Pantoprazole (Proton Pump Inhibitor)

Pantoprazole is a proton pump inhibitor (PPI). This drug works by reducing the amount of acid that the stomach produces. It is more effective at lowering acid than H2-blockers and non-prescription antacids.

Know the basics

What is pantoprazole used for?

• Heartburn
• Hyperacidity (acid reflux)
• Peptic ulcer disease (PUD)
• Gastroesophageal reflux disease (GERD)
• Zollinger-Ellison syndrome
• NSAID-induced ulcers
• Aspiration prophylaxis for general surgery

How should I take pantoprazole?

Read the directions on the packaging for complete information. Check the label and expiration date.

For regular tablets, swallow it whole without chewing, crushing, or dissolving it in liquid. Take it with or without food. If you are using a controlled-release tablet (e.g. extended-release), take it on an empty stomach, 1 hour before meals.

Parenteral (e.g. IV) dosage forms should be administered by a licensed healthcare professional.

How do I store pantoprazole?

This product is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store it in the bathroom or the freezer. 

There may be different brands of this drug that may have different storage needs. So, it is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush this product down the toilet or pour them into a drain unless instructed to do so. Additionally, it is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using pantoprazole?

Before using this drug, tell your doctor if you are/have:

• Pregnant or breastfeeding.
• Taking any other medicines. This includes any prescription, OTC, and herbal remedies.
• An allergy to any of the ingredients of this product.
• Any other illnesses, disorders, or medical conditions.

Is it safe to take pantoprazole during pregnancy or breast-feeding?

Unfortunately, there isn’t enough information about the safety of using this drug during pregnancy and breastfeeding. However, it is likely safe to take. The drug passes into breast milk, however, no adverse effects have been reported. Please always consult with your doctor to weigh the potential benefits and risks before taking any medication.

Know the side effects

What are the side effects of pantoprazole?

Like all drugs, this product may have side effects. If they occur, side effects are generally mild and resolve once treatment is finished or the dose is lowered. Some reported side effects include:

• Headache
• Edema
• Pruritus (itching)
• Photosensitivity
• Skin rash
• Increased triglyceride levels
• Abdominal pain
• Constipation
• Diarrhea
• Nausea, vomiting
• Flatulence
• Dry mouth
• Dizziness, vertigo
• Muscle and joint pain
• Blurred vision
• Increased risk of upper respiratory tract infections
• Fever

However, not everyone experiences these side effects. In addition, some people may experience other side effects. So, if you have any concerns about a side effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with pantoprazole?

This medication may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. 

To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. 

Drugs with known interactions:

• Rilpirvirine *contraindicated
• Atazanavir *
• Diuretics
• Digoxin
• Warfarin
• Methotrexate
• Azole antifungals
• Clopidogrel
• St. John’s wort
• Iron supplements
• Vitamin B supplements

If you experience an adverse drug interaction, inform your doctor immediately to reevaluate your treatment plan. Approaches include dose adjustment, drug substitution, or ending therapy.

Does food or alcohol interact with pantoprazole?

This drug may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with pantoprazole?

This drug may interact with underlying conditions. This interaction may worsen your health condition or alter the way the drug works. Therefore, it is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

• Gastric malignancies (e.g. stomach cancer)
• Osteoporosis
• Vitamin-deficiency anemia
• Liver impairment
• CYP2C19 poor metabolizers

Understand the dosage

The information provided is not a substitute for any medical advice. Therefore, you should always consult with your doctor or pharmacist before using any medication.

What is the dose for an adult?

PUD

H. pylori eradication

• Oral: Take 40 mg or 80 mg of pantoprazole two times a day along with prescribed antibiotics.

Uncomplicated ulcer

• Oral: Take 40 mg once a day for 4 to 8 weeks.

Complicated ulcers

• Oral/IV: Give 40 mg two times a day for 4 weeks, then 40 mg once a day.

GERD

Mild or intermittent (<2 episodes per week) esophagitis

• Oral: Take 20 mg once a day. If needed after 4 to 8 weeks, increase the dose to 40 mg. Stop taking this drug once you are asymptomatic for 8 weeks.

Severe, frequent, or erosive esophagitis

• Oral: Take 40 mg once a day for at least 8 weeks, or as instructed by your doctor.

Zollinger-Ellison syndrome

• Oral: Initially, take 80 mg two times a day. If needed, increase the dose up to 240 mg per day in divided doses.
• IV: Initially, give 80 mg every 8 to 12 hours, up to 240 mg per day in divided doses for up to 6 days.

NSAID-induced ulcers

Oral: Take 20 mg to 40 mg once a day during therapy with high-risk NSAIDs.

Aspiration prophylaxis for surgery

Oral: Give 40 mg the night before surgery and 40 mg the morning of the surgery.

IV: Administer 40 mg as a single dose 1 hour before giving anesthesia.

What is the dose for a child?

There is no established pediatric dose. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is pantoprazole available?

Pantoprazole is available in the following dosage forms and strengths:

Tablets: 20 mg; 40 mg

Delayed-release tablets: 20 mg, 40 mg

Powder for solution, IV: 40 mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to the nearest emergency room.

What should I do if I miss a dose?

If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.