What Is Pantoprazole?
Pantoprazole (Protonix) is a medicine classified as a proton pump inhibitor (PPI). It reduces the amount of acid that is in your pet’s stomach. It is used to treat and prevent ulcers (open sores) in the esophagus, throat, stomach, and intestines. It is more effective for preventing ulcers than medicines called H2 blockers such as famotidine (Pepcid), especially long-term. It can also be given to dogs as part of a combination of medicine to treat bacteria called helicobacter, which can infect the stomach and cause ulcers. It can also be given to pets undergoing surgery to prevent acid reflux.
All uses for pantoprazole in dogs and cats are considered to be “off-label” or “extra-label." This means that there may be evidence of safe and effective use but the FDA has not approved that use.
There is no veterinary-specific formulation for dogs or cats. The human medicine, which can be used in animals, is available in oral tablets, granules, and injections. Pantoprazole requires a veterinary prescription and is available from human pharmacies. Since these products are not formulated specifically for dogs or cats, discuss this with your veterinarian so that you get the right amount for your pet. Contact your veterinary compounding pharmacy for alternative dosing options.
How Is Pantoprazole Used in Pets?
Pantoprazole is usually given by mouth once or twice a day as directed by your veterinarian. Pantoprazole works best if given on an empty stomach at least 30 minutes before a meal. If vomiting occurs, try giving it with a small amount of food or a treat.
The granules are intended to be dissolved in apple juice or mixed into applesauce for humans. These granules could be dissolved in apple juice and given to an animal by mouth. But getting a proper dose for a pet can be difficult. If this is how your veterinarian prescribes the medicine, slowly give the liquid medicine into your pet’s mouth so that they receive all of the dose.
Pantoprazole injection is given by a veterinary professional in the hospital.
While pantoprazole is generally safe and well-tolerated, and it is more effective for long-term use than H2 blockers like famotidine, long-term use has been discouraged.
Always follow your veterinarian’s directions for giving medicines to animals. Remember to tell your veterinarian about any medicines, vitamins, supplements, or herbal therapies that you are giving your pet. Talk to your veterinarian before stopping any pet medicines.
What Are the Benefits of Pantoprazole in Pets?
- Pantoprazole is usually well-tolerated in dogs and cats.
- Pantoprazole is usually better than H2 blockers, such as famotidine, for longer-term use.
What Follow-up Is Required With Pantoprazole?
You and your veterinarian should monitor your pet for improvement of their condition as well as for side effects of the medicine. There are usually no routine blood tests that need to be performed.
Does Pantoprazole Have Warnings or Side Effects in Pets?
Do not use pantoprazole in animals that are allergic to it. The safety of pantoprazole in pregnant and nursing animals has not been established, so caution is advised.
Pantoprazole is well tolerated in dogs and cats, but there is less evidence for pantoprazole in dogs and cats than for another PPI called omeprazole. Side effects of oral pantoprazole are usually mild and usually associated with the gastrointestinal (GI) tract, including:
- Decreased appetite
- Nausea
- Vomiting
- Passing gas
- Diarrhea (dogs)
Contact your veterinarian if any of these worsens or continues for a few days.
If side effects persist with pantoprazole, stop the medicine and contact your veterinarian. Your veterinarian will discuss treatment options depending on the side effects and may recommend switching to a different medicine.
If you suspect that your pet is having a serious side effect or may have been overdosed, call your veterinary clinic immediately. If it is outside of regular office hours, you may contact a local emergency veterinary hospital or an animal poison control center. Note that fees may apply for emergency consultation.
You can reach the ASPCA Animal Poison Control Center at 888-426-4435 or the Pet Poison Helpline at 855-764-7661.
Does Pantoprazole Interact With Other Medicines?
Using multiple medicines can sometimes change how your pet’s medicines work or increase your pet’s risk for serious side effects. Always tell your veterinarian about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements that your pet is using.
In particular, make sure that you discuss if your pet is using any of the following before using pantoprazole:
“Azole” antifungals. Certain medicines to treat fungal infections are called “azole” antifungals. Common examples include fluconazole, itraconazole, and ketoconazole. These medicines are affected by the pH (acidity) of the stomach. Separate doses of pantoprazole and oral azole antifungals by at least 2 hours.
Cephalosporins. Certain medicines to treat bacterial infections are called cephalosporins. Common examples include cefpodoxime, cefuroxime, and cephalexin. These medicines are affected by the pH (acidity) of the stomach. Separate doses of pantoprazole and oral cephalosporins by at least 2 hours.
Levothyroxine. Levothyroxine is a medicine to replace thyroid hormones in animals that do not make enough themselves. Proton pump inhibitors (PPIs) such as omeprazole or pantoprazole may decrease the absorption of levothyroxine. Separating the doses does not usually resolve the problem. A higher dose of levothyroxine may need to be given with PPIs.
Warfarin. Warfarin is an anticoagulant medicine that is commonly used as a blood thinner to prevent blood clots from forming in the bloodstream. There is a greater risk for bleeding when this medicine is used with pantoprazole.
This may not be a complete list of medicines that can interact with pantoprazole. Always check with your veterinarian.
Are There Safety Concerns for Pet Owners?
- Keep pantoprazole out of reach of children.
- Wash your hands after giving pantoprazole to your pet.
- Do not handle pantoprazole if you are allergic to it.
What If My Pet Takes Too Much Medicine or Has an Overdose?
To prevent accidental swallowing of the medicine, the package should be stored in a secure location out of reach of the pet. If you suspect your pet has taken more pantoprazole than prescribed, call your veterinarian or veterinary emergency clinic immediately.
What if My Pet Misses a Dose?
If your pet misses a dose, give that dose if it is close to the original scheduled time. If it is closer to the next dosing time, skip the missed dose completely and give the next dose at the correct time. Do not double the dose of the medicine.
How Do I Store Pantoprazole?
Pantoprazole should be protected from light and kept at room temperature.
