Pantoprazole

💊 What is Pantoprazole used for?

• •Short-term treatment (the label says up to 8 weeks) to help heal and relieve symptoms of erosive esophagitis linked to gastroesophageal reflux disease (GERD), in adults and children 5 years and older
• •Maintaining healing of erosive esophagitis and reducing return of daytime and nighttime heartburn in adults with GERD. The label says controlled studies did not go beyond 12 months.
• •Long-term treatment of conditions where the stomach makes too much acid, including Zollinger-Ellison Syndrome, a rare condition, in adults

How it works

The label describes pantoprazole as a proton pump inhibitor that inhibits gastric acid secretion, which means it lowers the acid the stomach produces. Less stomach acid can allow the irritated lining of the esophagus to heal.

How it is usually taken

• •Take exactly as prescribed by your prescriber. The label says to swallow the tablet whole, with or without food, and not to split, chew, or crush it. If you cannot swallow a tablet, tell your prescriber, since the label mentions that some patients who cannot swallow a 40 mg tablet may take two 20 mg tablets. The label says antacids may be used while taking pantoprazole and do not affect how it is absorbed. Dosing schedules differ by condition (once daily or twice daily), so follow the instructions from your prescriber or pharmacist.

Comes as

• •20 mg delayed-release tablets: yellow, round, coated, printed R332 on one side
• •40 mg delayed-release tablets: yellow, round, coated, printed R333 on one side

⚠️ Pantoprazole side effects

🛑 Who should not take Pantoprazole, and who should be careful

The label says not to take it if

• 🚨You are allergic to pantoprazole sodium, any other PPI medicine, or any ingredient in the tablets. The label says to see the Medication Guide for the full ingredient list.
• 🚨You are taking a medicine containing rilpivirine (such as EDURANT, COMPLERA, ODEFSEY, or JULUCA) used to treat HIV-1. The label says this combination is contraindicated.

Tell your doctor before taking it if

• •Tell your doctor if you have low magnesium, low calcium, or low potassium levels in your blood.
• •Tell your doctor if you are pregnant or plan to become pregnant, or if you are breastfeeding or plan to.
• •Tell your doctor about all medicines you take, including prescription, over-the-counter medicines, vitamins, and herbal supplements. The label specifically mentions methotrexate, digoxin, and water pills (diuretics).
• •The label says that feeling better on this medicine does not rule out stomach cancer. Your doctor may consider more follow-up and testing if your symptoms do not respond well or come back after treatment.
• •The label says to use the lowest dose and shortest time needed for your condition.

🔀 Pantoprazole with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Warfarin: PPIs including pantoprazole may raise INR and prothrombin time. The label says this can lead to abnormal bleeding. Your doctor may monitor these levels.
• •Certain HIV antiretroviral medicines: The label says pantoprazole may lower the exposure of some (such as atazanavir and nelfinavir) and raise the exposure of others (such as saquinavir). The label advises avoiding nelfinavir with pantoprazole and monitoring for saquinavir toxicity.
• •Methotrexate: The label says PPIs may affect methotrexate levels. Ask your prescriber about this.
• •Clopidogrel: The label says pantoprazole had no clinically important effect on clopidogrel in healthy subjects.
• •Digoxin and water pills (diuretics): The label asks patients to specifically tell their doctor if they take these.

Alcohol and food

The label says pantoprazole tablets may be swallowed with or without food. The label does not give specific guidance about alcohol.

🤰 Pantoprazole in pregnancy and breastfeeding

Pregnancy

The label says published studies did not show an association between pantoprazole and major birth defects or other adverse pregnancy outcomes. Animal studies did not show harm to the fetus at the doses tested, but a rat study did show bone changes in pups. The Medication Guide says pantoprazole may harm an unborn baby, so tell your doctor if you become pregnant or think you may be pregnant during treatment.

Breastfeeding

The label says pantoprazole can pass into breast milk. Talk with your doctor about the best way to feed your baby if you take this medicine.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store the tablets at room temperature, between 20°C and 25°C (68°F to 77°F), with short excursions permitted between 15°C and 30°C (59°F to 86°F).

If a dose is missed

The label says to take a missed dose as soon as possible. If it is almost time for your next dose, skip the missed dose and take the next dose at the regular time. The label says not to take 2 doses at the same time.

If too much is taken

The label says experience with very high doses (greater than 240 mg) is limited, and pantoprazole is not removed by hemodialysis. Treatment is symptomatic and supportive. If you think there has been an overexposure, call your Poison Control Center at 1-800-222-1222 for current guidance.

🗒️ Questions to ask about Pantoprazole

• How long do I need to take pantoprazole for my condition?
• Should I take it before or after meals, or does it not matter? (The label says it may be taken with or without food.)
• Could this medicine affect any of my other medicines, such as warfarin, methotrexate, digoxin, or a water pill?
• Are my magnesium, calcium, and potassium levels a concern for me while I take this?
• What should I do if I have trouble swallowing the tablet?
• What symptoms mean I should contact you right away while I am on this medicine?
• Do I need follow-up testing to rule out other stomach problems, given my symptoms?

❓ Pantoprazole: frequently asked questions