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Why it's used

Pantoprazole is a prescription medicine that is used for the short-term treatment of digestive diseases in which stomach acid and bile flows back and irritates the food-pipe, also known as GERD. This medicine works by suppressing the production of acid in the stomach. Pantoprazole is also used for the management of inflammation and irritation of the food pipe, to treat the overproduction of stomach acid, and to prevent stomach ulcers caused by the use of certain medicines (called as, NSAIDs).
Proton Pump Inhibitors
Pantoprazole belongs to the Proton Pump Inhibitors class of medicines. Proton-pump inhibitors (PPIs) are a group of medicines that significantly reduce stomach acid production. Excess acid production causes diseases related to the stomach and intestines. PPIs are used to treat such disorders.

How to use

Read the directions on the product label, patient guide, or medicine guide provided by the medicine company or your pharmacist before starting to use Pantoprazole. If you have any questions related to this medicine, ask your doctor or pharmacist. Use this medicine as recommended by your doctor.
Pantoprazole is used with or without food. You should swallow Pantoprazole tablets whole. Do not split, crush or chew the tablets. Pantoprazole is used 30 minutes before meals with applesauce (for delayed-release oral suspension).

Typical Dosage

The typical dose of Pantoprazole is 40 mg once a day. The usual dose for children is 20 mg - 40 mg once a day. The maximum adult dose of Pantoprazole is 240 mg in a day. This medicine is typically used for a period of 8 weeks for erosive esophagitis associated with GERD. Pantoprazole is commonly used at the same time every day. It takes 2.5 hours for this medicine to start to work. This medicine is not known to be habit-forming.
This medicine is to be used for longer periods of time. Pantoprazole may be prescribed for long-term treatment of hypersecretory conditions that produce excess stomach acid and for the long-term treatment of inflammation of the food pipe (erosive esophagitis). You should continue to use this medicine as directed by the doctor even if you feel well.
If using the delayed-release form of this medicine, do not crush or chew the medicine, unless indicated on the package. Crushing or chewing of the medicine can result in unpleasant taste resulting in patients not following the medicine schedule. Crushing or chewing can also release all of the medicine at once, resulting in a decrease of effectiveness and a possible increase in side-effects.
The injection form of this medicine is for intravenous use only.
If using the liquid form of this medicine, measure the dose using the provided measuring cup, spoon, or dropper. Before pouring the medicine into the measuring device, you should check the measurement markings carefully. Then, pour the dose amount into the device. After use, clean and store the measuring device in a safe place for your next use. You should not use a tablespoon or teaspoon as the dose measuring devices since it can result in an incorrect dose. If indicated on the product package, shake the medicine before use.

Talk to Your Doctor

Talk to your doctor if your condition does not improve or worsens. Tell your doctor if conditions like irregular and tremor, dizziness, abnormal or fast heartbeat, shaking movements of the body, muscle weakness, and muscle pain occurs. If you have issues with the health of your liver, a daily dose of 20 mg will usually be prescribed in patients having issues with their liver. You should consult with your doctor before stopping the use of Pantoprazole.
Your doctor may recommend a lower initial dose of this medicine to see the impact of this medicine on the body. Please follow your doctor's directions.

Use in Children

If you are giving Pantoprazole to a child, be sure to use a product that is meant for children. Before giving this medicine to a child, use the child's weight or age to find the right dose from the product package. You can also read the dosage section of this page to know the correct dose for your child. Else, consult with your doctor and follow their recommendation.

Lab Tests

Your doctor may request that specific lab tests be performed before you start using Pantoprazole. You may need to have Magnesium test. Magnesium levels in the body should be checked before starting the treatment because low magnesium can happen in individuals who take a proton pump inhibitor medicine after three months of treatment.

Storage

You should store Pantoprazole at room temperature 15° to 30°C (59° to 86°F), and away from moisture. Store the medicine away from the reach of children and pets.
Medicines may be prescribed for uses other than those listed in the medicine guide. Do not use Pantoprazole for conditions for which it was not prescribed. Do not give Pantoprazole to other people who might have the same conditions or symptoms that you have. Self-medication may harm them.
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How to take Pantoprazole

The dose and frequency of using Pantoprazole will depend on the following factors:
  • age of the patient
  • the weight of the patient
  • patient's health
  • the health of the patient's kidneys
  • medicines recommended by the doctor
  • any other medicines being used
  • herbal supplements being used
  • response to the medicine

Pantoprazole Dosage

Dosage for short-term treatment of GERD

Adult
  • Recommended: 40 mg once daily for up to 8 weeks
Children (5 years and older having weight more than or equal to 40 kg/88 lb)
  • Recommended: 40 mg
Children (5 years and older with weight between 15-40 kg/33-88 lb)
  • Recommended: 20 mg once daily for up to 8 weeks

