Therapeutic Interchange Pantoprazole to Famotidine

On July 17, 2009, The Medical Center of Aurora Pharmacy & Therapeutics Committee approved the automatic interchange of pantoprazole (Protonix®) to famotidine (Pepcid®) when used for stress ulcer prophylaxis.

Pharmacists will only interchange pantoprazole to famotidine when they have determined:

1. The indication for use is only for stress ulcer prophylaxis
2. Absence of allergies or drug interactions with famotidine
3. Absence of thrombocytopenia
4. Evaluation of renal function (dosage reduction in renal insufficiency)

All therapeutic interchanges will be noted in the orders section of the patient chart.

D.A.W. (Dispense As Written) should be noted on any pantoprazole order in the event the physician prefers pantoprazole be administered.

The cost-savings that result from the therapeutic interchange will be very significant.

Patient safety will not be compromised.  A review of literature, comparing PPI's vs H2RA's, shows there are no increase in nosocomial pneumonia or in VAP following conversions from a proton pump inhibitor to a H2RA.