Therapeutic interchange: proton pump inhibitors

ClinDose template

Use as a template

Sign in and create or join an organization to copy this protocol into it as a draft.

ClinDose template, review and adapt before use

Orders for a nonformulary proton pump inhibitor are converted to the formulary agent per the table below, unless the prescriber writes "do not substitute" with a reason.

Therapeutic interchange

OrderedDispensed
esomeprazolepantoprazoleDose mapping set by your institution
omeprazolepantoprazoleDose mapping set by your institution
lansoprazolepantoprazoleDose mapping set by your institution
rabeprazolepantoprazoleDose mapping set by your institution
dexlansoprazolepantoprazoleDose mapping set by your institution

Restriction criteria

  • ApprovalNot required
  • Exclusions set by your institution (for example Zollinger-Ellison syndrome or a documented treatment failure)