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pantoprazole
Used for GERD, Heartburn
Used for GERD, Heartburn
Pantoprazole (Protonix) is a proton pump inhibitor (PPI) that lowers stomach acid. It treats erosive esophagitis, or damage to the esophagus caused by gastroesophageal reflux disease (GERD), in adults and certain children. In adults, it can also help keep the esophagus healed and treat other conditions that cause too much stomach acid. This medication comes as tablets and granules for suspension taken by mouth. An injection is also available, usually in the hospital. Common side effects include headache and diarrhea. It's available by prescription as a brand-name and generic medication.
What is Pantoprazole (Protonix)?
What is Pantoprazole (Protonix) used for?
- Short-term treatment of erosive esophagitis related to gastroesophageal reflux disease (GERD) - adults and children ages 5 years and older
- Keeping erosive esophagitis healed - adults
- Other medical conditions that cause too much stomach acid (e.g., Zollinger-Ellison syndrome) - adults
How Pantoprazole (Protonix) works
Pantoprazole (Protonix) is a proton pump inhibitor (PPI). It works by blocking the final step in making stomach acid. This lowers the amount of acid in your stomach and helps treat problems caused by too much stomach acid.
When does Pantoprazole (Protonix) start working?Time passed since treatment started:
Drug facts
| Common Brands | Protonix |
|---|---|
| Drug Class | PPI |
| Controlled Substance Classification | Not a controlled medication |
| Generic Status | Lower-cost generic available |
| Availability | Prescription only |
More on Pantoprazole (Protonix) essentials
Side effects of Pantoprazole (Protonix)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Headache (12%)
- Diarrhea (9%)
- Nausea (7%)
- Belly pain (6%)
Less Common Side Effects
- Vomiting
- Feeling gassy
- Dizziness
- Joint pain
Note: Note: Percentages are from adults with GERD. Similar side effects have been reported in children.
Pantoprazole (Protonix) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Possible other stomach problem: severe stomach pain, heartburn that gets worse or comes back after treatment, low appetite, unexplained weight loss
- Kidney problems: urinating more or less than usual, fever, poor appetite, nausea, weakness
- Infectious diarrhea (C. difficile-related diarrhea): rapid heart rate, fever, nausea, foul-smelling diarrhea, frequent bowel movements (even up to 15 times per day)
- Lupus symptoms: joint pain, skin rash on arms or cheeks that gets worse in the sunlight
- Low vitamin or mineral levels: tiredness, weakness, pale skin, tingling in your arms or legs, muscle cramps, irregular heartbeat
- Serious allergic reaction or skin reaction: hives, rash, blisters, skin peeling, skin reddening, fever, swelling of the lips or tongue, trouble breathing
When do Pantoprazole (Protonix) possible side effects begin and end?
Time passed since treatment started:
H
D
W
M
Headaches
If a line continues to the right, you'll likely keep experiencing this side effect once it starts.
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The following Pantoprazole (Protonix) side effects have also been reported
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
Blurred vision
flushed, dry skin
fruit-like breath odor
increased hunger
increased thirst
increased urination
stomach pain
sweating
trouble breathing
unexplained weight loss
vomiting
Incidence not known
Absence of or decrease in body movements
blindness
blistering, peeling, or loosening of the skin
bloody or cloudy urine
bloody, black, or tarry stools
blurred vision
chills
clay-colored stools
continuous ringing or buzzing or other unexplained noise in the ears
dark urine
decreased vision
difficulty with speaking
difficulty with swallowing
dizziness or lightheadedness
drowsiness
fast heartbeat
feeling of constant movement of self or surroundings
general feeling of tiredness or weakness
greatly decreased frequency of urination or amount of urine
headache
hearing loss
high fever
indigestion
joint pain
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
light-colored stools
loss of appetite
mood or mental changes
muscle cramp, 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
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
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 bowels
passing gas
trouble sleeping
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.
Get your GoodRx coupon
$16.33
GoodRx discount
$9.87
Pros and cons of Pantoprazole (Protonix)
Pros
- Taken once a day for most uses
- Tablets can be taken with or without food
- Also available as granules
Cons
- Can take a few days to have its full effect
- Long-term use can weaken bones and raise the risk of fractures
- Only available with a prescription
Pharmacist tips for Pantoprazole (Protonix)
- Take pantoprazole (Protonix) for as long as your prescriber recommends. Longer use can raise the risk of certain problems, such as bone fractures and low vitamin or mineral levels. Ask your prescriber if you're not sure how long you should take it.
- If you miss a dose of pantoprazole (Protonix), take it as soon as you remember. If it's almost time for your next dose, skip the missed dose and take the next dose at your next usual time. Don't take two doses at the same time to make up for the missed dose.
