Protonix 40 mg tbec: Comprehensive Guide on Uses, Dosage, Side Effects, Interactions, and Warnings
What are the uses of Protonix 40 mg tbec? What is the dosage for different conditions? What are the potential side effects and interactions? Find answers to these and other important questions about this medication.
Protonix 40 mg tbec: Uses, Dosage, and Administration
Protonix (pantoprazole) is a proton pump inhibitor medication used to treat various gastrointestinal conditions. The 40 mg strength is available in the form of delayed-release tablets (tbec).
Uses of Protonix 40 mg tbec
Protonix 40 mg tbec is approved for the following uses:
- Short-term treatment and maintenance of healing of erosive esophagitis (EE)
- Short-term treatment of gastroesophageal reflux disease (GERD) in patients with a history of EE
- Treatment of pathological hypersecretory conditions, including Zollinger-Ellison syndrome
Dosage for Erosive Esophagitis
For the treatment of erosive esophagitis, the recommended adult dose is 40 mg orally once daily. If the patient is not healed after 8 weeks or if EE recurs, an additional 8 weeks of treatment may be considered.
For maintenance of healing of EE, the recommended adult dose is also 40 mg orally once daily.
Dosage for Gastroesophageal Reflux Disease (GERD)
The recommended adult dose for the short-term treatment of GERD is 40 mg orally once daily. The recommended duration of therapy is 8 weeks.
For patients who cannot tolerate the oral formulation, Protonix is also available as an intravenous (IV) formulation, which can be administered at a dose of 40 mg once daily, given over at least 2 minutes or over 15 minutes.
Dosage for Zollinger-Ellison Syndrome and Other Pathological Hypersecretory Conditions
For the treatment of Zollinger-Ellison syndrome and other pathological hypersecretory conditions, the recommended adult oral dose is 40 mg twice daily, with a maximum dose of 240 mg per day.
The IV formulation can be used initially at a dose of 80 mg every 12 hours, given over at least 2 minutes or over 15 minutes. The maintenance dose can be 80 mg every 8 to 12 hours, with a maximum dose of 240 mg per day.
Protonix 40 mg tbec: Dosage Adjustments
Renal Dose Adjustments
No dose adjustments are necessary for patients with renal impairment.
Liver Dose Adjustments
For patients with severe liver disease, a maximum dose of 20 mg of Protonix per day is recommended.
Protonix 40 mg tbec: Side Effects and Interactions
Potential Side Effects
The most common side effects of Protonix 40 mg tbec include headache, diarrhea, nausea, and abdominal pain. More serious side effects, such as Clostridium difficile-associated diarrhea, bone fractures, and vitamin B12 deficiency, may also occur.
Drug Interactions
Protonix may interact with certain medications, such as warfarin, methotrexate, and some antifungal drugs. Patients should inform their healthcare provider about all medications they are taking, including over-the-counter drugs and supplements.
Protonix 40 mg tbec: Warnings and Precautions
Protonix should be used with caution in patients with severe liver disease, as the maximum recommended dose is 20 mg per day. The drug should also be used with caution in patients with osteoporosis, as it may increase the risk of bone fractures.
Patients should be monitored for the development of Clostridium difficile-associated diarrhea, which can occur with the use of Protonix and other proton pump inhibitors.
Protonix 40 mg tbec: Pediatric Dosing
Protonix 40 mg tbec is approved for use in children 5 years of age and older. The recommended dose for children weighing 15 to less than 40 kg is 20 mg orally once daily, and for children weighing 40 kg and greater, the dose is 40 mg orally once daily. The maximum duration of treatment is 8 weeks.
Conclusion
Protonix 40 mg tbec is a proton pump inhibitor medication used to treat various gastrointestinal conditions, including erosive esophagitis, gastroesophageal reflux disease, and pathological hypersecretory conditions. The recommended dosage and administration vary depending on the specific condition being treated, and the medication should be used with caution in patients with certain medical conditions or taking certain other medications.
Pantoprazole Dosage Guide + Max Dose, Adjustments
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Medically reviewed by Drugs.com. Last updated on Dec 26, 2022.
Applies to the following strengths: 40 mg; 20 mg
Usual Adult Dose for:
- Erosive Esophagitis
- Gastroesophageal Reflux Disease
- Zollinger-Ellison Syndrome
- Pathological Hypersecretory Conditions
Usual Pediatric Dose for:
- Erosive Esophagitis
- Gastroesophageal Reflux Disease
Additional dosage information:
- Renal Dose Adjustments
- Liver Dose Adjustments
- Dose Adjustments
- Precautions
- Dialysis
- Other Comments
Usual Adult Dose for Erosive Esophagitis
Treatment: 40 mg orally once a day
- Duration of therapy: 8 weeks
Maintenance: 40 mg orally once daily
Comments:
- If patients are not healed after 8 weeks or erosive esophagitis (EE) recurs with the oral formulation, treatment for another 8 weeks may be considered.
- Controlled studies using the oral formulation for maintenance did not extend beyond 12 months.
