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Protonix (Intravenous)

Generic Name: pantoprazole (Intravenous route)

pan-TOE-pra-zole

Medically reviewed on Oct 31, 2018

Commonly used brand name(s)

In the U.S.

  • Protonix
  • Protonix IV

Available Dosage Forms:

  • Powder for Solution

Therapeutic Class: Gastric Acid Secretion Inhibitor

Pharmacologic Class: Proton Pump Inhibitor

Uses For Protonix

Pantoprazole injection is used to treat certain conditions in which there is too much acid in the stomach. It is used for short-term treatment (7 to 10 days) of gastroesophageal reflux disease (GERD) with a history of erosive esophagitis. GERD is a condition in which the acid in the stomach washes back up into the esophagus. This medicine may also be used to treat Zollinger-Ellison syndrome or other conditions (eg, cancer) in which the stomach produces too much acid.

Pantoprazole is a proton pump inhibitor (PPI). It works by decreasing the amount of acid produced by the stomach.

This medicine is given only by or under the direct supervision of your doctor.

Before Using Protonix

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of pantoprazole injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of pantoprazole injection in the elderly. However, elderly patients are more sensitive to the effects of this medicine than younger adults.

Pregnancy

Pregnancy Category Explanation
All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Rilpivirine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acalabrutinib
  • Atazanavir
  • Bosutinib
  • Capecitabine
  • Cilostazol
  • Citalopram
  • Dacomitinib
  • Dasatinib
  • Erlotinib
  • Eslicarbazepine Acetate
  • Gefitinib
  • Ketoconazole
  • Ledipasvir
  • Methotrexate
  • Mycophenolate Mofetil
  • Nelfinavir
  • Neratinib
  • Nilotinib
  • Pazopanib
  • Saquinavir
  • Secretin Human
  • Sunitinib
  • Velpatasvir
  • Vismodegib

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Levothyroxine
  • Warfarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

  • Cranberry

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Diarrhea or
  • Hypomagnesemia (low magnesium in the blood), history of or
  • Kidney disease or
  • Osteoporosis (thinning of the bones) or
  • Systemic lupus erythematosus (SLE) or
  • Zinc deficiency—Use with caution. May make these conditions worse.
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of pantoprazole

This section provides information on the proper use of a number of products that contain pantoprazole. It may not be specific to Protonix. Please read with care.

A nurse or other trained health professional will give you this medicine in a medical facility. It is given through a needle placed into one of your veins.

It may take several days before this medicine begins to relieve stomach pain. To help relieve this pain, antacids may be taken with pantoprazole, unless your doctor tells you otherwise.

Tell your doctor if you have had problems with your zinc levels in your body. Your doctor may want you to take zinc supplements.

Your doctor will give you a few doses of this medicine until your condition improves, and then switch you to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

Precautions While Using Protonix

It is important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects. If your condition does not improve, or if it becomes worse, check with your doctor.

You should not receive pantoprazole together with medicines containing rilpivirine (eg, Complera®, Edurant®, Odefsey®).

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing or swallowing, or any swelling of your hands, face, or mouth after you receive the medicine.

Serious skin reactions can occur with this medicine. Tell your doctor right away if you have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or skin rash, sores or ulcers on the skin, or fever or chills while you are receiving this medicine.

This medicine may cause an injection site reaction called thrombophlebitis. Check with your doctor right away if you notice any of these side effects at the injection site: changes in skin color, pain, tenderness, or swelling of the foot or leg.

Check with your doctor right away if you have a fever, joint pain, skin rash, swelling of the body, feet, or ankles, or unusual weight gain after receiving this medicine. These could be symptoms of a serious kidney problem called acute interstitial nephritis.

This medicine may cause diarrhea, and in some cases it can be severe. Do not take any medicine to treat diarrhea without first checking with your doctor. Check with your doctor right away if you have watery diarrhea that does not go away, stomach pain, and fever while receiving this medicine.

Pantoprazole injection may increase your risk of having fractures of the hip, wrist, and spine. This is more likely if you receive several doses of this medicine per day or use it for 1 year or more. Call your doctor right away if you have severe bone pain or are unable to walk or sit normally.

This medicine may cause hypomagnesemia (low magnesium in the blood). This is more likely to occur if you are using this medicine for more than 1 year, or if you are using this medicine together with digoxin (Lanoxin®) or certain diuretics (water pills). Check with your doctor right away if you have convulsions (seizures), fast, racing, or uneven heartbeat, muscle spasms (tetany), tremors, or unusual tiredness or weakness.

Cutaneous or systemic lupus erythematosus may occur or get worse in patients receiving a PPI. Call your doctor right away if you have joint pain or a skin rash on your cheeks or arms that gets worse when exposed to the sun.

This medicine may increase your risk for fundic gland polyps (abnormal tissue growth in the upper part of your stomach). This is more likely if you are receiving this medicine for more than 1 year. Talk ti your doctor if you have concerns.

Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription (eg, atazanavir, nelfinavir, Reyataz®, Viracept®) or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Protonix Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Less common

  • Accumulation of pus
  • bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
  • changes in skin color
  • fever
  • pain, tenderness, or swelling of the foot or leg
  • stomach pain
  • swollen, red, tender area of infection

Rare

  • Drowsiness
  • loss of appetite
  • mood or mental changes
  • muscle spasms (tetany) or twitching
  • nausea
  • seizures
  • trembling
  • unusual tiredness or weakness
  • vomiting

Incidence not known

  • Absence of or decrease in body movement
  • blindness
  • blistering, peeling, or loosening of the skin
  • bloating of the abdomen or stomach
  • bloody or cloudy urine
  • bloody, black, or tarry stools
  • blurred vision
  • chills
  • constipation
  • continuing ringing or buzzing or other unexplained noise in the ears
  • cough
  • dark urine
  • decreased vision
  • diarrhea
  • difficulty with speaking
  • difficulty with swallowing
  • dizziness or lightheadedness
  • fast heartbeat
  • feeling of constant movement of self or surroundings
  • greatly decreased frequency of urination or amount of urine
  • hearing loss
  • hives, itching, or rash
  • increased watering of the mouth
  • indigestion
  • joint or muscle pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
  • light-colored stools
  • muscle cramps, pain, or stiffness
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • pale skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • sensation of spinning
  • severe abdominal or stomach cramps or pain
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stomach tenderness
  • swelling of the feet or lower legs
  • swollen glands
  • tightness in the chest
  • unexplained bleeding or bruising
  • watery and severe diarrhea, which may also be bloody
  • yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Headache

Less common

  • Belching
  • excess air or gas in the stomach or bowels
  • full feeling
  • passing gas

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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