Pantoprazole (Tablet) Dosage in Children

Oral Tablet Dosing by Age/Weight

GERD with Erosive Esophagitis (approved indication, up to 8 weeks)

GERD (general, limited data)

• Infants, children, and adolescents: 1-2 mg/kg/24 hr orally once daily; max dose: 40 mg/24 hr, for 4-8 weeks.

Ages 1-5 years (limited data, erosive esophagitis)

• Doses of 0.3, 0.6, or 1.2 mg/kg/24 hr PO once daily have all shown improvement in an 8-week multicenter RCT.
• Note: No commercially available tablet formulation is appropriate for children under 5 years - the oral suspension or granules are used in younger children.

Children younger than 5 years

• Dose must be determined by the treating physician. The tablet form is not recommended - use oral suspension or delayed-release granules instead.

Important Notes

• Children 1-2 years show more rapid drug clearance and may require higher doses.
• Tablets can be taken with or without food.
• For Zollinger-Ellison syndrome (hypersecretory conditions) in pediatric patients, dose must be determined by a physician (adult dosing starts at 40 mg twice daily, titrated up to 240 mg/24 hr).
• Do not crush or chew tablets - the enteric coating is protective. If the child cannot swallow tablets, use the granule/suspension formulation.
• Long-term use may cause hypomagnesemia, increased risk of C. difficile diarrhea, and fundic gland polyps.

Clinical reminder: Always confirm dosing with a current formulary or prescribing physician, especially for children under 5 years where tablet use is not standard and weight-based dosing with appropriate formulations is preferred.