Uses
What is pantoprazole used for?
Pantoprazole is used to treat heartburn and certain other conditions caused by too much acid in the stomach.
- Gastroesophageal reflux disease (GERD), where stomach acid backs up into your esophagus
- To treat erosive esophagitis (EE)
- Other conditions where your stomach makes too much acid
Pantoprazole may also be used for other conditions as determined by your healthcare provider.
How does pantoprazole work (mechanism of action)?
Pantoprazole works by decreasing the amount of acid your stomach makes.
How is pantoprazole supplied (dosage forms)?
Pantoprazole is available as Protonix and generic pantoprazole in the following dosage forms that are taken by mouth.
- 20 mg delayed-release oral tablets
- 40 mg delayed-release oral tablets
- 40 mg packets of granules for delayed-release oral suspension
Pantoprazole is also available in injectable forms.
How should I store pantoprazole?
Pantoprazole should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C), for shorter periods of time, such as when transporting it. Store in a cool, dry place.
Side Effects
What are the most common side effects of pantoprazole?
The most common side effects of pantoprazole are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Headache
- Diarrhea
- Nausea
- Stomach pain
- Vomiting
- Gas
- Dizziness
- Joint pain
- Common cold symptoms (children ages 5 to 17 years)
- Fever (children ages 5 to 17 years)
- Rash (children ages 5 to 17 years)
There may be other side effects of pantoprazole that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of pantoprazole?
While less common, the most serious side effects of pantoprazole are described below, along with what to do if they happen.
Kidney problems. A type of kidney problem called acute tubulointerstitial nephritis can happen at any time during treatment with pantoprazole. If you notice a decrease in the amount of your urine or see blood in your urine, call your doctor right away.
Antibiotic-associated Diarrhea. An overgrowth of germs called Clostridioides difficile, or “C. diff,” can happen in your gut during treatment with pantoprazole. Call your healthcare provider right away if you have any of the following symptoms of this condition.
- Watery diarrhea
- Diarrhea that does not go away
- Blood in your stool (poop)
- Severe stomach cramps
- Fever that starts after you start or finish the medicine
Severe Skin Reactions. Pantoprazole can cause severe skin reactions, such as Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), that can lead to death if not treated. If you develop a rash, stop pantoprazole and call your healthcare provider right away. Get emergency help right away if you have any of the following symptoms of SJS or TEN.
- Painful red or purple skin that looks burned and peels off
- Flat red rash or blisters on your skin, mouth, nose, and genitals
- Red, painful, watery eyes
Severe Allergic Reaction called DRESS. Pantoprazole can cause a specific type of allergic reaction called DRESS. DRESS stands for Drug Reaction with Eosinophilia and Systemic Symptoms. It is also sometimes called multi-organ hypersensitivity. This is a reaction that can affect multiple parts of the body including your liver, kidneys, and heart. Stop using the medicine and get help right away if you have any of the following symptoms of this serious allergic reaction.
- Skin rash or pale red bumps on the skin called hives
- Fever or general ill feeling
- Swollen lymph nodes
- Shortness of breath
- Swelling in your feet, ankles, or legs
- Dark colored urine
- Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
Lupus. Some medicines, such as pantoprazole, can cause certain types of lupus or cause worsening of lupus you already have. Lupus is an autoimmune disorder where your immune cells attack other cells or organs in your body. Tell your provider right away if you have new or worsening joint pain or a rash on your arms or cheeks.
Vitamin B-12 deficiency. Pantoprazole can cause you to absorb less vitamin B-12 than usual, which can cause low vitamin B-12 levels. You have a higher risk of this if you take pantoprazole for a long time (3 years or longer). Stop using pantoprazole and call your healthcare provider if you have any of the following symptoms.
- Sore tongue
- Weakness
- Tingling or numbness in your hands or feet
Hypomagnesemia. Pantoprazole can cause low magnesium levels, also known as hypomagnesemia, which can be serious. Decreased magnesium levels can cause seizures or heart rhythm problems. Some people have a higher risk of this, including people who take the pantoprazole for a long time or those that take other medicines that can cause low magnesium. Stop using pantoprazole and call your healthcare provider if you have any of the following symptoms.
- Changes in your heart rate or rhythm, such as fast or skipping heartbeat
- Dizziness
- Muscle spasms
- Seizures
Bone loss and fractures. Pantoprazole may cause bone loss and increase your risk for fractures. The risk is higher in older adults and people taking pantoprazole for a long time or taking a high dose.
Injection site reaction. Pantoprazole injection can cause pain and inflammation around the area where the infusion was given. Tell your healthcare provider if you have pain, swelling, or redness in the area pantoprazole was administered.
Severe Allergic Reactions. Pantoprazole may cause allergic reactions, which can be serious. Stop using pantoprazole and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Warnings & Precautions
Who should not use pantoprazole?
Allergies to Ingredients. People who are allergic to any of the following should not use pantoprazole.
- Pantoprazole
- Protonix
- Any other medicine known as a proton pump inhibitor
- Any of the ingredients in the specific product dispensed
Drug Interactions. Pantoprazole should not be taken while you are using certain other medicines. Before taking pantoprazole, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
What should I know about pantoprazole before using it?
Do not take pantoprazole unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
Do not share pantoprazole with other people, even if they have the same condition as you. It may harm them.
Keep pantoprazole out of the reach of children.
Do not chew, cut, or crush pantoprazole.
Antacids may be taken with pantoprazole if needed.
Pantoprazole should not be used for immediate relief of heartburn. It may take 1 to 4 days for the medicine to fully work.
Pantoprazole tablets may be taken with or without food. Take pantoprazole oral suspension 30 minutes before a meal.
Pantoprazole packets should only be mixed with apple juice or applesauce.
If pantoprazole is given through a nasogastric (NG) tube, your health care provider will give you instructions on how to properly give it.
What should I tell my healthcare provider before using pantoprazole?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if pantoprazole is right for you.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Low blood potassium level (hypokalemia)
- Low blood magnesium level (hypomagnesemia)
- Low blood calcium level (hypocalcemia)
Other Medicines and Supplements. Pantoprazole may interact with other medicines and supplements. Before using pantoprazole, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Pregnancy. It is not known if or how pantoprazole could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant.
Breastfeeding. Pantoprazole passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take pantoprazole while breastfeeding.
Interactions
Does pantoprazole interact with foods or drinks?
Pantoprazole tablets may be taken with or without food. Take pantoprazole oral suspension 30 minutes before a meal.
Pantoprazole granules should only be mixed with apple juice or applesauce. Do not mix with any other foods or liquids.
It is unknown if drinking alcohol will affect pantoprazole.
Does pantoprazole interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before using pantoprazole.
- Methotrexate (Trexall and others)
- Warfarin, which is used as a blood thinner
- Rilpivirine (Edurant) or other medicines that contain rilpivirine, which are used to treat HIV
- Certain antiretoviral medicines, such as rilpivirine (Edurant), nelfinavir (Viracept), or saquinavir (Invirase), which are used for HIV or AIDS
Pantoprazole may affect the absorption of some other medicines. Tell your healthcare provider about all medicines that you take or have recently taken.
This may not be a complete list of medicines that can interact with pantoprazole. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much pantoprazole?
If you or someone else has used too much pantoprazole, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of pantoprazole?
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.
Are you currently using Pantoprazole (Protonix)?
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