pantoprazole (Oral route)

Pronunciation

pan-TOE-pra-zole

Commonly used brand name(s)

In the U.S.

  • Protonix

Available Dosage Forms:

  • Tablet
  • Tablet, Enteric Coated
  • Packet

Therapeutic Class: Gastric Acid Secretion Inhibitor

Pharmacologic Class: Proton Pump Inhibitor

Uses For pantoprazole

Pantoprazole is used to treat certain conditions in which there is too much acid in the stomach. It is used to treat erosive esophagitis or "heartburn" caused by gastroesophageal reflux disease (GERD), a condition where the acid in the stomach washes back up into the esophagus. pantoprazole may also be used to treat Zollinger-Ellison syndrome, a condition where the stomach produces too much acid.

Slideshow: 2014 Update - First Time Brand-to-Generic Switches

Pantoprazole is a proton pump inhibitor (PPI). It works by decreasing the amount of acid produced by the stomach.

pantoprazole is available only with your doctor's prescription.

Before Using pantoprazole

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For pantoprazole, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to pantoprazole or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of pantoprazole in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of pantoprazole in the elderly.

Pregnancy

Pregnancy Category Explanation
All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking pantoprazole, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using pantoprazole with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Rilpivirine

Using pantoprazole with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Atazanavir
  • Bosutinib
  • Citalopram
  • Dabrafenib
  • Dasatinib
  • Erlotinib
  • Eslicarbazepine Acetate
  • Ketoconazole
  • Methotrexate
  • Mycophenolate Mofetil
  • Nelfinavir
  • Nilotinib
  • Pazopanib
  • Ponatinib
  • Saquinavir
  • Topotecan
  • Vismodegib

Using pantoprazole with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Cranberry
  • Warfarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of pantoprazole. Make sure you tell your doctor if you have any other medical problems, especially:

  • Diarrhea or
  • Hypomagnesemia (low magnesium in the blood), history of or
  • Osteoporosis (bone problem) or
  • Seizures, history of—Use with caution. May make these conditions worse.

Proper Use of pantoprazole

Take pantoprazole only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

Swallow the delayed-release tablet whole. Do not split, crush, or chew it. You may take the tablet with or without food.

The delayed-release oral suspension granules should only be mixed with applesauce or apple juice. Do not mix the granules with water, other liquids, or food. Do not chew or crush the granules. Take the mixture at least 30 minutes before a meal. If you have a nasogastric feeding tube, make sure the tube is not clogged before you put pantoprazole in the tube with apple juice.

Dosing

The dose of pantoprazole will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of pantoprazole. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (delayed-release tablets or suspension):
    • For erosive esophagitis:
      • Adults—40 milligrams (mg) once a day for up to 8 weeks. Your doctor may want you to take pantoprazole for more than 8 weeks for certain conditions.
      • Children—Use and dose must be determined by your doctor.
    • For Zollinger-Ellison syndrome:
      • Adults—At first, 40 milligrams (mg) two times a day. Your doctor may increase your dose if needed.
      • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of pantoprazole, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using pantoprazole

It is very important that your doctor check your progress at regular visits to make sure pantoprazole is working properly. Blood and other laboratory tests may be needed to check for unwanted effects.

Before you have any medical tests, tell the medical doctor in charge that you are taking pantoprazole. The results of some tests may be affected by pantoprazole. .

Taking pantoprazole for a long time may make it harder for your body to absorb vitamin B12. Tell your doctor if you have concerns about vitamin B12 deficiency. .

Pantoprazole may increase your risk of having fractures of the hip, wrist, and spine. This is more likely if you are 50 years of age and older, if you receive high doses of pantoprazole, or use it for one year or more.

pantoprazole may cause hypomagnesemia (low magnesium in the blood). This is more likely to occur if you are taking pantoprazole for more than one year, or if you are taking pantoprazole together with digoxin (Lanoxin®) or certain diuretics or "water pills". Stop using pantoprazole and check with your doctor right away if you have convulsions (seizures); fast, racing, or uneven heartbeat; muscle spasms (tetany); tremors; or unusual tiredness or weakness.

Check with your doctor right away if you have watery stool that does not go away, stomach pain, and fever while taking pantoprazole.

Do not stop taking pantoprazole without first checking with your doctor, or unless told to do so by your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription (e.g., atazanavir, Reyataz®) or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

pantoprazole Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common
  • Abdominal or stomach pain
  • blurred vision
  • dry mouth
  • flushed, dry skin
  • fruit-like breath odor
  • increased hunger
  • increased thirst
  • increased urination
  • nausea
  • sweating
  • troubled breathing
  • unexplained weight loss
  • vomiting
Incidence not known
  • Absence of or decrease in body movements
  • blindness
  • blistering, peeling, or loosening of the skin
  • bloating
  • bloody or cloudy urine
  • bloody, black, or tarry stools
  • blurred vision
  • chills
  • clay-colored stools
  • constipation
  • continuous ringing or buzzing or other unexplained noise in the ears
  • cough
  • dark-colored urine
  • decreased vision
  • diarrhea
  • difficulty with speaking
  • difficulty with swallowing
  • dizziness or lightheadedness
  • drowsiness
  • fast heartbeat
  • feeling of constant movement of self or surroundings
  • fever
  • general feeling of tiredness or weakness
  • greatly decreased frequency of urination or amount of urine
  • headache
  • hearing loss
  • high fever
  • hives
  • indigestion
  • itching
  • joint pain
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • light-colored stools
  • loss of appetite
  • mood or mental changes
  • muscle cramps
  • muscle pain or stiffness
  • muscle spasms (tetany) or twitching
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • pale skin
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • seizures
  • sensation of spinning
  • shortness of breath
  • skin rash
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stomach pain, continuing
  • swelling of the feet or lower legs
  • swollen glands
  • tightness in the chest
  • trembling
  • unexplained bleeding or bruising
  • unpleasant breath odor
  • unusual tiredness or weakness
  • vomiting of blood
  • wheezing
  • yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common
  • Belching
  • bloated or full feeling
  • excess air or gas in the stomach or intestines
  • passing gas
  • sleeplessness
  • trouble sleeping
  • unable to sleep
Incidence not known
  • Increased watering of the mouth

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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