Cedars-Sinai Medical Center

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A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF Sept. 28, 2012 Issue | Archived Issues

Pantoprazole as preferred PPI, change from Gamunexto Gammaked

Pharmacy focus

Pantoprazole (Protonix®) is now the preferred proton pump inhibitor and Gammaked® is being dispensed in place of Gamunex®.

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Pantoprazole as preferred PPI, change from Gamunexto Gammaked

Pharmacy focus

Pantoprazole (Protonix®) as Preferred PPI

On June 5, Cedars-Sinai's Pharmacy and Therapeutics Committee approved pantoprazole (Protonix®) as the preferred proton pump inhibitor. Starting Wednesday, Sept. 26, new orders for PO and IV PPIs are automatically being substituted to pantoprazole per medical center-approved automatic substitutions.

  • Pantoprazole adult dosing:
    • 40mg PO or IVP daily
    • IV Infusion: 80mg IVPB bolus, then 8mg/hr continuous infusion
  • Automatic substitutions:
    • Autosub from esomeprazole to pantoprazole
      • Esomeprazole 40 mg IVP TO 40 mg IV push at same interval
      • Esomeprazole 80 mg IVPB bolus then 8 mg/hr continuous infusion TO 80 mg IVPB bolus then 8 mg/hr continuous infusion
      • Esomeprazole 40 mg PO TO 40mg PO or as solution via enteral tube at same interval
      • Esomeprazole 40 mg via enteral tube TO 40mg solution via enteral tube at same interval
    • Autosub from lansoprazole to pantoprazole
      • Lansoprazole 30 mg IVPB TO 40 mg IV push at same interval
      • Lansoprazole 60 mg IVPB bolus then 6 mg/hr cont infusion TO 80 mg IVPB bolus then 8 mg/hr continuous infusion
      • Lansoprazole 30 mg PO TO 40 mg PO at same interval
      • Lansoprazole 30 mg suspension via enteral tube TO 40mg solution via enteral tube at same interval
    • Autosub from omeprazole to pantoprazole
      • Omeprazole 10-. 20- or 40mg PO TO 40mg PO or via enteral tube
    • Pantoprazole 40mg IV TO pantoprazole 40mg PO or via enteral tube at same interval
    • Dexlanzoprazole 30- and 60mg PO TO pantoprazole 40mg PO or via enteral tube at same interval
    • Rabeprazole 20mg PO TO pantoprazole 40mg PO or via enteral tube at same interval

NOTE: Pantoprazole tablets may not be crushed. For patients requiring NG/GT administration, please select the suspension option to assure that the appropriate formulation is dispensed. Lansoprazole suspension will continue to be available for pediatric patients only.

Change from Gamunex® to Gammaked® IVIG brand name product

Starting Wednesday, Sept. 26, the Department of Pharmacy Services began dispensing Gammaked® in place of Gamunex®. Gammaked is identical to Gamunex, but is being sold by a different manufacturer under the brand name of Gammaked. The CS-Link™ order panel has been updated to include the Gammaked brand name product as the non-sucrose based product for NON-ESRD patients or patients prior to renal transplant. Infusion guidelines will remain unchanged.

Please see the following PDF: B2B. Gammaked vs Gammunex-C Comparison 05.12 (PDF)

Pharmacy and Therapeutics Committee approvals

Cedars-Sinai's P&T Committee released approvals from its August meeting. Please see the following PDF: Pharmacy and Therapeutics Committee Approvals - August 2012 (PDF)