Uses:
- Short-term treatment in the healing and symptomatic relief of EE
- Maintenance of healing of EE
Usual Adult Dose for Gastroesophageal Reflux Disease
Oral: 40 mg orally once a day
- Duration of therapy: 8 weeks
Parenteral: 40 mg via IV infusion once a day, given over at least 2 minutes OR over 15 minutes
- Duration of therapy: 7 to 10 days
Comments:
- IV treatment should be discontinued once the patient is able to take an oral formulation.
- Use of the IV formulation has not been studied for longer than 10 days.
- Safety and efficacy for uses otherwise described (e.g., life-threatening gastrointestinal bleeds) are not available; however, use of this drug at 40 mg/day doses did not raise gastric pH to sufficient levels to contribute to the treatment of life-threatening conditions.
- If patients are not healed after 8 weeks with the oral formulation, treatment for another 8 weeks may be considered.
Uses:
- Short-term treatment of gastroesophageal reflux disease (GERD) in patients with a history of erosive esophagitis
- Reduction of relapse rates of daytime and nighttime heartburn symptoms in adult patients with GERD
Usual Adult Dose for Zollinger-Ellison Syndrome
Oral: 40 mg orally 2 times a day
- Maximum dose: 240 mg/day
Parenteral:
- Initial dose: 80 mg via IV infusion every 12 hours, given over at least 2 minutes OR over 15 minutes
- Maintenance dose: 80 mg via IV infusion every 8 to 12 hours, given over at least 2 minutes OR over 15 minutes
- Maximum dose: 240 mg/day
- Maximum duration of therapy: 6 days
Comments:
- IV treatment should be discontinued once the patient is able to take an oral formulation.
- Use of the IV formulation for longer than 6 days and/or with doses higher than 240 mg has not been adequately studied.
- Patients may be vulnerable to increased acid production despite a short period of loss of effective inhibition.
- Patients given the oral formulation should be continued on therapy for as long as clinically necessary.
Uses:
- Treatment of pathological hypersecretory conditions, including Zollinger-Ellison syndrome
- Pathological hypersecretion conditions, including Zollinger-Ellison syndrome
Usual Adult Dose for Pathological Hypersecretory Conditions
Oral: 40 mg orally 2 times a day
- Maximum dose: 240 mg/day
Parenteral:
- Initial dose: 80 mg via IV infusion every 12 hours, given over at least 2 minutes OR over 15 minutes
- Maintenance dose: 80 mg via IV infusion every 8 to 12 hours, given over at least 2 minutes OR over 15 minutes
- Maximum dose: 240 mg/day
- Maximum duration of therapy: 6 days
Comments:
- IV treatment should be discontinued once the patient is able to take an oral formulation.
- Use of the IV formulation for longer than 6 days and/or with doses higher than 240 mg has not been adequately studied.
- Patients may be vulnerable to increased acid production despite a short period of loss of effective inhibition.
- Patients given the oral formulation should be continued on therapy for as long as clinically necessary.
Uses:
- Treatment of pathological hypersecretory conditions, including Zollinger-Ellison syndrome
- Pathological hypersecretion conditions, including Zollinger-Ellison syndrome
Usual Pediatric Dose for Erosive Esophagitis
5 years and older:
15 to less than 40 kg: 20 mg orally once a day
40 kg and greater: 40 mg orally once a day
Duration of therapy: Up to 8 weeks
Comment: Safety has not been established in treatment beyond 8 weeks.
Uses:
- Short-term treatment in the healing and symptomatic relief of EE
- Short-term treatment of GERD in patients with a history of EE
Usual Pediatric Dose for Gastroesophageal Reflux Disease
5 years and older:
15 to less than 40 kg: 20 mg orally once a day
40 kg and greater: 40 mg orally once a day
Duration of therapy: Up to 8 weeks
Comment: Safety has not been established in treatment beyond 8 weeks.
Uses:
- Short-term treatment in the healing and symptomatic relief of EE
- Short-term treatment of GERD in patients with a history of EE
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
IV: Data not available
Oral: Doses over 40 mg/day have not been studied in patients with liver impairment. No adjustment recommended.
Dose Adjustments
CYP450 2C19 Poor Metabolizers:
Adults: No adjustment recommended.
Pediatric patients: Oral dose reductions should be considered.
Pathological Hypersecretion (including Zollinger-Ellison syndrome):
- Acid output target range: Less than 10 mEq/h
Precautions
CONTRAINDICATIONS:
- Hypersensitivity to the active component, substituted benzimidazoles, or any of the ingredients
- Patients receiving rilpivirine-containing products
Safety and efficacy of oral formulations have not been established in patients younger than 5 years.
The IV formulation is not recommended for use in children.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- Tablet formulations should be swallowed whole, without crushing/chewing; tablets may be taken with or without food.
- For patients unable to swallow a 40 mg tablet, two 20 mg tablets may be taken; however, the 40 mg oral suspension packet formulation should not be divided to create two-20 mg dosages.
