Pantoprazole IV Dilution Fluids
Pantoprazole for injection can be diluted in 0.9% sodium chloride (normal saline), 5% dextrose in water (D5W), or lactated Ringer's injection. 1
FDA-Approved Dilution Options
According to the FDA prescribing information, pantoprazole sodium for injection is compatible with three specific IV fluids for dilution 1:
- 0.9% Sodium Chloride Injection, USP (Normal Saline)
- 5% Dextrose Injection, USP (D5W)
- Lactated Ringer's Injection, USP
Preparation Protocols by Indication
For GERD with Erosive Esophagitis (40 mg dose):
15-Minute Infusion Method:
- Reconstitute with 10 mL of 0.9% sodium chloride 1
- Further dilute with 100 mL of any of the three compatible fluids (NS, D5W, or LR) to achieve final concentration of approximately 0.4 mg/mL 1
- Administer over 15 minutes at approximately 7 mL/minute 1
2-Minute Infusion Method:
- Reconstitute with 10 mL of 0.9% sodium chloride only (final concentration 4 mg/mL) 1
- Administer over at least 2 minutes without further dilution 1
For Zollinger-Ellison Syndrome (80 mg dose):
15-Minute Infusion Method:
- Reconstitute each 40 mg vial with 10 mL of 0.9% sodium chloride 1
- Combine both vials and dilute with 80 mL of any compatible fluid (NS, D5W, or LR) to total volume of 100 mL with final concentration of approximately 0.8 mg/mL 1
Critical Compatibility Information
Y-Site Administration:
- When using Y-site administration, pantoprazole is compatible with 5% dextrose, 0.9% sodium chloride, or lactated Ringer's 1
- Flush the IV line before and after pantoprazole administration with any of these three compatible solutions 1
Important Incompatibilities:
- Midazolam HCl is incompatible with Y-site administration of pantoprazole 1
- Products containing zinc may be incompatible 1
- Immediately discontinue infusion if precipitation or discoloration occurs during Y-site administration 1
Stability Data
Research confirms extended stability when properly diluted 2:
- Pantoprazole 0.4 mg/mL in D5W stored in PVC minibags: stable 2 days at room temperature or 14 days refrigerated 2
- Pantoprazole 0.8 mg/mL in D5W: stable 3 days at room temperature or 28 days refrigerated 2
- Pantoprazole 0.4 or 0.8 mg/mL in normal saline: stable 3 days at room temperature or 28 days refrigerated 2
Storage Requirements
- Reconstituted solution: store up to 6 hours at room temperature before further dilution 1
- Diluted solution: use within 24 hours from initial reconstitution 1
- No light protection required for either reconstituted or diluted solutions 1
- Do not freeze reconstituted or diluted solutions 1
Common Pitfalls to Avoid
- Never use only D5W or lactated Ringer's for initial reconstitution—always reconstitute with 0.9% sodium chloride first, then dilute with any compatible fluid 1
- Ensure dedicated IV line or proper Y-site flushing to prevent incompatibility reactions 1
- Avoid co-administration with midazolam or zinc-containing products through the same line 1
- Inspect visually for particulate matter and discoloration before and during administration 1