Dosage for the healing of inflammation of food pipe

Adult
  • Recommended: 40 mg once daily

Dosage for overproduction of stomach acid (Zollinger-Ellison syndrome)

Adult
  • Recommended: 40 mg twice daily (adjust dosage based on patient needs)
  • Maximum: 240 mg per day

Minimum Age

5 years

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Forms

Delayed-release tablet
Strength: 20 mg, 40 mg
Delayed-release oral suspension
Strength: 40 mg
Powder for solution for injection
Strength: 40 mg

Special Instructions

Tablet
If you are not able to swallow a single 40 mg tablet, take two 20 mg tablets instead.
Delayed release oral suspension in applesauce
Prepare the granules in one teaspoonful (5 ml) of applesauce and do not use other food. Take this suspension within 10 minutes of preparation. Do not chew or crush the granules.
Suspension use through nose or stomach
Prepare the granules in two teaspoonfuls (10 ml) of apple juice and shake the preparation well. Repeat this procedure at least twice using the same method each time, and no granules should be present in the tube.
Delayed release oral suspension in applejuice
Prepare the granules in one teaspoonful (5 ml) of apple juice. Stir the preparation for 5 seconds and swallow immediately.
Powder for solution for injection
After preparation, use the solution within 12 hours.

Missed Dose

In case a dose is missed, take it as soon as you remember but if it is the time of the next dose then take the next regular dose. Two doses at the same time should not be taken to compensate for the missed dose.

Overdose

What to do if you overdose on Pantoprazole?
The treatment should depend upon the symptoms that appear (symptomatic and supportive treatment).
If you think you have overdosed on Pantoprazole, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Pantoprazole

Before you use Pantoprazole, tell your doctor of your medical and health history including the following:
  • disease in which body attacks its own tissues (also known as, systemic lupus erythematosus)
  • low magnesium level
  • low vitamin B12 level in the body
  • stomach ulcers
  • upper gastrointestinal bleeding
  • weak bone density caused by osteoporosis
Before you use Pantoprazole, tell your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Discuss with your doctor if you are allergic to benzimidazole.
The use of this medicine may change magnesium levels in the body. If you are taking any proton pump inhibitor for at least three months, this can lead to low level of magnesium in your body.
The use of Pantoprazole may change the vitamin B12 level in the body. If you are taking any proton pump inhibitor over a period of more than three years, it may lead to the body not absorbing vitamin B12 properly.

Use when Pregnant

Consult with your doctor on the use of Pantoprazole during pregnancy or if you are planning to become pregnant. It is not known if this medicine can harm the unborn baby. There have been no controlled studies in humans so its best to only use Pantoprazole in pregnancy when required.

If Breastfeeding

Consult with your doctor on the use of Pantoprazole during breastfeeding. This medicine may pass into breast milk but your doctor can best judge if it can impact the baby.

If trying to Conceive

Consult with your doctor on the use of Pantoprazole, if you are trying to conceive. Impact of this medicine on fertility is not known although animal studies have shown no negative impact on fertility.

Seizures

Pantoprazole can make you feel sleepy. Be careful, especially while driving, while using heavy machinery, or when doing any activity that needs you to be completely alert. The consumption of alcohol with Pantoprazole can worsen the sleepiness. Pantoprazole may cause seizures in some people. Hence, you should discuss with your doctor before performing any activities where a loss of consciousness may cause harm to you or others.

Increase in Risk

This medicine may increase your sensitivity to sunlight and make you prone to sunburn. If this happens, limit your time outdoors to prevent sunburn. Use a sunscreen and cover your skin.

Side-effects in Children

Younger patients may see an increased risk of vomiting, headache, rash, fever, stomach pain, diarrhea, and lung infection.

