What is the recommended dose for a Pantop (Pantoprazole) infusion?

Pantoprazole (Pantop) Infusion Dosage Recommendations

The recommended dose for Pantoprazole (Pantop) infusion is 40 mg given once daily by intravenous infusion for 7 to 10 days for GERD with history of erosive esophagitis, or 80 mg intravenously every 12 hours for pathological hypersecretion conditions including Zollinger-Ellison syndrome. 1

Dosing Based on Indication

For Gastroesophageal Reflux Disease (GERD) with History of Erosive Esophagitis:

• 40 mg once daily by intravenous infusion
• Treatment duration: 7 to 10 days
• Discontinue IV treatment as soon as patient can take oral pantoprazole 1

For Pathological Hypersecretion Including Zollinger-Ellison Syndrome:

• Initial dose: 80 mg intravenously every 12 hours
• Dose adjustment: Based on acid output measurements
• For patients requiring higher dosage: 80 mg IV every 8 hours (to maintain acid output below 10 mEq/h)
• Maximum daily dose: 240 mg
• Maximum studied duration: 6 days 1

Preparation and Administration Methods

Fifteen Minute Infusion (Standard Method):

1. Reconstitute with 10 mL of 0.9% Sodium Chloride Injection
2. Further dilute with 100 mL of 5% Dextrose Injection, 0.9% Sodium Chloride Injection, or Lactated Ringer's Injection (final concentration ~0.4 mg/mL)
3. Inspect solution for particulate matter and discoloration
4. Administer over approximately 15 minutes at a rate of ~7 mL/minute 1

Two Minute Infusion (Alternative Method):

1. Reconstitute with 10 mL of 0.9% Sodium Chloride Injection (final concentration ~4 mg/mL)
2. Inspect solution for particulate matter and discoloration
3. Administer over at least 2 minutes 1

Storage Considerations

• Reconstituted solution (15-minute method): May be stored up to 6 hours at room temperature before dilution
• Diluted solution (15-minute method): May be stored at room temperature and must be used within 24 hours from initial reconstitution
• Reconstituted solution (2-minute method): May be stored up to 24 hours at room temperature
• Neither solution requires protection from light
• Do not freeze either solution 1

Clinical Efficacy

• In patients with Zollinger-Ellison syndrome, pantoprazole infusions of 80-120 mg every 8-12 hours effectively controlled acid output within 1 hour (mean onset of effective control: 41 minutes) 2
• 81% of patients with hypersecretory conditions were effectively controlled with 80 mg every 12 hours for up to 7 days 2

Monitoring and Safety Considerations

• Inspect solution visually for particulate matter and discoloration prior to and during administration 1
• No serious or unexpected adverse events have been observed with IV pantoprazole in clinical studies 2
• Consider premedication with pantoprazole (40 mg) during procedures requiring sedation to reduce risk of gastric acid aspiration 3

Important Caveats

• Pantoprazole 40 mg once daily does not raise gastric pH to levels sufficient to treat life-threatening upper gastrointestinal bleeds 1
• For patients requiring higher doses, monitor acid output to guide dosing adjustments 1
• For patients with severe liver cirrhosis, the half-life of pantoprazole is prolonged to 7-9 hours, which may require dosage adjustment 4

Remember that IV pantoprazole should be discontinued as soon as the patient can receive oral pantoprazole treatment.