Pantoprazole

Pantoprazole (Protonix) to help you overcome acid reflux

This article is about Pantoprazole (Protonix), a proton pump inhibitor used to reduce the production of acid in the stomach, and treat acid reflux and accompanying symptoms. In what follows, the reader will find information on what Pantoprazole is, how it works, which active and inactive ingredients it contains, how to take it, which possible side effects it may cause, and contraindications. If you suffer from acid reflux, also known as heartburn, doctors at Medzino can issue a prescription for Pantoprazole 20mg or 40mg.

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Information

Reviewed by Dr Roy Kedem, MD

Information last reviewed 11/29/19

About

What is Pantoprazole?

Pantoprazole (Protonix) is in a class of medications known as proton pump inhibitors, which function to reduce acid production in the stomach.  It is frequently prescribed to treat gastroesophageal reflux disease (GERD); the condition responsible for heartburn.  Pantoprazole is also prescribed to treat inflammation in the esophagus, ulcers in the esophagus and stomach, and other rare conditions which result from excess acid production. 

What is acid reflux?

Acid reflux, also known as gastroesophageal disease (GERD), is a common condition characterized by a burning pain in the lower chest area. Symptoms frequently occur after eating.  If you suffer from GERD, the sphincter muscles at the bottom of your esophagus may be relaxing at the wrong time, allowing acid from the stomach to travel upward into your throat.  This in turn can lead to heartburn, difficulty swallowing, and a persistent cough. Taking Pantoprazole will help alleviate these symptoms and allow your stomach and esophagus to heal.

How does Pantoprazole work?

Pantoprazole belongs to a class of drugs called “proton pump inhibitors” (PPIs).  PPIs block a specific enzyme in the wall of the stomach which normally leads to acid production. By decreasing acid production, Pantoprazole alleviates the symptoms of GERD and allows inflammation in the stomach and oesophagus to resolve.

How long does Pantoprazole take to work?

Pantoprazole begins to work within 30 minutes of ingestion, however, the maximum effect can take several days. Best results are seen when the medication is taken continuously, and not as needed, for a period of time until GERD, esophagitis or gastritis have time to heal (usually 8 weeks).

Ingredients

Active ingredients

Pantoprazole contains the active ingredient pantoprazole sodium at a concentration of 20mg, or 40mg.

Inactive ingredients

It also contains the following inactive ingredients: calcium stearate, crospovidone, hypromellose, iron oxide, mannitol, methacrylic acid copolymer, polysorbate 80, povidone, propylene glycol, sodium carbonate, sodium lauryl sulfate, titanium dioxide, and triethyl citrate

Dosage

How to take Pantoprazole

Always take Pantoprazole exactly as prescribed by your doctor.

To treat acid reflux in adults and adolescents (12 years and over), the recommended dosage is usually 40mg (1 tablet) per day. Take the tablet orally (by mouth) with a glass of water at approximately the same time each day.  Do not break, chew, or crush the tablet. If the 40mg tablet is too big for you to swallow, you can request the 20mg tablet and take 2 instead of 1.  Depending on your symptoms, your doctor may increase the dosage to 2 tablets a day. In this case, take one dose in the morning and one in the evening. The treatment for acid reflux usually lasts between 4 to 8 weeks, but may vary depending on your doctor’s recommendation.

Pantoprazole dosage

The dose of Pantoprazole is 20mg to 40mg once daily for up to 8 weeks. The lower dose (20mg once daily) has been used successfully to treat mild GERD. 

What should I do if I miss a dose of Pantoprazole?

If you miss a dose of Pantoprazole, take it as soon as you remember. However, if it is almost time for your next dose, skip the one you forgot and take your next scheduled dose at the usual time. Do not double the dose to make up for the one you missed.

What should I do if I take too much Pantoprazole?

If you have taken too much Pantoprazole, call the Poison Control Center 1-800-222-1222. 

