Skip to Content

Protonix (pantoprazole) Disease Interactions

There are 3 disease interactions with Protonix (pantoprazole):


Pantoprazole (Includes Protonix) ↔ Liver Disease

Moderate Potential Hazard, Low plausibility

Applies to: Liver Disease

Pantoprazole is primarily metabolized by the liver. In patients with mild to moderate hepatic impairment, little drug accumulation has been observed following once-daily, multiple-dose administration. No dosage adjustments are necessary in these patients. However, data are limited concerning the pharmacokinetic disposition of pantoprazole in patients with severe hepatic impairment. Alternate-day dosing may be appropriate in some cases.


  1. "Product Information. Protonix (pantoprazole)" Wyeth-Ayerst Laboratories, Philadelphia, PA.

Proton Pump Inhibitors (Includes Protonix) ↔ Bone Fractures

Moderate Potential Hazard, Moderate plausibility

Applies to: Osteoporosis

Various published observational studies have reported that PPI therapy may be associated with an increased risk for osteoporosis related fractures of the hip, wrist or spine. The risk was increased in patients who received high doses (multiple daily doses), and long term treatment (a year or longer). Patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated. Caution should be used in patients at risk for osteoporosis related fractures and should be managed according to established treatment guidelines.


Proton Pump Inhibitors (Includes Protonix) ↔ Hypomagnesemia

Moderate Potential Hazard, Moderate plausibility

Applies to: Magnesium Imbalance

Symptomatic and asymptomatic hypomagnesemia has been reported rarely in patients treated with PPIs for at least 3 months, in most cases after a year of therapy. Serious adverse events can include tetany, seizures, and arrhythmias. Caution should be used in patients prone to magnesium imbalances such as patients taking other medications that can cause hypomagnesemia (e.g., diuretics). Regular monitoring is recommended.

Protonix (pantoprazole) drug Interactions

There are 258 drug interactions with Protonix (pantoprazole)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No information available.

Do not stop taking any medications without consulting your healthcare provider.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.