- Tell your care team about all the medications and supplements you take. Pantoprazole (Protonix) can interact with many medications and affect how they work. For example, taking it with warfarin can raise your risk of bleeding. It can also cause your body to absorb less iron from supplements. Your care team can check for interactions and make changes if needed.
- Pay attention to foods or drinks that make your symptoms worse. Common triggers include spicy, fatty foods, or acidic foods and alcohol. Limiting these might help with symptoms. Talk to your prescriber about diet changes that can help along with pantoprazole (Protonix).
- If you're pregnant, planning to become pregnant, or breastfeeding: Talk to your prescriber about if pantoprazole (Protonix) is right for you. It's generally considered safe during pregnancy and while breastfeeding. But there could be other options to try first, so your prescriber can help find the best choice for you.
Tips for pantoprazole (Protonix) tablets:
- Take pantoprazole (Protonix) with or without food. Swallow the tablets whole. Don't chew or crush them because it can damage the outer coating and affect how the medication works.
Tips for pantoprazole (Protonix) oral granules:
- Take the pantoprazole (Protonix) oral granules about 30 minutes before a meal. You'll need to mix them with applesauce or apple juice first. Don't crush or chew the granules.
- Use the entire packet of granules (40 mg). Don't split the contents of the packet to get a smaller dose because the dose might not be divided evenly.
- Mixing with applesauce: Mix the granules with 1 teaspoon (5 mL) of applesauce. Then, take the mixture within 10 minutes. Afterwards, drink a few sips of water to get the full dose.
- Mixing with apple juice: Mix the granules with 1 teaspoon (5 mL) of apple juice and drink it right away. Then, rinse your cup 1 or 2 times with more apple juice and drink it to make sure you get the full dose.
- Taking the granules with a nasogastric or gastronomy tube: Follow the specific instructions for preparing and administering the dose. Ask your care team if you need help.
More on Pantoprazole (Protonix) tips
Risks and warnings for Pantoprazole (Protonix)
Pantoprazole (Protonix) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Heartburn as a sign of a more serious stomach problem
Frequent heartburn can sometimes be a sign of a more serious problem, such as stomach cancer. Tell your prescriber if your heartburn gets worse or comes back after you finish taking pantoprazole (Protonix). Also tell them if you have a low appetite, unexplained weight loss, or weakness. They can check for other health problems that might be causing your symptoms.
Serious kidney problems
Rarely, some people taking PPIs like pantoprazole (Protonix) have developed a kidney problem called tubulointerstitial nephritis (TIN). This causes swelling or inflammation in the kidneys. TIN can happen at any time while taking pantoprazole (Protonix). If not treated, it can lead to kidney failure.
Tell your care team right away if you urinate more or less than usual. Also tell them if you have nausea, weakness, fever, rash, or joint pain. Your care team might order tests to check how well your kidneys are working.
Risk of severe diarrhea from a bacterial infection (Clostridioides difficile)
- Risk factors: Older adults | Hospitalized people | People with a weakened immune system
PPIs like pantoprazole (Protonix) might raise your risk of an infection caused by bacteria called Clostridioides difficile (C. difficile). These bacteria can normally live in your gut without causing problems. But sometimes, they can cause severe diarrhea.
Get medical help right away if you have diarrhea that doesn't get better or becomes severe or very frequent. Other signs can include foul-smelling diarrhea, fever, nausea, or a fast heartbeat. C. difficile infections can sometimes become serious or life-threatening. Your care team can test you for the infection and decide if you should stop pantoprazole (Protonix).
Risk of bone fractures
- Risk factors: Taking high doses of pantoprazole (Protonix) | Taking pantoprazole (Protonix) for longer than a year | Risk of osteoporosis
PPIs like pantoprazole (Protonix) might be linked to a higher risk of bone fractures in the hip, wrist, or spine. The risk can be higher if you take more than one dose of pantoprazole (Protonix) a day or take it for longer than a year.
To lower your risk, take the lowest dose of pantoprazole (Protonix) for the shortest amount of time your prescriber recommends. Tell your prescriber if you have osteoporosis (weak bones) or have had a bone fracture before. They can talk to you about your risk.
Serious allergic or skin reactions
PPIs like pantoprazole (Protonix) have caused serious allergic or skin reactions. Allergic reactions can include anaphylaxis and cause hives, swelling of the face or lips, or trouble breathing. Serious skin reactions can cause a red or purple rash, blisters, or peeling skin. Sometimes, these skin reactions can start with body aches or fever.
Stop taking pantoprazole (Protonix) and get medical help right away if you have signs of a serious allergic or skin reaction.
Lupus
Some people taking PPIs like pantoprazole (Protonix) have developed new or worsening lupus, an autoimmune condition. This has within days or even years after starting pantoprazole (Protonix).
