Pantoprazole is a brand-name drug that’s prescribed to help ease symptoms caused by excess stomach acid. Pantoprazole belongs to the proton pump inhibitor drug class.

  1. Pantoprazole oral tablet is available as both a generic and a brand-name drug. Brand name: Protonix.
  2. Pantoprazole comes in three forms: a delayed-release oral tablet, a delayed-release oral liquid suspension, and an intravenous (IV) form that’s injected into a vein by a healthcare professional. (“Delayed release” means the drug is released into your body slowly over time.)
  3. Pantoprazole oral tablet is used to reduce the amount of stomach acid your body makes. It helps treat painful symptoms caused by conditions such as gastroesophageal reflux disease (GERD).

  • Long-term use warning: Long-term use of pantoprazole can lead to an increased risk of certain side effects and complications. These include:
    • Increased risk of bone fracture in people taking higher, multiple daily doses for more than 1 year.
    • Vitamin B12 deficiency, which can lead to serious nerve damage and deteriorating brain functions. This has been seen in some people taking pantoprazole for longer than 3 years.
    • Hypomagnesemia (low blood level of magnesium), which has been seen in some people taking pantoprazole for as few as 3 months. More often, it occurs after a year or more of treatment.
  • Severe diarrhea warning: Severe diarrhea caused by Clostridioides difficile bacteria can occur in some people treated with pantoprazole, especially people in the hospital.
  • Allergy warning: Though it’s rare, pantoprazole can cause an allergic reaction. Symptoms may include rash, swelling, and breathing problems. This can progress to interstitial nephritis, a kidney disorder that can lead to kidney failure. Symptoms of this condition include:
  • Cutaneous lupus erythematosus and systemic lupus erythematosus warning: Pantoprazole can cause cutaneous lupus erythematosus (CLE) and systemic lupus erythematosus (SLE). CLE and SLE are autoimmune diseases. Symptoms of CLE can range from a rash on the skin and nose to a raised, scaly rash that’s red, brown, or discolored on certain parts of the body. Symptoms of SLE can include fever, tiredness, weight loss, blood clots, heartburn, and abdominal pain. If you have any of these symptoms, call your doctor.
  • Fundic gland polyps warning: Long-term use (especially over 1 year) of pantoprazole can cause fundic gland polyps. These polyps are growths on the lining of your stomach that can become cancerous. To help prevent these polyps, you should use this drug for as short a time as possible.

Pantoprazole oral tablet is a prescription drug that’s available as the brand-name drug Protonix. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in all strengths or forms as the brand-name drug.

Pantoprazole comes in three forms: a delayed-release oral tablet, a delayed-release oral liquid suspension, and an intravenous (IV) form that’s injected into a vein by a healthcare professional. (“Delayed release” means the drug is released into your body slowly over time.)

Why it’s used

Pantoprazole oral tablet is used to reduce the amount of stomach acid your body makes. It helps treat painful symptoms caused by conditions such as gastroesophageal reflux disease (GERD). With GERD, gastric juices flow upward from your stomach and into the esophagus.

Pantoprazole oral tablet is also used to treat other conditions involving excessive stomach acid, such as Zollinger-Ellison syndrome.

How it works

Pantoprazole belongs to a class of drugs called proton pump inhibitors. It works to shut off the acid-pumping cells in your stomach. This reduces the amount of stomach acid and helps to decrease painful symptoms related to conditions such as GERD.

Pantoprazole can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking this drug. These lists do not include all possible side effects.

For more information on the possible side effects of pantoprazole, see this article. You can also talk with your doctor or pharmacist, who may have tips for managing a bothersome side effect.

