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Protonix IV Side Effects

Generic Name: pantoprazole

Note: This page contains side effects data for the generic drug pantoprazole. It is possible that some of the dosage forms included below may not apply to the brand name Protonix IV.

For the Consumer

Applies to pantoprazole: oral packet, oral tablet, oral tablet enteric coated

As well as its needed effects, pantoprazole (the active ingredient contained in Protonix IV) may cause unwanted side effects that require medical attention.

Major Side Effects

If any of the following side effects occur while taking pantoprazole, check with your doctor immediately:

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, itching, or skin rash
  • indigestion
  • 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
  • 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
  • yellow eyes or skin

Minor Side Effects

Some pantoprazole side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

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

For Healthcare Professionals

Applies to pantoprazole: intravenous powder for injection, oral delayed release tablet, oral granule enteric coated


The most commonly reported side effects were headache, diarrhea, and injection site thrombophlebitis (in IV formulations).[Ref]

Nervous system

Very common (10% or more): Headache (Up to 26.4%), taste perversion (Up to 18.2%)
Common (1% to 10%): Metallic/bitter taste, dizziness
Rare (0.01% to 0.1%): Taste disorders
Very rare (less than 0.01%): Reduced movement and speech disorder, change to the sense of taste
Frequency not reported: Paresthesia
Postmarketing reports: Somnolence, ageusia, dysgeusia[Ref]

Headache was a very commonly reported side effect in pediatric patients 2 to 16 years of age. In adults, headache occurred most frequently in patients given quadruple therapy (pantoprazole, bismuth, metronidazole, tetracycline) for Helicobacter pylori infections, but was also very common in triple therapy (pantoprazole, amoxicillin, clarithromycin).

Taste perversion most frequently occurred in patients given triple therapy, but it was also very common in patients given quadruple therapy.[Ref]


Very common (10% or more): Nasopharyngitis (Up to 13.6%), pharyngolaryngeal pain (Up to 13.2%)
Common (1% to 10%): Pharyngitis, nasal congestion, cough
Very rare (less than 0.01%): Dyspnea, change to the sense of smell
Frequency not reported: Upper respiratory tract infection[Ref]

Nasopharyngitis and pharyngolaryngeal pain occurred in pediatric patients between the ages of 2 to 16 years.[Ref]


Diarrhea occurred most frequently in patients given quadruple therapy (pantoprazole (the active ingredient contained in Protonix IV) bismuth, metronidazole, tetracycline) for Helicobacter pylori infections, but was also very common in triple therapy (pantoprazole, amoxicillin, clarithromycin).

Nausea, vomiting, abdominal pain, dry mouth, and constipation were more commonly reported in patients given triple therapy, compared to patients given quadruple therapy.

Fecal and/or tongue discoloration occurred more commonly in patients given quadruple therapy versus patients given triple therapy.[Ref]

Very common (10% or more): Diarrhea (Up to 11.6%)
Common (1% to 10%): Nausea, vomiting, abdominal pain/discomfort, upper abdominal pain, constipation, dry mouth, fecal discoloration, tongue discoloration, tongue pain, loose stools, heartburn, flatulence
Uncommon (0.1% to 1%): Abdominal distention, bloating, oral moniliasis, buccal inflammation, dyspepsia
Rare (0.01% to 0.1%): Rectal disorder, colon polyp
Very rare (less than 0.01%): Increased saliva
Frequency not reported: Severe eructation
Postmarketing reports: Clostridium difficile associated diarrhea[Ref]


Common (1% to 10%): Tiredness, influenza-like symptoms
Uncommon (0.1% to 1%): Asthenia, fatigue, malaise
Rare (0.01% to 0.1%): Fever/body temperature increased, sepsis
Very rare (less than 0.01%): Tinnitus
Frequency not reported: Facial edema[Ref]


Confusion, especially in predisposed patients, has occurred with use, and was aggravated in patients with preexisting confusion.[Ref]

Common (1% to 10%): Depression (and all aggravations)
Uncommon (0.1% to 1%): Sleep disorders
Rare (0.01% to 0.1%): Confusion, hallucination, disorientation (and all aggravations)
Very rare (less than 0.01%): Anxiety[Ref]


Severe hepatocellular damage leading to jaundice/hepatic failure is predicted to have a frequency of 1 in 1,000,000 patients.[Ref]

Common (1% to 10%): Increased liver enzymes (transaminases, gamma glutamyl transferase [GGT])
Rare (0.01% to 0.1%): Increased bilirubin
Very rare (less than 0.01%): Hepatic failure, cholestatic hepatitis/hepatitis, bilirubinemia, jaundice
Frequency not reported: Hepatocellular injury/failure[Ref]


Common (1% to 10%): Rash
Uncommon (0.1% to 1%): Exanthema/exanthemata, eruption, pruritus, increased sweating
Rare (0.01% to 0.1%): Urticaria
Very rare (less than 0.01%): Stevens-Johnson syndrome, Lyell syndrome, erythema multiforme, photosensitivity, toxic epidermal necrolysis, flushing
Frequency not reported: Subacute cutaneous lupus erythematosus[Ref]


Common (1% to 10%): Substernal chest pain/chest pain
Rare (0.01% to 0.1%): Peripheral edema, hypertension, thrombophlebitis
Very rare (less than 0.01%): Hot flushes, circulatory collapse
Frequency not reported: Generalized edema[Ref]


Muscle spasm occurred as a consequence of electrolyte disturbances[Ref]

Common (1% to 10%): Arthralgia
Uncommon (0.1% to 1%): Fracture of the hip/wrist/spine
Rare (0.01% to 0.1%): Myalgia
Very rare (less than 0.01%): Skeletal pain/pain
Frequency not reported: Muscle spasm, elevated creatine phosphokinase (CPK)
Postmarketing reports: Rhabdomyolysis, bone fracture[Ref]


Hypocalcemia occurred in association with hypomagnesemia.

Anorexia commonly occurred in patients treated for Helicobacter pylori infections.[Ref]

Common (1% to 10%): Anorexia
Rare (0.01% to 0.1%): Hyperlipidemia, increased triglycerides/cholesterol, weight changes
Frequency not reported: Hyponatremia, hypomagnesemia, hypocalcemia, hypokalemia[Ref]


Common (1% to 10%): Injection site thrombophlebitis[Ref]


Common (1% to 10%): Moniliasis[Ref]


Rare (0.01% to 0.1%): Hypersensitivity reactions, angioedema/Quincke's edema, anaphylactic shock/reactions
Frequency not reported: Allergic reactions[Ref]


Rare (0.01% to 0.1%): Agranulocytosis, anemia
Very rare (less than 0.01%): Thrombocytopenia, leukopenia, pancytopenia, increased coagulation time[Ref]


Rare (0.01% to 0.1%): Visual disturbances/blurred vision
Very rare (less than 0.01%): Conjunctivitis[Ref]


Rare (0.01% to 0.1%): Gynecomastia[Ref]


Very rare (less than 0.01%): Interstitial nephritis (with possible progression to renal failure)[Ref]


1. Cerner Multum, Inc. "Australian Product Information." O 0

2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

3. "Product Information. Protonix I.V. (pantoprazole)" Wyeth-Ayerst Laboratories, Philadelphia, PA.

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

It is possible that some side effects of Protonix IV may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.