1. Pantoprazole oral tablet is available as both a generic and a brand-name drug. Brand-name: Protonix.
  2. Pantoprazole comes in three forms: an oral tablet, an oral liquida suspension, and an intravenous (IV) form that’s injected into your vein by a healthcare provider.
  3. Pantoprazole oral tablet is used to reduce the amount of stomach acid your body makes. It helps treat painful symptoms caused by conditions such as gastroesophageal reflux disease (GERD).

  • Long-term use warning: Long-term use of pantoprazole can lead to an increased risk of certain side effects and complications. These include:
    • Increased risk of bone fracture in people taking higher, multiple daily doses for more than one year.
    • Vitamin B-12 deficiency, which can lead to serious nerve damage and deteriorating brain functions. This has been seen in some people taking pantoprazole for longer than three years.
    • Chronic inflammation of the stomach's lining (atrophic gastritis) when taking pantoprazole long term. People with H. pylori are particularly at risk.
    • Low blood magnesium (hypomagnesemia), this has been seen in some people taking pantoprazole for as few as three months. More often, it occurs after a year or more of treatment.
  • Severe diarrhea warning: Severe diarrhea caused by Clostridium difficile bacteria can occur in some people treated with pantoprazole, especially hospitalized people.
  • Allergy warning: Though it’s rare, pantoprazole can cause an allergic reaction. Symptoms could include rash, swelling, or breathing problems. This can progress to interstitial nephritis, a kidney disorder that can lead to kidney failure. Symptoms of this condition include:
    • nausea or vomiting
    • fever
    • rash
    • confusion
    • blood in your urine
    • bloating
    • elevated blood pressure
  • Cutaneous lupus erythematosus and systemic lupus erythematosus warning: Pantoprazole can cause cutaneous lupus erythematosus (CLE) and systemic lupus erythematosus (SLE). CLE and SLE are autoimmune diseases. Symptoms of CLE can range from a rash on the skin and nose, to a raised, scaly, red or purple rash on certain parts of the body. Symptoms of SLE can include fever, tiredness, weight loss, blood clots, heartburn, and stomach pain. If you have any of these symptoms, call your doctor.
  • Fundic gland polyps warning: Long-term use (especially over one year) of pantoprazole can cause fundic gland polyps. These polyps are growths on the lining of your stomach that can become cancerous. To help prevent these polyps, you should use this drug for as short a time as possible.

Pantoprazole oral tablet is a prescription drug that’s available as the brand-name drug Protonix. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in all strengths or forms as the brand-name drug.

Pantoprazole comes in three forms: an oral tablet, an oral liquid suspension, and an intravenous (IV) form that’s injected into your vein by a healthcare provider.

Why it’s used

Pantoprazole oral tablet is used to reduce the amount of stomach acid your body makes. It helps treat painful symptoms caused by conditions such as gastroesophageal reflux disease (GERD). With GERD, gastric juices flow upward from your stomach and into the esophagus.

Pantoprazole oral tablet is also used to treat other conditions in which the stomach makes excess acid, such as Zollinger-Ellison syndrome.

How it works

Pantoprazole belongs to a class of drugs called proton pump inhibitors. It works to shut off the acid-pumping cells in your stomach. It reduces the amount of stomach acid and helps to reduce painful symptoms related to conditions such as GERD.

Pantoprazole oral tablet does not cause drowsiness. However, it can cause other side effects.

More common side effects

The more common side effects that can occur with pantoprazole include:

  • headache
  • diarrhea
  • stomach pain
  • nausea or vomiting
  • gas
  • dizziness
  • joint pain

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Low magnesium levels. Using this drug for three months or longer can cause low magnesium levels. Symptoms can include:
    • seizures
    • abnormal or fast heart rate
    • tremors
    • jitteriness
    • muscle weakness
    • dizziness
    • spasms of your hands and feet
    • cramps or muscle aches
    • spasm of your voice box
  • Vitamin B-12 deficiency. Using this drug for longer than three years can make it harder for your body to absorb vitamin B-12. Symptoms can include:
    • nervousness
    • neuritis (inflammation of a nerve)
    • numbness or tingling in your hands and feet
    • poor muscular coordination
    • changes in menstruation
  • Severe diarrhea. This may be caused by a Clostridium difficile infection in your intestines. Symptoms can include:
    • watery stool
    • stomach pain
    • fever that doesn’t go away
  • Bone fractures
  • Kidney damage. Symptoms can include:
    • flank pain (pain in your side and back)
    • changes in urination
  • Cutaneous lupus erythematosus (CLE). Symptoms can include:
    • rash on the skin and nose
    • Cutaneous lupus erythematosus on the back.
    • raised, red, scaly, red or purple rash on your body
  • Systemic lupus erythematosus (SLE). Symptoms can include:
    • fever
    • tiredness
    • weight loss
    • blood clots
    • heartburn
  • Fundic gland polyps (don’t usually cause symptoms)

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

Pantoprazole oral tablet can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Examples of drugs that can cause interactions with pantoprazole are listed below.

HIV drugs

Taking certain HIV drugs with pantoprazole is not recommended. Pantoprazole may significantly decrease the amount of these drugs in your body. This can reduce their ability to control HIV infection. These drugs are:

  • atazanavir
  • nelfinavir

Anticoagulant

Some people taking warfarin with pantoprazole can experience increases in INR and prothrombin time (PT). This can lead to an increased risk of severe bleeding. If you take these drugs together, your doctor should monitor you for increases in INR and PT.

