판토프라졸
Pantoprazole
Pantoprazole sodium sesquihydrate
다른 이름: Protonix · Pantoloc · Controloc · Zurcal · Pantozol · Pantop · Protium · Somac-MA · BY-1023 · SKF-96022
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
동물 종별 용량
🌎 NA — North America🌍 EU — Europe
개
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
고양이
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
말
| 적응증 | 용량 | 경로 | 빈도 | 기간 | 지역 |
|---|---|---|---|---|---|
| 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.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
판토프라졸은 위궤양, 미란성 식도염, 스트레스성 점막 질환 등 위산 관련 병리를 치료하고 예방하는 데 사용되는 강력한 프로톤 펌프 억제제(PPI)입니다.
오메프라졸(Omeprazole)이 수의학에서 가장 널리 알려진 경구용 PPI이지만, 판토프라졸은 정맥 주사(IV) 제형이 있어 임상에서 매우 유용하게 쓰입니다. 이는 경구 투여가 불가능하거나 위장관 흡수가 손상된 입원 중증 환자(예: 중증 췌장염, 파르보바이러스 장염 또는 활동성 위장관 출혈이 있는 개나 고양이)에게 탁월한 선택이 됩니다.
- 임상 요점: 혈장 반감기는 매우 짧지만(약 1시간), 수용체 부위에 비가역적으로 결합하기 때문에 임상 효과는 24시간 이상 지속됩니다. 또한 시험관 내에서 헬리코박터 파일로리*의 수를 직접적으로 감소시키는 것으로 나타났으며, 일부 제균 프로토콜에 활용됩니다.
작용 기전
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.
안전성·주의사항
금기사항
- 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
부작용
- 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)
주의
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.
약물 상호작용
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
모니터링
- 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
약동학
흡수
Neonatal foals: Intragastric (IG) bioavailability is 41%. Humans: Rapidly absorbed orally with 77% bioavailability. Food reduces the rate but not the extent of absorption.
분포
Humans: 98% protein bound, primarily to albumin.
대사
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.
배설
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.
과다투여
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.
제품
제형
- 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
인용의약품
- 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
규제 현황
Human authorized product used off-label in veterinary medicine under the cascade.
POM (Prescription Only Medicine). Human authorized product used off-label.
규제 데이터 없음: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
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.
보호자 정보
중요: 알약은 통째로 먹여야 합니다. 쪼개거나 부수거나 반려동물이 씹지 않도록 하십시오. 특수 코팅이 되어 있어 약물이 흡수되기 전에 위산에 의해 파괴되는 것을 막아줍니다.
- 수의사의 지시대로 정확하게 투여하십시오.
- 심각한 증상 모니터링: 반려동물에게 혈변, 타르처럼 검은 변(흑변)이 나타나거나 피를 토하는 경우(또는 커피 찌꺼기처럼 보이는 구토물), 즉시 수의사에게 연락하십시오.
- 구토나 설사가 지속되거나 심해지면 수의사에게 연락하십시오.
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