More common side effects

The more common side effects that can occur with pantoprazole include:

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Hypomagnesemia (low magnesium levels). Using pantoprazole for 3 months or longer can cause low magnesium levels. Symptoms can include:
    • seizures
    • atypical or fast heart rate
    • tremors
    • jitteriness
    • muscle weakness
    • dizziness
    • spasms of your hands and feet
    • cramps or muscle aches
    • loss of taste
  • Vitamin B12 deficiency. Using this drug for longer than 2 years can make it harder for your body to absorb vitamin B12. Symptoms can include:
    • nervousness
    • neuritis (inflammation of a nerve)
    • numbness or tingling in your hands and feet
    • problems with muscle coordination
    • changes in menstruation
  • Severe diarrhea. This may be caused by a Clostridioides difficile infection in your intestines. Symptoms can include:
    • watery stool
    • abdominal pain
    • fever that doesn’t go away
  • Bone fractures
  • Kidney damage. Symptoms can include:
    • flank pain (pain in your side and back)
    • changes in urination
  • Cutaneous lupus erythematosus (CLE). Symptoms can include:
    • rash on the skin and nose
    • raised, scaly rash that’s red, brown, or discolored
  • Systemic lupus erythematosus (SLE). Symptoms can include:
    • fever
    • tiredness
    • weight loss
    • blood clots
    • heartburn
  • Fundic gland polyps (growths on the lining of your stomach that can become cancerous). These typically don’t cause symptoms. But when they do, symptoms can include:
    • nausea or vomiting
    • abdominal pain

Pantoprazole can interact with several other medications. Different interactions can cause different effects. For instance, some can interfere with how well a drug works, while others can cause increased side effects.

This section discusses medications that can interact with pantoprazole. It does not mention all drugs that may interact with pantoprazole.

Before taking pantoprazole, be sure to tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

HIV drugs

Taking certain HIV drugs with pantoprazole is not recommended. Pantoprazole may significantly decrease the amount of these drugs in your body. This can reduce their ability to effectively manage HIV. These drugs include:

  • atazanavir (Reyataz)
  • nelfinavir (Viracept)

Anticoagulant

Some people taking warfarin (Jantoven) with pantoprazole can experience an increase in the time it takes for blood clots to form. This can lead to an increased risk of severe bleeding. If you take these drugs together, your doctor should monitor you for this interaction.

Drugs affected by stomach pH

Pantoprazole affects stomach acid levels. As a result, it can reduce your body’s absorption of certain drugs that are sensitive to the effects of decreased stomach acid. This can make these drugs less effective.

Examples of these drugs include:

  • ketoconazole
  • ampicillin
  • atazanavir (Reyataz)
  • iron salts
  • erlotinib
  • mycophenolate mofetil (CellCept)

Cancer drug

Taking methotrexate (Trexall) with pantoprazole may increase the amount of methotrexate in your body. If you’re taking high doses of methotrexate, your doctor may have you stop taking pantoprazole during your methotrexate therapy.

As with all medications, the cost of pantoprazole can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Drug coupons: You can visit Optum Perks for price estimates of pantoprazole. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with any insurance copays or benefits.

Financial and insurance assistance: If you need financial support to pay for pantoprazole, or if you need help understanding your insurance coverage, help may be available. The sites below provide information on drug assistance programs and other services:

To learn more about saving money on prescriptions, check out this article.

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Pantoprazole oral tablet comes with several warnings.

Allergy warning

Though it’s rare, pantoprazole can cause an allergic reaction. Symptoms may include rash, swelling, and breathing problems.

This allergic reaction can progress to interstitial nephritis, a kidney disorder that can lead to kidney failure. Symptoms of this condition include:

If you experience any of these symptoms, call your doctor right away. If your symptoms seem severe or life threatening, go to an emergency room or call 911.

Warnings for people with certain health conditions

For people with osteoporosis: Pantoprazole can increase a person’s risk for osteoporosis, a condition that causes bones to become brittle. Tell your doctor if you have a history of osteoporosis.

For people with hypomagnesemia (low blood level of magnesium): Pantoprazole can decrease the amount of magnesium in your body. Tell your doctor if you have a history of hypomagnesemia.

For people being tested for neuroendocrine tumors: Pantoprazole can cause incorrect results in tests for neuroendocrine tumors. For this reason, your doctor will have you stop taking this drug at least 14 days before you have this testing. They may also have you repeat the testing if needed.

Warnings for other groups

Pregnant people: If you’re pregnant or plan to become pregnant, speak with your doctor about this drug.

Studies of the drug in pregnant animals have shown risk of harm to the fetus. There aren’t enough studies of pregnant people to show that the drug poses a risk of harm to a human fetus.