- Oral suspension/granule formulations should be taken on an empty stomach, preferably 30 to 60 minutes before a meal.
- The granule formulation may be sprinkled into applesauce or mixed into a small volume of either apple juice or orange juice and swallowed immediately. This drug may be mixed with apple juice and administered via nasogastric tube.
Storage requirements: The manufacturer product information should be consulted.
Reconstitution/preparation techniques: The manufacturer product information should be consulted.
IV compatibility: The manufacturer product information should be consulted.
General:
- This drug may be used concomitantly with antacids without affecting the absorption.
- Reflux symptoms may take 2 to 3 days to improve after initiation.
- Rapid acid control may be achieved within an hour at an IV dose of 160 mg.
Monitoring:
- HEPATIC: Liver function tests, especially in patients with impaired liver function
- METABOLIC: Magnesium levels, especially in patients taking other drugs that could result in hypomagnesemia or those on long-term therapy; Vitamin B12 levels, especially in patients on long-term therapy
- MUSCULOSKELETAL: Bone fractures, especially in patients at high-risk for osteoporosis-related events
- RENAL: Renal function tests
Patient advice:
- Advise patients to avoid taking concomitant proton pump inhibitors and/or h3 antagonists during treatment.
- If using this drug to treat H pylori, tell patients that it is important to complete the full regimen.
- Instruct patients to seek medical attention if signs/symptoms of hypersensitivity, Clostridium difficile, or systemic cutaneous lupus erythematosus occur.
- Patients should be told that treatment may not provide immediate relief and that they should not take this drug for prophylaxis. Symptomatic relief may occur after 1 day of treatment, but patients should continue treatment for the full duration to achieve complete symptom control.
- Inform patients that this drug may cause dizziness or blurred vision, and they should avoid driving or operating machinery if these side effects occur.
- Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.
Frequently asked questions
- Pantoprazole vs. omeprazole: What’s the difference between them?
- Can you take pantoprazole 40 mg twice a day?
- How long can I take pantoprazole?
- Does pantoprazole cause bloating?
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Patient resources
- Drug Information
- Pantoprazole (Intravenous) (Advanced Reading)
- Pantoprazole (Oral) (Advanced Reading)
- Pantoprazole Delayed-Release Granules
- Pantoprazole Delayed-Release Tablets
- Pantoprazole Injection
Other brands
Protonix, Protonix IV
Professional resources
- Prescribing Information
Related treatment guides
- Erosive Esophagitis
- Barrett’s Esophagus
- Dumping Syndrome
- Duodenal Ulcer
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medical Disclaimer
Pantoprazole Interactions Checker – Drugs.com
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There are 163 drugs known to interact with
pantoprazole, along with
4 disease interactions.
Of the total drug interactions,
16 are major, 128 are moderate, and 19 are minor.
Does pantoprazole interact with my other drugs?
Enter other medications to view a detailed report.
- View all 163 medications that may interact with pantoprazole
- View pantoprazole disease interactions (4)
Most frequently checked interactions
View interaction reports for pantoprazole and the medicines listed below.
- Major
- Moderate
- Minor
- Unknown
- Aspir 81 (aspirin)
- Aspirin Low Strength (aspirin)
- Benadryl (diphenhydramine)
- CoQ10 (ubiquinone)
- Crestor (rosuvastatin)
- Cymbalta (duloxetine)
- Eliquis (apixaban)
- Fish Oil (omega-3 polyunsaturated fatty acids)
- Flonase (fluticasone nasal)
- Lasix (furosemide)
- Lexapro (escitalopram)
- Lipitor (atorvastatin)
- Lyrica (pregabalin)
- Metoprolol Succinate ER (metoprolol)
- Metoprolol Tartrate (metoprolol)
- MiraLAX (polyethylene glycol 3350)
- Norco (acetaminophen / hydrocodone)
- Plavix (clopidogrel)
- ProAir HFA (albuterol)
- Singulair (montelukast)
- Symbicort (budesonide / formoterol)
- Synthroid (levothyroxine)
- Tylenol (acetaminophen)
- Vitamin B12 (cyanocobalamin)
- Vitamin C (ascorbic acid)
- Vitamin D2 (ergocalciferol)
- Vitamin D3 (cholecalciferol)
- Xanax (alprazolam)
- Xarelto (rivaroxaban)
- Zyrtec (cetirizine)
Pantoprazole disease interactions
There are 4 disease interactions with pantoprazole which include:
- C. diff
- liver disease
- bone fractures
- hypomagnesemia
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More about pantoprazole
- pantoprazole consumer information
- Compare alternatives
- Pricing & coupons
- Reviews (415)
- Drug images
- Side effects
- Dosage information
- Patient tips
- During pregnancy
- Support group
- Drug class: proton pump inhibitors
- Breastfeeding
- En español
Related treatment guides
- Erosive Esophagitis
- Barrett’s Esophagus
- Dumping Syndrome
- Duodenal Ulcer
