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Pantoprazole, Oral Tablet

Highlights for pantoprazole

  1. Pantoprazole oral tablet is available as both a generic and brand-name drug. Brand-name Protonix.
  2. Pantoprazole also comes in a liquid suspension that you prepare from granules and a form that is injected into a vein that is only given by a healthcare provider.
  3. Pantoprazole 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).
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Important warnings

Important warnings

  • 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.

About

What is pantoprazole?

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. In some cases, they may not be available in every strength or form as the brand-name version.

Pantoprazole also comes as a liquid suspension you prepare from granules. You take these forms by mouth. An intravenous (IV) form of pantoprazole is also available, but it is only given by a healthcare provider.

Why it's used

Pantoprazole is used to treat gastroesophageal reflux disease (GERD), a condition that causes gastric juices to flow upward from your stomach and into the esophagus. It also treats 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 gastroesophageal reflux disease (GERD).

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Side effects

Pantoprazole side effects

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

Most common side effects

The most common side effects that occur with pantoprazole include:

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

Serious side effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening, or if you think you’re experiencing a medical emergency, call 911.

  • Low magnesium levels. Using this drug for 3 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 3 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
    • raised, red, scaly, red or purple rash on your body
  • Systemic lupus erythematosus (SLE). Symptoms can include:
    • fever
    • tiredness
    • weight loss
    • blood clots
    • heartburn

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.

Interactions

Pantoprazole may interact with other medications

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.

Human immunodeficiency virus (HIV) drugs

  • atazanavir
  • nelfinavir

Combining these drugs with pantoprazole is not recommended. Pantoprazole may significantly decrease atazanavir or nelfinavir blood levels and reduce their ability to control HIV infection.

Anticoagulants

  • warfarin

Some people taking warfarin with pantoprazole experience increases in INR and prothrombin time (PT). This can lead to an increased risk of possibly severe bleeding. People taking proton pump inhibitors and warfarin should be monitored for increases in INR and PT.

Drugs affected by stomach pH

These drugs include:

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

Pantoprazole affects stomach acid levels. It can reduce the absorption of certain drugs that are sensitive to the effects of decreased stomach acid. Because of this, absorption of certain drugs can be reduced when used in combination with pantoprazole.

Methotrexate

Pantoprazole may increase blood levels of methotrexate. If you’re taking high doses of methotrexate, your doctor may have you stop taking pantoprazole during 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 are taking.

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Other warnings

Pantoprazole warnings

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. Let your healthcare provider know if you have a history of osteoporosis.

For people with low blood magnesium (hypomagnesemia): Pantoprazole can lower blood magnesium levels. Let your healthcare provider know if you have a history of hypomagnesemia.

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

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

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Dosage

How to take pantoprazole

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
  • how severe your condition is
  • 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 is 20 mg to 40 mg per day, taken once a day with or without food.

Child dosage (ages 5-17 years)

  • For children who weigh 40 kilograms and more, the dose is 40 mg taken once per day for up to 8 weeks.
  • For children who weigh between 15 and 40 kilograms, the dose is 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 is 20 mg to 40 mg per day, taken once a day with or without food.

Child dosage (ages 0-17 years)

A safe and effective dose hasn’t been established.

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 to speak with your doctor or pharmacist about dosages that are right for you.

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Take as directed

Take as directed

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

Important considerations

Important considerations for taking pantoprazole

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

You can store it for a short time in 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.

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Alternatives

Are there any alternatives?

Possible alternatives to the oral tablet include:

  • lansoprazole (Prevacid)
  • esomeprazole (Nexium)
  • omeprazole (Prilosec)
  • rabeprazole (Aciphex)
  • dexlansoprazole (Dexilant)

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.

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