Short-term treatment (7–10 days) of GERD associated with a history of erosive esophagitis. Pathological hypersecretory conditions (eg, Zollinger-Ellison syndrome).
≥18yrs: GERD: 40mg once daily for 7–10 days; switch to tabs or oral suspension as soon as possible. Pathological hypersecretory conditions: 80mg every 8–12 hours; usual max 240mg/day or 6 days' treatment.
<18yrs: not established.
Proton pump inhibitor.
Gastric malignancy. Increased risk of osteoporosis-related fractures of the hip, wrist or spine with long-term and multiple daily dose PPI therapy. Monitor magnesium levels with long-term therapy. 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, ampicillin). Concomitant digoxin or drugs that may cause hypomagnesemia (eg, diuretics); consider monitoring magnesium levels. Monitor warfarin. May give antacids concomitantly. IV: caution with concomitant other EDTA-containing products. May potentiate methotrexate. May cause false (+) urine THC test.
Headache, GI upset, dizziness, arthralgia, inj site reactions; also children: upper respiratory infection, fever, rash, abdominal pain; rare: cyanocobalamin deficiency, 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)—10, 25