Pantoprazole Side-effects

The following side-effects may commonly occur when using Pantoprazole. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
The following side-effects may commonly occur in children when using Pantoprazole. Discuss with your doctor if any of these side-effects last for a long time or are severe:
Rarely, the use of Pantoprazole may cause the following side-effects:
  • abnormal sensations in the body
  • blurred vision
  • burned skin layer (Lyell syndrome)
  • burning sensation in body parts
  • constipation
  • dry mouth
  • facial swelling
  • fatigue
  • feeling of discomfort
  • fluid collection in body tissues
  • fracture of the hip, wrist or spine
  • gas or fluid, abdominal distension/bloating
  • hallucination
  • high lipid levels in the body
  • increased creatine kinase level
  • increased levels of fatty acids
  • increased transaminases level
  • inflammation of the liver (hepatitis)
  • insomnia
  • involuntary contraction of muscles
  • kidney failure
  • loss of body balance
  • lupus
  • mental confusion
  • muscle pain
  • physical weakness
  • severe itching of the skin
  • skin rash
  • skin rash caused by disease or fever
  • skin rashes with itchy and raised bumps
  • stomach discomfort
  • swelling due to fluid build up inside the veins and arteries
  • swelling in-between kidney tubules (interstitial nephritis)
  • swollen male breast tissue
  • taste disorder
  • weight changes
The following severe side-effects may also occur when using Pantoprazole:
Your doctor has prescribed Pantoprazole because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious side-effects. This page does not list all possible side-effects of Pantoprazole.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Abnormal Liver Function

Patients having issues with the functioning of their liver are at an increased risk when using this medicine. Such patients may see an increase in levels of liver enzymes. Liver enzymes should be monitored regularly by your doctor during long-term therapy of Pantoprazole. The patient should discontinue the use of this medicine if there is an increase in levels of liver enzymes.

Stomach Cancer

Patients with stomach cancer are at an increased risk when using this medicine. Effect of Pantoprazole overlaps the symptoms of stomach cancer and may delay its diagnosis.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Patients who are using Pantoprazole to prevent stomach and intestinal issues because of treatment with NSAIDs should be evaluated. The evaluation should make sure that they need NSAIDs and have risk factors that may cause them to develop stomach and intestinal issues caused by NSAIDs.

Risk of Bacterial Infections

This medicine may lead to increased risk of infections caused by bacteria such as Salmonella and Campylobacter in the stomach or intestines.

Increased Levels of Chromogranin A (protein)

This medicine increases chromogranin A level, which can interfere in the examination of neuroendocrine tumors. Pantoprazole treatment should be discontinued for at least five days before the start of chromogranin A measurements.

Helicobacter Pylori (Bacteria) Positive Patients

Such patients are at an increased risk when using this medicine. These patients may suffer from an increased risk of swelling and pain in the stomach, also known as atrophic gastritis.

Use of Pantoprazole with Methotrexate

Patients undergoing treatment with both proton pump inhibitors and methotrexate are at an increased risk. Pantoprazole may increase the level and effects of methotrexate on the body. Withdrawal of the proton pump inhibitor on a temporary basis may be considered in these patients.

Vitamin B12 Deficiency

Patients who use acid-suppressing medicines for long periods of time are at an increased risk. These patients may develop a vitamin B12 deficiency.

Long-Term Therapy Using Pantoprazole

Patients who are on high-dose and follow the long-term therapy of proton pump inhibitors are at an increased risk. Such patients may see an increased risk for fractures of the hip, wrist, or spinal area. These patients should use the lowest effective dose for a shorter duration of time.

Magnesium Deficiency

Patients undergoing treatment with proton pump inhibitors for at least three months and after a year of therapy are at increased risk. Such patients may see an increased risk of side effects which include muscular spasms, palpitation, and seizures. In such cases, the level of magnesium in the body should be monitored before the start of treatment with Pantoprazole.

Interactions with Pantoprazole

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
This page does not contain all the possible interactions of Pantoprazole. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Antiretroviral Drugs

Pantoprazole may interact with antiretroviral drugs (atazanavir or nelfinavir), which are used to treat HIV infections. The combined use of these medicines reduces the level of HIV medicines in the body. This may lead to the loss of effects of the HIV medicines and development of resistance to the medicines.

Coumarin Anticoagulants

There may be an interaction of Pantoprazole with coumarin anticoagulants (warfarin and phenprocoumon), which are used to prolong the time needed for blood to clot. Abnormal bleeding occurs when both the medicines are used together which can be possibly fatal. Patients undergoing treatment with both the drugs should be closely monitored for an increase in bleeding time.

Antimetabolites

Pantoprazole interacts with methotrexate, which is used to treat rheumatoid arthritis, itchy, psoriasis, and cancer. The combined use of these medicines may lead to increased level and effects of methotrexate on the body. In such cases, the temporary withdrawal of Pantoprazole may be required.

Azole Antifungals

Special instructions need to be followed while taking this medicine along with azole antifungals (ketoconazole, itraconazole, and posaconazole) which are used to treat fungal infections. Pantoprazole may interfere with absorption of these medicines.

Urine Screening Tests

Your doctor's guidelines may need to be followed while taking this medicine along with Urine tests. False positive urine screening tests for certain chemicals (such as, tetrahydrocannabinol) has been reported in patients using Pantoprazole. Another test may need to be conducted to verify the results.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Pantoprazole is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.

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