Pantoprazol
Pantoprazole
Pantoprazole sodium sesquihydrate
También conocido como: Protonix · Pantoloc · Controloc · Zurcal · Pantozol · Pantop · Protium · Somac-MA · BY-1023 · SKF-96022
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Intravenous treatment of stress-related mucosal disease | 0.7-1 mg/kg | IV | once daily | — | 🌎 NA |
| Gastric acid suppression | 0.5-1 mg/kg | IV | q24h | — | 🌎 NA |
| All uses (ulcers, oesophagitis, hypersecretory conditions) | 0.7-1.0 mg/kg | IV | q24h | Not specified | 🌍 EU |
- Gastric acid suppression: Administer over 15 minutes
- All uses (ulcers, oesophagitis, hypersecretory conditions): Administer over 15 min. Oral dose not established but likely similar to IV dose.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Gastric acid suppression | 0.5-1 mg/kg | IV | q24h | — | 🌎 NA |
| All uses (ulcers, oesophagitis, hypersecretory conditions) | 0.7-1.0 mg/kg | IV | q24h | Not specified | 🌍 EU |
- Gastric acid suppression: Administer over 15 minutes
- All uses (ulcers, oesophagitis, hypersecretory conditions): Administer over 15 min. Oral dose not established but likely similar to IV dose.
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Gastric acid suppression in neonatal foals | 1.5 mg/kg | IV | once daily | — | 🌎 NA |
- Gastric acid suppression in neonatal foals: From an experimental study evaluating normal neonatal foals. Further studies required for critically ill patients.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El pantoprazol es un potente inhibidor de la bomba de protones (IBP) utilizado para tratar y prevenir patologías relacionadas con el ácido gástrico, tales como úlceras gástricas, esofagitis erosiva y enfermedad de la mucosa relacionada con el estrés.
Aunque el omeprazol es el IBP oral más reconocido en medicina veterinaria, el pantoprazol es altamente valorado en la práctica clínica por su formulación intravenosa (IV). Esto lo convierte en una excelente opción para pacientes hospitalizados en estado crítico (por ejemplo, perros o gatos con pancreatitis severa, enteritis por parvovirus o hemorragia gastrointestinal activa) que no toleran la medicación oral o tienen una absorción gastrointestinal comprometida.
- Perla clínica: Aunque su vida media plasmática es muy corta (alrededor de 1 hora), su efecto clínico dura 24 horas o más debido a la unión irreversible en el sitio del receptor.
- También se ha demostrado que reduce directamente los recuentos in vitro de Helicobacter pylori y se utiliza en algunos protocolos de erradicación.
Mecanismo de acción
Pantoprazole is a substituted benzimidazole weak base. It accumulates in the highly acidic environment of the gastric parietal cell secretory canaliculi, where it is protonated and converted into its active sulfenamide form.
- Mechanism: The active form binds irreversibly via covalent disulfide bonds to the H+/K+ ATPase enzyme system (the "proton pump") at the secretory surface of gastric parietal cells.
- Pathway: Systemic circulation → Parietal cell → Acidic canaliculi → Active sulfenamide → Irreversible inhibition of H+/K+ ATPase → Profound suppression of both basal and stimulated gastric acid secretion.
Because the binding is irreversible, acid secretion only resumes when new proton pump enzymes are synthesized by the parietal cell, explaining the prolonged duration of action despite rapid systemic clearance.
Seguridad y advertencias
Contraindicaciones
- Known hypersensitivity to pantoprazole or other substituted benzimidazole PPIs
- Intramuscular (IM) or Subcutaneous (SQ) administration (parenteral form must be given IV)
- Intramuscular (IM) administration
- Subcutaneous (SC) administration
Efectos adversos
- Diarrhea
- Headache (reported in humans)
- Hyperglycemia (rare, ~1% in humans)
- Injection site reactions (thrombophlebitis, abscess) with IV use
- Potential increased risk of community-acquired pneumonia (noted in human literature)
- Diarrhoea
- Hyperglycaemia (rare)
- Increased risk of pneumonia
- Thrombophlebitis (associated with IV injection)
Precauciones
Parenteral pantoprazole MUST be administered IV; do not give IM or SQ. Reconstituted injection (4 mg/mL) must be administered intravenously over not less than 2 minutes. Use with caution in pregnant animals (FDA Category B in humans) though animal studies have not demonstrated teratogenic effects. May cause false-positive results for urine screening tests for THC.
