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Pantoprazole Intravenous for Adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Important information

  • High dose regimen:  unlicensed and is used for 72 hours only
  • Standard dose regimen: data are available for use up to 7 days - unlicensed for longer durations.  Switch to oral route as soon as possible

Available preparations

Pantoprazole 40mg vial

Reconstitution

Sodium chloride 0.9% ONLY

10ml per 40mg vial

Infusion fluids

Sodium chloride 0.9% or Glucose 5%

Methods of intravenous administration

Can use either slow intravenous injection or intravenous infusion for 40mg doses - choice depends on practicalities such as time available, fluid status of patient, etc.  High doses must be given by infusion as specified below

Slow intravenous injection (ref 1)

  • Administer over at least 2 minutes

Intermittent intravenous infusion (ref 1) 

  • Add required dose to 100ml infusion fluid and administer over 15 minutes

Loading dose infusion, followed immediately by continuous infusion (for bleeding gastric ulcer (unlicensed)(ref 1)

  • Loading dose 

    • Give 80mg

      • by slow intravenous injection  - give two vials of 40mg, over 2 minutes each
      • OR by short infusion as above
  • Continuous infusion 
    • Reconstitute two 40mg vials, each with 10ml Sodium chloride 0.9% taken from the same 100ml bag 
    • Return the reconstituted vials to the bag to give an 80mg in 100ml infusion solution

Dose in adults

Usual dose

  • Give 40mg once daily

High dose infusion for bleeding gastric ulcer (unlicensed)(ref 1)

  • Loading dose: give 80mg (as detailed above), FOLLOWED immediately by a maintenance dose of 8mg per hour for 72 hours  ( = 10ml per hour of 80mg in 100ml infusion as reconstituted above)

Zollinger-Ellison syndrome

  • Initially 80mg (160mg if rapid acid control required (give doses above 80mg in two divided doses) then 80mg once daily (adjusted according to response)

Renal impairment

  • No dosage adjustment required

Hepatic impairment

  • Do not exceed 20mg daily in patients with severe hepatic impairment.  Monitor liver enzymes, discontinue if liver function deteriorates

Storage

  • Store below 25°C
  • Infusion must be changed every 12 hours (note: in most cases, the infusion will only last 10 hours if it is being administered at the rate specified above) (ref 1)

References

SPC Pantoprazole Laboratories Azevedos 27/04/2017

1: Injectable Medicines Guide, Medusa Downloaded 28/10/2021

Therapeutic classification

Proton pump inhibitor