潘妥拉唑
Pantoprazole
Pantoprazole sodium sesquihydrate
別名: Protonix · Pantoloc · Controloc · Zurcal · Pantozol · Pantop · Protium · Somac-MA · BY-1023 · SKF-96022
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| 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.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
潘妥拉唑 (Pantoprazole) 是一種強效的質子幫浦抑制劑 (PPI)，用於治療和預防與胃酸相關的病理情況，如胃潰瘍、糜爛性食道炎和壓力性黏膜疾病。
雖然奧美拉唑 (Omeprazole) 是獸醫學中最廣泛使用的口服 PPI，但潘妥拉唑因其靜脈注射 (IV) 劑型而在臨床實務中備受重視。這使其成為無法耐受口服藥物或胃腸道吸收受損的住院重症病患（例如患有嚴重胰臟炎、小病毒性腸炎或活動性胃腸道出血的犬貓）的絕佳選擇。
- 臨床要點： 儘管其血漿半衰期非常短（約 1 小時），但由於其在受體位點的不可逆結合，其臨床效果可持續 24 小時或更長時間。 研究顯示它能直接減少體外幽門螺旋桿菌*的數量，並被用於某些根除治療方案中。
作用機轉
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.
安全性與警告
禁忌症
- 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
不良反應
- 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.
藥物交互作用
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
監測
- 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
藥物動力學
吸收
Neonatal foals: Intragastric (IG) bioavailability is 41%. Humans: Rapidly absorbed orally with 77% bioavailability. Food reduces the rate but not the extent of absorption.
分佈
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.
排除
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.
過量
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.
可用產品
劑型
- 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
人用標示
- 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
各地核准狀態
Human authorized product used off-label in veterinary medicine under the cascade.
POM (Prescription Only Medicine). Human authorized product used off-label.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
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.
飼主須知
重要提示： 錠劑必須整顆吞服；請勿剝半、壓碎或讓您的寵物咀嚼。特殊的腸溶包衣可保護藥物在被吸收前不被胃酸破壞。
- 請完全依照獸醫師的指示給藥。
- 監測嚴重症狀： 如果您的寵物出現血便、柏油樣黑便（黑糞症）或吐血（或嘔吐物看起來像咖啡渣），請立即聯繫您的獸醫師。
- 如果嘔吐或腹瀉持續存在或變得嚴重，請聯繫您的獸醫師。
VetSheet 藥物參考供合格獸醫專業人員作臨床決策輔助之用，不能取代專業判斷或廠商最新仿單。