Interacciones farmacológicas
Decreased drug absorption due to increased gastric pH (these drugs require an acidic environment for optimal absorption)
May decrease the bioavailability of orally administered pantoprazole
Pantoprazole may increase the anticoagulant effect
Decreased absorption of itraconazole due to increased gastric pH
Decreased absorption of ketoconazole due to increased gastric pH
Monitorización
- Efficacy (resolution of clinical signs, improvement in gastric pH)
- Adverse effects (vomiting, diarrhea)
- Injection site reactions (thrombophlebitis, abscess) if used IV
- Resolution of clinical signs (vomiting, melena, regurgitation)
- Gastric pH (in critical care settings)
- IV catheter site for signs of thrombophlebitis
Farmacocinética
Absorción
Neonatal foals: Intragastric (IG) bioavailability is 41%. Humans: Rapidly absorbed orally with 77% bioavailability. Food reduces the rate but not the extent of absorption.
Distribución
Humans: 98% protein bound, primarily to albumin.
Metabolismo
Metabolized in the liver, primarily by CYP2C19 isoenzymes. CYP3A4, 2D6, 2C9, and 1A2 are minor components. Metabolites do not have pharmacologic activity. Does not appear to clinically induce or inhibit these isoenzymes.
Eliminación
Humans: About 71% excreted as metabolites in urine, remainder in feces. Elimination half-life is ~1 hour, but pharmacologic action persists >24 hours due to irreversible receptor binding.
Sobredosis
Limited information available in veterinary species. A single oral dose of 887 mg/kg was lethal in dogs, causing acute toxic signs including ataxia, hypo-activity, and tremor. In humans, single oral overdoses up to 600 mg have been reported without adversity. In the event of a large overdose, contact an animal poison control center for guidance.
Productos disponibles
Formulaciones
- Delayed-release tablets
- Delayed-release granules for suspension
- Lyophilized powder for injection
- 20 mg gastro-resistant tablet
- 40 mg gastro-resistant tablet
- 40 mg powder in vial for IV injection
Etiquetado para humanos
- Pantoprazole Sodium Delayed-Release Tablets: 20 mg & 40 mg (Protonix, generic)
- Pantoprazole Lyophilized Powder for Injection Solution: 40 mg in vials (Protonix I.V.)
- Pantoprazole Sodium Delayed-Release Granules for Suspension: 40 mg (Protonix)
- Protium 20 mg gastro-resistant tablets
- Protium 40 mg gastro-resistant tablets
- Pantoprazole 40 mg powder for injection
Estado regulador
Human authorized product used off-label in veterinary medicine under the cascade.
POM (Prescription Only Medicine). Human authorized product used off-label.
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Delayed-release tablets: Store between 15-30°C. Powder for injection: Store protected from light at 20-25°C. Reconstitute with 10 mL of 0.9% NaCl for a 2-minute IV infusion (stable for 2 hours at room temp). For a 15-minute infusion, dilute further with 100 mL of D5W, 0.9% NaCl, or LRS to ~0.4 mg/mL (stable for 22 hours at room temp). Reconstituted solutions do not need light protection. Do not freeze. Discard if discoloration or precipitates are seen. Incompatible with midazolam and zinc-containing solutions.
Información para el cliente
Importante: Los comprimidos deben administrarse enteros; no los parta, triture ni permita que su mascota los mastique. El recubrimiento especial protege al fármaco de ser destruido por el ácido estomacal antes de que pueda ser absorbido.
- Administre el medicamento exactamente como lo indique su veterinario.
- Monitoree signos graves: Si su mascota presenta diarrea con sangre, heces de color negro alquitranado (melena) o vomita sangre (o material que parece posos de café), contacte a su veterinario de inmediato.
- Contacte a su veterinario si los vómitos o la diarrea persisten o se vuelven severos.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.