A Survey of the Use of Bolus Subcutaneous Injection of Pantoprazole in Palliative Care

To investigate the use, feasibility and tolerability of bolus subcutaneous injection of pantoprazole in the specialist palliative care hospice inpatient setting.

A retrospective review of the electronic records and paper administration charts of the first 10 patients who received a slow bolus subcutaneous injection of pantoprazole in a hospice inpatient unit.

The most common indications for a proton pump inhibitor were gastro-esophageal reflux disease and gastroprotection. Loss of swallow in the last days of life was the most common reason for the subcutaneous route. 80% of patients tolerated bolus subcutaneous pantoprazole and may have received clinical benefit. Two patients developed skin irritation at the subcutaneous injection site.

Bolus subcutaneous pantoprazole is a potential alternative treatment when a proton pump inhibitor is indicated, and the oral route is not available or effective. There is a risk of skin irritation requiring careful monitoring. Controlled research is needed.