PROTON 20/MG EC TAB 14/TAB

Dosage & Administration

Dosing by Condition

Erosive esophagitis (healing): 40 mg PO once daily for up to 8 weeks (may extend to 8 additional weeks if needed). Maintenance of healing: 40 mg PO once daily. Pathological hypersecretory conditions (e.g., Zollinger-Ellison): 40 mg PO twice daily initially, then titrate to clinical response (doses up to 240 mg daily administered).

Initial Dose

20mg once daily (children ≥15 kg to <40 kg for erosive esophagitis); 40mg once daily (adults for GERD/erosive esophagitis); 40mg twice daily (pathological hypersecretory conditions)

Maintenance Dose

40mg once daily for maintenance of healing of erosive esophagitis.

Maximum Dose

240mg daily has been administered for pathological hypersecretory conditions.

Dose Adjustment Notes

Renal impairment: no dosage adjustment necessary. Hepatic impairment: no dosage adjustment necessary; doses higher than 40 mg/day have not been studied in hepatically-impaired patients. No routine adjustment for CYP2C19 poor metabolizers.

How to Take

Swallow the 20 mg enteric‑coated tablet whole with water; do not crush, chew, or split. Take with or without food.

Special Populations

Pregnancy

Caution

Storage & Patient Advice

Patient Counseling

Swallow the enteric‑coated tablet whole with water; do not crush/chew/split. Take on an empty stomach 30-60 minutes before a meal; not for immediate relief. Seek care for severe/persistent diarrhea, rash, new/worsening abdominal pain, or symptoms of low magnesium (cramps, palpitations); inform clinicians about HIV meds (rilpivirine/atazanavir/nelfinavir), warfarin, clopidogrel, and methotrexate. Long‑term use may increase fracture and nutrient deficiency risks-use the lowest effective dose and follow monitoring advice.

Pharmacology

Mechanism of Action

Prodrug that irreversibly (covalently) inhibits the gastric parietal cell H+/K+‑ATPase (proton pump), suppressing basal and stimulated acid secretion.

Onset of Action

Onset begins within a few hours after a dose (about 2-3 hours), with maximal acid suppression achieved after 2-4 days of daily dosing.

Duration of Effect

Acid suppression lasts about 24 hours with once‑daily dosing (often >24 hours in some patients).

Product Information

Composition per Dose

Each enteric-coated tablet: 20mg pantoprazole as pantoprazole sodium sesquihydrate

OTC Alternatives

OTC options for mild/intermittent symptoms include antacids (e.g., aluminum/magnesium hydroxide, calcium carbonate) and H2‑receptor antagonists (e.g., famotidine); in some countries, low‑dose PPIs (e.g., omeprazole 20 mg) are OTC, but availability varies by region.

Gi Condition

Acid Reflux/GERD, Ulcer

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