Drugs affected by stomach pH

Pantoprazole affects stomach acid levels. As a result, it can reduce your body’s absorption of certain drugs that are sensitive to the effects of decreased stomach acid. This effect can make these drugs less effective.

Examples of these drugs include:

  • ketoconazole
  • ampicillin
  • atazanavir
  • iron salts
  • erlotinib
  • mycophenolate mofetil

Cancer drug

Taking methotrexate with pantoprazole may increase the amount of methotrexate in your body. If you’re taking high doses of methotrexate, your doctor may have you stop taking pantoprazole during your methotrexate therapy.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you’re taking.

Pantoprazole oral tablet comes with several warnings.

Allergy warning

Though it’s rare, pantoprazole can cause an allergic reaction. Symptoms may include rash, swelling, or breathing problems.

This allergic reaction can progress to interstitial nephritis, a kidney disorder that can lead to kidney failure. Symptoms of this condition include:

  • nausea or vomiting
  • fever
  • rash
  • confusion
  • blood in your urine
  • bloating
  • elevated blood pressure

If you experience any of these symptoms, call your doctor right away. If your symptoms seem severe or life threatening, go to an emergency room or call 911.

Warnings for people with certain health conditions

For people with osteoporosis: Pantoprazole can increase a person’s risk for osteoporosis, a condition that causes bones to become brittle. Tell your doctor if you have a history of osteoporosis.

For people with low blood magnesium (hypomagnesemia): Pantoprazole can decrease the amount of magnesium in your body. Tell your doctor if you have a history of hypomagnesemia.

For people being tested for neuroendocrine tumors: Pantoprazole can cause incorrect results in these tests. For this reason, your doctor will have you stop taking this drug at least 14 days before you have this testing. They may also have you repeat the testing if needed.

Warnings for other groups

For pregnant women: Pantoprazole is a pregnancy category C drug. That means two things:

  1. Studies of the drug in pregnant animals have shown risk to the fetus.
  2. There aren’t enough studies done in pregnant women to show that the drug poses a risk to the fetus.

If you’re pregnant or plan to become pregnant, speak with your doctor about this drug.

For women who are breastfeeding: Pantoprazole may pass through breast milk and could be passed to a breastfeeding baby. Talk to your healthcare provider about other treatment options while breastfeeding.

For children: Pantoprazole is sometimes used for short-term treatment of erosive esophagitis in children ages 5 and older. This condition is associated with GERD. It causes irritation and damage to the throat from stomach acid. Your child’s doctor will provide the correct dose.

This dosage information is for pantoprazole oral tablet. All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • the severity of your condition
  • other medical conditions you have
  • how you react to the first dose

Forms and strengths

Generic: Pantoprazole

  • Form: oral tablet
  • Strengths: 20 mg and 40 mg

Brand: Protonix

  • Form: oral tablet
  • Strengths: 20 mg and 40 mg

Dosage for gastroesophageal reflux disease (GERD)

Adult dosage (ages 18 years and older)

Typical dosage: 40 mg per day, taken once a day with or without food.

Child dosage (ages 5–17 years)

  • Typical dosage for children who weigh 40 kilograms or more: 40 mg taken once per day for up to 8 weeks.
  • Typical dosage for children who weigh between 15 and 40 kilograms: 20 mg taken once per day for up to 8 weeks.

Dosage for excess acid production, such as Zollinger-Ellison syndrome

Adult dosage (ages 18 years and older)

  • Typical dosage: 40 mg twice daily, with or without food.

Child dosage (ages 0–17 years)

A safe and effective dose hasn’t been established for children in this age range.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always speak with your doctor or pharmacist about dosages that are right for you.

Pantoprazole oral tablet may be prescribed for either short-term or long-term use. How long you take it will depend on the type and severity of your condition. It comes with serious risks if you don’t take it as prescribed.

If you don’t take it or stop taking it: If you don’t take the drug at all or stop taking it, you risk decreased ability to control your symptoms of GERD.

If you don’t take it on schedule: Not taking pantoprazole every day, skipping days, or taking doses at different times of day may also decrease your control of GERD.

What to do if you miss a dose: If you miss a dose, take the next dose as planned. Don’t double your dose.

How to tell if the drug is working: You can tell that pantoprazole is working if it reduces your GERD symptoms, such as:

  • heartburn
  • nausea
  • difficulty swallowing
  • regurgitation
  • sensation of a lump in your throat

Keep these considerations in mind if your doctor prescribes pantoprazole oral tablet for you.

General

  • You can take this form with or without food. Take at the same time every day for best effects.
  • Don’t cut, crush, or chew this medication.

Storage

  • Store this drug at room temperature between 68°F and 77°F (20°C and 25°C).
  • You can store it for a short time at temperatures as low as 59°F (15°C) and as high as 86°F (30°C).

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Clinical monitoring

Pantoprazole can lower magnesium levels in certain people. Your doctor may suggest having your blood magnesium levels monitored if you’re treated with pantoprazole for three months or more.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport X-ray machines. They won’t damage your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
  • Don’t put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Possible alternatives to the oral tablet include:

  • lansoprazole
  • esomeprazole
  • omeprazole
  • rabeprazole
  • dexlansoprazole

Talk to your doctor about other drug options that may work for you.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.