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# Sompraz HP (Pantoprazole) ## Overview Pantoprazole is a proton pump inhibitor (PPI) that decreases gastric acid production. ## Primary Indications * Gastroesophageal reflux disease (GERD) * Healing of erosive esophagitis * Pathological hypersecretory conditions (e.g., Zollinger-Ellison syndrome) ## Adult Dosing * **GERD/Erosive Esophagitis:** 40 mg orally once daily. May be increased to 80 mg once daily for severe cases. * **Pathological Hypersecretory Conditions:** Starting dose typically 40 mg orally twice daily. Doses adjusted based on gastric acid output. Maximum dose generally 80 mg twice daily. ## Pediatric Dosing * **GERD/Erosive Esophagitis:** * **1 month to <5 years:** 10 mg orally once daily. * **5 years to <12 years:** 20 mg orally once daily. * **≥12 years:** 40 mg orally once daily. ## Dose Adjustments No specific dose adjustments are typically required for renal impairment. Caution in severe hepatic impairment; may require dose reduction (e.g., 20 mg once daily). ## Contraindications * Known hypersensitivity to pantoprazole or any component of the formulation. ## Adverse Effects Common: Diarrhea, headache, nausea, abdominal pain, dizziness. Long-term use associated with increased risk of: * Fractures (hip, wrist, spine) * Clostridium difficile infection * Vitamin B12 deficiency * Hypomagnesemia ## Key Drug Interactions * **Drugs requiring gastric acid for absorption:** Ketoconazole, itraconazole, iron salts, ritonavir, mycophenolate mofetil. Pantoprazole can decrease their absorption. * **Methotrexate:** PPIs may increase methotrexate levels. * **CYP2C19 substrates:** Monitor for potential interactions if co-administered with drugs primarily metabolized by CYP2C19. ## Monitoring * Electrolytes (especially magnesium) with long-term therapy. * Bone mineral density if patient has risk factors for osteoporosis. * Signs and symptoms of C. difficile infection. ## Clinical Pearls * Administer 30-60 minutes before a meal. * Pantoprazole is generally less dependent on CYP2C19 metabolism than omeprazole or esomeprazole, potentially leading to fewer drug interactions. * For IV administration, reconstitute and dilute according to manufacturer's instructions. Ensure compatibility with other IV medications. *** *This information is intended for clinical use and does not replace professional medical advice. Always consult the most current prescribing information and relevant guidelines for complete details and to verify dosing and safety before initiating therapy.*