Side Effects

Pantoprazole side effects

Stop taking these tablets and tell your doctor immediately if you experience any of the following serious side effects:

  • An allergic reaction with a rash, swelling of the tongue/throat/face, difficulty breathing or difficulty swallowing
  • Fever
  • Serious skin reactions such as blistering, erosions (including slight bleeding of eyes, nose, mouth/lips, or genitals), and sensitivity to light
  • Yellowing of the skin or white of the eyes (jaundice) due to liver damage
  • Swelling or inflammation of the kidneys which can lead to painful urination and back pain
  • Unintentional weight loss
  • Vomiting blood
  • Severe and/or persistent vomiting
  • Blood in your stool
  • Pallor, weakness or shortness of breath with exertion (anemia)
  • Chest pain
  • Severe and/or persistent diarrhea

 

Some possible common side effects include:

  • Headache
  • Diarrhea
  • Dizziness
  • Benign polyps in the stomach
  • Nausea with or without vomiting
  • Gas
  • Constipation
  • Dry mouth
  • Abdominal pain or discomfort
  • Skin rash
  • Itching
  • Feeling tired, or weak
  • Joint pain
  • Sleep disorders

Drug Interactions

Pantoprazole may interact with other medications.  Patients taking Rilpivirine for the treatment of HIV should not take Pantoprazole. 

Pantoprazole is not recommended with the following medications:

  • Acalabrutinib
  • Amphetamine
  • Atazanavir
  • Benzphetamine
  • Bosutinib
  • Capecitabine
  • Cilostazol
  • Citalopram
  • Dacomitinib
  • Dasatinib
  • Dextroamphetamine
  • Erlotinib
  • Eslicarbazepine Acetate
  • Gefitinib
  • Ketoconazole
  • Ledipasvir
  • Lisdexamfetamine
  • Methamphetamine
  • Methotrexate
  • Mycophenolate Mofetil
  • Nelfinavir
  • Neratinib
  • Nilotinib
  • Pazopanib
  • Saquinavir
  • Secretin Human
  • Sunitinib
  • Velpatasvir
  • Vismodegib
  • Levothyroxine
  • Warfarin

 

In some cases it may be necessary to take one or more of these medications when also taking Pantoprazole. If the medications are prescribed together, your doctor may need to adjust the dosages accordingly.

Contraindications

If you are pregnant, considering becoming pregnant, or if you are breast-feeding, ask your doctor for advice before taking Pantoprazole.

It is contraindicated to take Pantoprazole in the following cases:

  • If you are allergic to pantoprazole sodium or any other ingredients in Pantoprazole (see ingredients above)
  • If you are allergic to any other Proton Pump Inhibitors
  • If you suffer from Clostridium difficile (bacteria that can infect the bowel and cause diarrhoea
  • If you have inadequate vitamin B12 levels
  • If you have low amount of magnesium in the blood
  • If you suffer from a kidney disorder calles interstitial nephritis
  • If you suffer from subacute cutaneous lupus erythematosus (uncommon skin rash that is made worse by sunlight)
  • If you suffer from systemic lupus erythematosus (chronic disease that causes inflammation in connective tissues such as cartilage and lining of blood vessels)
  • If you have osteroporosis
  • If you have a broken bone
  • If you do not metabolize the CYP2C19 enzyme well

Q&A

Disclaimer: This is not medical advice. You and your physician will determine if and how you should take any medication prescribed to you following a medical consultation.

  1. WebMD, ‘Who should not take Pantoprazole Sodium?’ [website],https://www.webmd.com/drugs/2/drug-17633/pantoprazole-oral/details/list-contraindications [last accesses 27 May 2019]
  2. WebMD, ‘Protonix’, [website],https://www.webmd.com/drugs/2/drug-18142/protonix-oral/details [last accesses 27 May 2019]
  3. EMC, ‘Pantoprazole’, [website],https://www.medicines.org.uk/emc/product/484/pil [last accesses 27 May 2019]
  4. MedicineNet,‘Pantoprazole’[website], https://www.medicinenet.com/pantoprazole/article.htm [last accesses 27 May 2019]
  5. Mayo Clinic, ‘Pantoprazole’, [website],https://www.mayoclinic.org/drugs-supplements/pantoprazole-oral-route/side-effects/drg-20071434?p=1 [last accesses 27 May 2019]
  6. RxList, ‘Pantoprazole’, [website],https://www.rxlist.com/protonix-drug.htm#description [last accesses 27 May 2019]

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