Proton-P Special Precautions

Proton-pump inhibitors should be used with caution in patients with liver disease, in pregnancy and breastfeeding, before treatment the presence of gastric malignancy should be excluded. No problem with pantoprazole that has been encountered in clinical use with elderly patients. No dosage adjustment of pantoprazole is required in patients with renal impairment but prolongation of metabolism leading to a slight rise in peak plasma levels occurs in hepatic cirrhosis and it is recommended that the dosing is reduced to every other day.
Use in pregnancy: Pregnancy Category B: Proton-P should be used during pregnancy only if clearly needed.
Use in lactation: Pantoprazole is likely to be excreted in human milk, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of Proton-P to the mother.
Use in children: There are no data currently available on the use of pantoprazole in children.