パントプラゾール
Pantoprazole
Pantoprazole sodium sesquihydrate
別名: Protonix · Pantoloc · Controloc · Zurcal · Pantozol · Pantop · Protium · Somac-MA · BY-1023 · SKF-96022
VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
動物種別用量
🌎 NA — North America🌍 EU — Europe
犬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
猫
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
馬
| 適応 | 用量 | 経路 | 頻度 | 期間 | 地域 |
|---|---|---|---|---|---|
| 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.
用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。
概要
パントプラゾールは強力なプロトンポンプ阻害薬（PPI）であり、胃潰瘍、びらん性食道炎、ストレス性粘膜疾患などの胃酸関連疾患の治療および予防に使用されます。
獣医学において最も広く認識されている経口PPIはオメプラゾールですが、パントプラゾールはその静脈内（IV）製剤があるため、臨床現場で高く評価されています。これにより、経口薬に耐えられない、または消化管吸収が低下している入院中の重症患者（重度の膵炎、パルボウイルス性腸炎、または活動性消化管出血の犬や猫など）にとって優れた選択肢となります。
- 臨床のポイント： 血漿中半減期は非常に短い（約1時間）ですが、受容体部位での不可逆的な結合により、臨床効果は24時間以上持続します。 また、in vitroでヘリコバクター・ピロリ*の数を直接減少させることが示されており、一部の除菌プロトコルで利用されています。
作用機序
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.
安全性・警告
禁忌
- 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
有害事象
- 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)
注意事項
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.
医薬品相互作用
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
監視
- 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
薬物動態
吸収
Neonatal foals: Intragastric (IG) bioavailability is 41%. Humans: Rapidly absorbed orally with 77% bioavailability. Food reduces the rate but not the extent of absorption.
分布
Humans: 98% protein bound, primarily to albumin.
代謝
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.
消失
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.
過剰投与
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.
製品
製剤
- 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
ヒト用医薬品
- 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
規制ステータス
Human authorized product used off-label in veterinary medicine under the cascade.
POM (Prescription Only Medicine). Human authorized product used off-label.
規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
保管・安定性
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.
飼主向け情報
重要： 錠剤はそのまま与えてください。割ったり、砕いたり、ペットに噛ませたりしないでください。特殊なコーティングにより、吸収される前に薬が胃酸で破壊されるのを防いでいます。
- 獣医師の指示通りに正確に投与してください。
- 重篤な症状の観察： ペットに血便、タール状の黒色便（メレナ）、または吐血（コーヒーの粉のように見える嘔吐物）が見られた場合は、直ちに獣医師に連絡してください。
- 嘔吐や下痢が続く場合、または重度になる場合は、獣医師に連絡してください。
VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。