Is pantoprazole compatible with dilution in 5% dextrose in water (D5W)?

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Pantoprazole Compatibility with D5W

Yes, pantoprazole is fully compatible with 5% dextrose in water (D5W) for dilution and administration. 1

FDA-Approved Dilution Instructions

The FDA label explicitly authorizes D5W as an acceptable diluent for pantoprazole sodium for injection 1:

  • For 15-minute infusion: Reconstitute with 0.9% sodium chloride, then dilute with D5W (or NS or Lactated Ringer's) to final concentration of approximately 0.8 mg/mL 1
  • Flush compatibility: The IV line may be flushed with D5W before and after pantoprazole administration 1
  • Y-site compatibility: Pantoprazole is compatible with D5W when administered through a Y-site 1

Stability Data in D5W

Concentration-dependent stability has been established through rigorous research:

  • 0.4 mg/mL in D5W: Stable for 2 days at room temperature (20-25°C) or 14 days refrigerated (2-8°C) 2
  • 0.8 mg/mL in D5W: Stable for 3 days at room temperature or 28 days refrigerated 2
  • 0.16-0.80 mg/mL in D5W: Stable for 11 days at 4°C plus an additional 6 hours at 23°C 3

These stability periods significantly exceed the manufacturer's conservative 24-hour expiry recommendation 3.

Important Compatibility Caveats

Avoid zinc-containing products: Pantoprazole may not be compatible with products containing zinc 1

Monitor for precipitation: Immediately discontinue infusion if precipitation or discoloration occurs during Y-site administration 1

D5W performs slightly worse than normal saline: Solutions in D5W degrade faster than those in NS, though both remain clinically acceptable 3. If extended storage is required, NS is preferable for maximum stability 3.

Storage Recommendations

Reconstituted and diluted solutions do not require light protection but must not be frozen 1. The diluted D5W solution may be stored at room temperature and must be used within 24 hours from initial reconstitution per FDA guidelines 1, though research supports longer periods under controlled conditions 2, 3.

Particle counts increase after dilution in all container types, particularly for small-size particles, but remain within acceptable limits for clinical use 4.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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