mycophenolate mofetil.