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Subcutaneous pantoprazole in an elderly, palliative care patient
  1. Hugues Michelon1,
  2. Hélène Souchu2,
  3. Bénédicte Chauvron-Defilippi2,
  4. Anne Lecoeur3,
  5. Maryvonne Villart1 and
  6. Michel Denis2
  1. 1Pharmacy Department, Site Sainte-Périne, AP-HP, Hôpitaux Universitaires Paris Ile-de-France Ouest, Paris, France
  2. 2Palliative Care Unit, Site Sainte-Périne, AP-HP, Hôpitaux Universitaires Paris Ile-de-France Ouest, Paris, France
  3. 3Pharmacy Department, Site Ambroise Paré, AP-HP, Hôpitaux Universitaires Paris Ile-de-France Ouest, Boulogne-Billancourt, France
  1. Correspondence to Dr Hugues Michelon, Pharmacy Department, Site Sainte-Périne, AP-HP, Hôpitaux Universitaires Paris Ile-de-France Ouest, Paris 75016, France; hugues.michelon{at}aphp.fr

Abstract

Proton pump inhibitors (PPIs) have become the agents of choice for acid-related diseases. In some clinical situations, PPI therapy by oral or intravenous route may be difficult especially among elderly and patients in palliative care. Off-label PPI subcutaneous injection could be the last alternative to improve patient relief, despite limited published data. We report a case of linitis plastica, peritoneal carcinomatosis and occlusive syndrome who suffered from painful regurgitations which rapidly improved after subcutaneous pantoprazole. No related adverse effects were observed during PPI therapy. Despite some limitations, this report suggests that off-label subcutaneous pantoprazole could be an interesting alternative route when intravenous infusion may be difficult or harmful for elderly and patients in palliative care. Nevertheless, clinical safety and efficiency data on larger populations are needed to validate this use in such population.

  • geriatrics
  • palliative care
  • pantoprazole
  • proton pump inhibitor
  • subcutaneous route
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Footnotes

  • Contributors All authors were involved in the patient care. HM wrote the manuscript with the help of HS and AL. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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