Select therapeutic use:
Indications for PROTONIX for ORAL SUSP:
Short-term treatment (up to 8 weeks) and maintenance of healing of erosive esophagitis (EE). Pathological hypersecretory conditions (eg, Zollinger-Ellison syndrome).
Swallow whole. Do not crush or chew granules. Susp: Take 30 mins before a meal. Mix contents of packet in 5mL of apple juice or applesauce (do not mix in water, other liquids or foods); then swallow. May give via NG tube (see full labeling). Treatment of EE: 40mg once daily for ≤8 weeks; if not healed, may repeat for 8 more weeks. Maintenance of EE healing: 40mg once daily. Pathological hypersecretory conditions: initially 40mg twice daily; max 240mg/day.
Swallow whole. Do not crush or chew granules. Susp: Take 30 mins before a meal. Mix contents of packet in 5mL of apple juice or applesauce (do not mix in water, other liquids or foods); then swallow. May give via NG tube (see full labeling). <5yrs: not recommended. Treatment of EE: Give once daily for up to 8 weeks. ≥5yrs: (≥15kg to <40kg): 20mg; (≥40kg): 40mg.
Symptomatic response does not preclude gastric malignancy. Discontinue if acute interstitial nephritis, cutaneous/systemic lupus erythematosus occurs. Long-term therapy may lead to malabsorption/deficiency of Vit. B12. Increased risk of osteoporosis-related fractures (hip, wrist or spine) with long-term and multiple daily dose PPI therapy. Monitor magnesium levels with long-term therapy. Use lowest effective dose for shortest duration. Reevaluate periodically. IV: consider zinc supplementation in those prone to zinc deficiency. Pregnancy (Cat.B). Nursing mothers: not recommended.
Concomitant atazanavir or nelfinavir: not recommended. May alter absorption of gastric pH-dependent drugs (eg, ketoconazole, iron, atazanavir, erlotinib, mycophenolate mofetil, ampicillin). Concomitant digoxin, diuretics may predispose patients to hypomagnesemia. Monitor warfarin. May give antacids concomitantly. May potentiate methotrexate (consider temporary withdrawal of the PPI); monitor. May cause false (+) urine THC test. IV: caution with concomitant other EDTA-containing products.
Proton pump inhibitor.
Headache, diarrhea, nausea, vomiting, flatulence, dizziness, arthralgia, inj site reactions; also children: fever, rash, abdominal pain; rare: hypomagnesemia (w. prolonged PPI therapy); possible C. difficile-associated diarrhea.
Hepatic (CYP2C19, 3A4). 98% protein bound.
Renal (primarily), fecal.
Tabs, IV (YES); oral soln (NO)
Tabs—90; Susp—30 packets/box; Vials (40mg)—1, 10, 25