Signs of lupus can include joint pain or a rash. Let your prescriber know if you notice these symptoms. They might have you stop pantoprazole (Protonix) and see a specialist. Most times, symptoms improve within 1 to 3 months after stopping the medication.
Low vitamin B12 and magnesium
- Risk factors: Long-term use | Taking medications that can lower magnesium levels
It's rare, but medications that lower stomach acid like pantoprazole (Protonix) can cause low vitamin B12 levels. This can happen because they can lower how much vitamin B12 your body absorbs. The risk is higher after several years of treatment. Tell your care team if you have signs of low vitamin B12 while taking pantoprazole (Protonix). This can include tiredness, weakness, pale skin, or tingling in your arms or legs.
Pantoprazole (Protonix) can also cause low magnesium levels, especially with longer use. You might be at risk if you take certain medications, such as digoxin (Lanoxin) or water pills. Your care team might check your magnesium and other electrolyte levels during treatment. Tell them right away if you have muscle cramps, shaking, or an irregular heartbeat.
Interactions with other medications
Pantoprazole (Protonix) can interact with some medications and cause serious problems. For example, don't take pantoprazole (Protonix) with rilpivirine (Edurant). Pantoprazole (Protonix) can lower the amount of rilpivirine in the body. This can make rilpivirine work less well to treat human immunodeficiency virus (HIV).
Pantoprazole (Protonix) can also interact with high doses of methotrexate. It can raise the amount of methotrexate in the body. This can raise the risk of serious side effects.
Tell your prescriber and pharmacist about all the medications you take before starting pantoprazole (Protonix). They can check for interactions and make sure your medications are safe to take together.
Inaccurate lab work
Pantoprazole (Protonix) can affect the results of certain medical or drug tests. This can cause incorrect results. Tell your care team that you take pantoprazole (Protonix) before getting tested. For certain tumor screenings, they might ask you to stop pantoprazole (Protonix) for at least 2 weeks before the test.
Pantoprazole (Protonix) dosage
The average cost for 30 tablets of 40mg of Pantoprazole (Protonix) is $9.87 with a free GoodRx coupon. This is 39.56% off the average retail price of $16.33.
Typical dosage for Pantoprazole (Protonix)
-
Adults
- Erosive esophagitis caused by GERD: The typical dose is 40 mg by mouth once a day for up to 8 weeks. If needed, your prescriber might decide to continue treatment for another 8 weeks.
- Keeping erosive esophagitis healed: The typical dose is 40 mg by mouth once a day.
- Medical conditions that cause too much stomach acid: The typical starting dose is 40 mg by mouth twice a day.
-
Children ages 5 years and older
- Erosive esophagitis caused by GERD: The dose is based on body weight.
- Weighing 33 lbs to less than 88 lbs (15 kg to less than 40 kg): The typical dose is 20 mg by mouth once a day for up to 8 weeks.
- Weighing 88 lbs or more (40 kg or more): The typical dose is 40 mg by mouth once a day for up to 8 weeks.
- Erosive esophagitis caused by GERD: The dose is based on body weight.
Pantoprazole (Protonix) is also available as an intravenous (IV) injection that's given into a vein. This form is usually given in the hospital.
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Interactions between Pantoprazole (Protonix) and other drugs
Pantoprazole (Protonix) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Pantoprazole (Protonix). Please note that only the generic name of each medication is listed below.
More on Pantoprazole (Protonix) interactions
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 this medicine, 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 this medicine 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.
Using this medicine 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.
- Acalabrutinib
- Amphetamine
- Atazanavir
- Benzphetamine
- Bosutinib
- Capecitabine
- Cilostazol
- Citalopram
- Dacomitinib
- Dasatinib
- Dextroamphetamine
- Erlotinib
- Eslicarbazepine Acetate
- Gefitinib
- Ketoconazole
- Ledipasvir
- Lisdexamfetamine
- Methamphetamine
- Methotrexate
- Mycophenolate Mofetil
- Nelfinavir
- Neratinib
- Nilotinib
- Octreotide
- Pazopanib
- Pexidartinib
- Saquinavir
- Secretin Human
- Selpercatinib
- Sunitinib
- Velpatasvir
- Vismodegib
Using this medicine 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.
How much does Pantoprazole (Protonix) cost?
To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
Pantoprazole (Protonix) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Pantoprazole (Protonix) will not be safe for you to take.
- Allergy to pantoprazole (Protonix) or similar medications
- Taking rilpivirine (Edurant) or medications containing rilpivirine (e.g., Complera)
What are alternatives to Pantoprazole (Protonix)?
There are a number of medications that your doctor can prescribe in place of Pantoprazole (Protonix). Compare a few possible alternatives below.
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Pantoprazole (Protonix) images