Those who are breastfeeding: Pantoprazole may pass through breast milk and could be passed to a child who is breastfed. Talk with your healthcare professional about other treatment options while breastfeeding.

For children: Pantoprazole is sometimes used for short-term treatment of erosive esophagitis in children ages 5 years and older. This condition is associated with gastroesophageal reflux disease (GERD). It causes irritation and damage to the throat from stomach acid. Your child’s doctor will provide the correct dosage of pantoprazole for this use.

The pantoprazole dosage your doctor prescribes will depend on several factors. These include:

  • the type and severity of the condition you’re using pantoprazole to treat
  • your age
  • the form of pantoprazole you take
  • other medical conditions you may have

Typically, your doctor will start you on a low dosage and adjust it over time to reach the dosage that’s right for you. They’ll ultimately prescribe the smallest dosage that provides the desired effect. The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to suit your needs.

Forms and strengths

Generic: pantoprazole

  • Form: delayed-release oral tablet
  • Strengths: 20 milligrams (mg) and 40 mg

Brand: Protonix

  • Form: delayed-release oral tablet
  • Strengths: 20 mg and 40 mg

“Delayed release” means the drug is released into your body slowly over time.

Dosage for gastroesophageal reflux disease (GERD)

Adult dosage (ages 18 years and older)

Typical dosage: 20 mg to 40 mg per day, taken once per day with or without food, depending on severity.

Child dosage (ages 5 to 17 years)

  • Typical dosage:
    • For children who weigh 40 kilograms (kg) or more (about 88 pounds [lb] or more): 40 mg per day for up to 8 weeks.
    • For children who weigh 15 kg (about 33 lb) to less than 40 kg: 20 mg per day for up to 8 weeks.

Dosage for excess acid production, such as Zollinger-Ellison syndrome

Adult dosage (ages 18 years and older)

  • Typical dosage: 40 mg twice per day, with or without food. This can be increased up to a maximum of 240 mg per day.

Child dosage (ages 0 to 17 years)

A safe and effective dose hasn’t been established for children in this age range.

Pantoprazole oral tablet may be prescribed for either short-term or long-term use. How long you take it will depend on the type and severity of your condition. It comes with serious risks if you don’t take it as prescribed.

If you don’t take it or stop taking it: If you don’t take the drug at all or stop taking it, you risk decreased ability to manage your symptoms of gastroesophageal reflux disease (GERD).

If you don’t take it on schedule: Not taking pantoprazole every day, skipping days, or taking doses at different times of day may also decrease your management of GERD.

What to do if you miss a dose: If you miss a dose, take the next dose as planned. Do not double your dose.

How to tell if the drug is working: You can tell that pantoprazole is working if it reduces your GERD symptoms, such as:

  • heartburn
  • nausea
  • difficulty swallowing
  • regurgitation
  • sensation of a lump in your throat

Keep these considerations in mind if your doctor prescribes pantoprazole oral tablet for you.

General

  • You can take this form with or without food. Take it at the same time every day for the best effects.
  • Do not cut, crush, or chew this medication.

Storage

  • Store this drug at a room temperature of 68°F to 77°F (20°C to 25°C).
  • You can store it for a short time at temperatures as low as 59°F (15°C) and as high as 86°F (30°C).

Refills

A prescription for this medication is refillable. You should not need a new prescription for this medication to be refilled. Your doctor will write the number of refills authorized on your prescription.

Clinical monitoring

Pantoprazole can lower magnesium levels in certain people. Your doctor may suggest having your blood magnesium levels monitored if you’re treated with pantoprazole for 3 months or more.

Travel

When traveling with your medication:

  • Always carry your medication with you. When flying, never put it into a checked bag. Keep it in your carry-on bag.
  • Don’t worry about airport X-ray machines. They won’t damage your medication.
  • You may need to show airport staff the pharmacy label for your medication. Always carry the original prescription-labeled container with you.
  • Do not put this medication in your car’s glove compartment or leave it in the car. Be sure to avoid doing this when the weather is very hot or very cold.

Possible alternatives to the oral tablet include:

Talk with your doctor about other drug options that may work for you.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.