Pantoprazole is a medicine that reduces the amount of acid produced in your stomach. Pantoprazole is used to treat GERD disease (gastroesophageal reflux disease), peptic ulcer disease, and other problems of the esophagus (the tube that connects the throat (pharynx) and stomach – the food pipe). Pantoprazole is also commonly prescribed to prevent and treat stomach ulcers.
The dose of Pantoprazole, and the duration of treatment, will vary depending on what you are being treated for, but it is usually the lowest possible dose for the shortest time needed to treat your condition. Pantoprazole is usually taken on an empty stomach (at least 1 hour or 30 minutes before food). The patient should be instructed to continue taking the medication as prescribed even if symptoms disappear quickly.
If your condition requires taking Pantoprazole for a long time (more than three months), your doctor will ask you to do regular check-ups to check the levels of magnesium in your blood, because it can decrease with prolonged use of this medicine.
Common side effects of Pantoprazole include: headache, constipation or diarrhea, stomach pain, feeling sick or nausea. These side effects are usually mild and go away with continued treatment, but talk to your doctor if they bother you or do not go away with time.
Pantoprazole, available in two concentrations of 20 mg and 40 mg. The usual dose of Pantoprazole is one tablet once before bedtime or one tablet twice daily before breakfast and before bedtime for a period of 14 days mostly.
Pantoprazole, tablets are available in two concentrations of 20 mg and 40 mg. The usual dose of Pantoprazole is one tablet once before bedtime or one tablet twice daily before breakfast and before bedtime for a period of 14 days mostly. Pantoprazole reduces the amount of acid produced by the stomach. It is a widely used remedy for indigestion, heartburn (acidity) and GERD, and is also taken to prevent and treat stomach ulcers. Sometimes it is taken as a treatment for a rare disease caused by a tumor in the pancreas or intestine called Zollinger-Ellison syndrome.
There are negative effects that result from prolonged use only. The risk of side effects may increase the longer you take this medicine. You may be at greater risk of breaking a bone if you take this medicine regularly and for a long time (more than 6 months).
As a general guideline for all patients, foods that appear to make symptoms worse, such as spicy and fatty foods, should be avoided. Also, the patient should be instructed, during the period of treatment with Pantoprazole, to reduce caffeinated beverages, such as tea, coffee and cola, as well as alcohol.
This medicine is not suitable for some people. So before taking this medicine you should tell your doctor if you have serious liver problems, take medicines for HIV, if you have had an allergic reaction to similar medicines in the past, or if you have osteoporosis.
Alcohol does not interfere with the way Pantoprazole works. However, drinking alcohol makes your stomach produce more acid than usual, and this can reduce the effect of the medicine.
During pregnancy and lactation, the use of Pantoprazole is not usually recommended during pregnancy and lactation; However, the doctor may consider it necessary to prescribe Pantoprazole to a pregnant woman or a nursing mother, when other, safer medications fail to control the disease.
Pantoprazole belongs to a class of drugs called proton pump inhibitors, which are used to treat GERD, increased acidity and stomach ulcers.
Quick tips
Pantoprazole is a well-tolerated drug that provides prolonged relief. Here are some health tips:
- Avoid excessive intake of carbonated drinks, citrus juices, fried foods, and caffeinated beverages such as tea and coffee.
- Avoid alcohol and smoking.
- Avoid eating late at night or before bed.
- Tell your doctor if you develop watery diarrhea, fever, or stomach pain that does not go away.
Long-term use of Pantoprazole can lead to weak bones and a deficiency of minerals such as magnesium. Therefore, we advise you to take an adequate amount of calcium and magnesium or their nutritional supplements as prescribed by your doctor.
Check with your doctor right away if you have decreased urination, edema (swelling due to fluid retention), lower back pain, nausea, tiredness, skin rash or fever. These could be signs of a kidney problem caused by the medication.
Pantoprazole reduces the amount of acid produced by the stomach. It is a widely used remedy for indigestion, heartburn (acidity) and GERD, and is also taken to prevent and treat stomach ulcers. Sometimes it is taken as a treatment for a rare disease caused by a tumor in the pancreas or intestine called Zollinger-Ellison syndrome.
Pantoprazole – frequently asked questions
Q: What is the best time to take Pantoprazole?
Usually, Pantoprazole is taken once a day, first thing in the morning an hour before breakfast. If you take Pantoprazole twice a day, take one dose in the morning and one dose in the evening. The tablets should be swallowed whole (remember not to chew or crush them) and taken at least 1 hour before a meal with some water.
Q: Can I take Pantoprazole with domperidone?
Yes, Pantoprazole can be safely taken with Domperidone (commercially known as Motilium) as no adverse effects have been reported clinically. Domperidone works by increasing the motility of the gut, while Pantoprazole reduces acid production in the stomach. Therefore, this formulation is highly effective in treating reflux esophagitis associated with acidity, heartburn, and ulcers of the intestines and stomach.
Q: Can I take antacids with Pantoprazole?
Yes, you can take local antacids such as Gaviscon or Maalox along with Pantoprazole. Take it 2 hours before or after a dose of Pantoprazole.
Q: Can I take Pantoprazole for a long time?
Pantoprazole is usually prescribed for short-term use only. However, if needed, such as to treat peptic ulcer disease and Zollinger-Ellison syndrome (a chronic condition), Pantoprazole can be prescribed for a long time as well.
Long-term use may carry an increased risk of side effects and should be discussed with your doctor. Please use Pantoprazole as directed and under your doctor’s supervision. Long-term use of Pantoprazole may increase the chances of bone fractures, especially as a result of bone mineral deficiency.
Q: What are the long term side effects of Pantoprazole tablets?
If Pantoprazole is used for more than 3 months, some long-term side effects may appear. The most important of these is low levels of magnesium in the blood, which can make you feel tired, confused, dizzy, shaky, or dizzy. Hypomagnesemia may also cause muscle spasms or an irregular heartbeat.
If Pantoprazole is used for more than 6 months, you may have an increased risk of bone fractures, stomach infections, and vitamin B12 deficiency. Vitamin B12 deficiency can lead to anemia, and as a result you may feel more tired, weak, or pale. In addition, anemia caused by vitamin B12 deficiency may cause you palpitations, shortness of breath, dizziness, indigestion, loss of appetite, flatulence (gas) or neurological problems such as numbness, tingling, and trouble walking.
Q: Can I stop taking Pantoprazole if I feel better?
If you have been taking Pantoprazole for a long time, stopping it suddenly could lead to increased acid production, thus worsening your symptoms. Therefore, you should discuss any changes in dosage with your doctor. Gradual discontinuation is also recommended, especially if you have been taking Pantoprazole for extended periods.
Q: Can Pantoprazole cause weight gain?
Weight gain has been reported in less than 1% of patients taking Pantoprazole but the exact cause is not known. One possible explanation is eating larger amounts of food once reflux symptoms have eased. Lifestyle modifications such as proper diet and exercise can help prevent weight gain.
Q: Is it safe to use Pantoprazole?
Yes, Pantoprazole is relatively safe to use. Most people who take Pantoprazole do not experience side effects. It is recommended to take it as directed by your doctor for maximum benefit.
Q: Can I take Pantoprazole Tablets with famotidine?
Yes, Pantoprazole tablets can be taken with famotidine. According to research reports, there are no significant interactions between Pantoprazole and famotidine, however, you should only take them together based on a doctor’s prescription.
Q: Can I drink alcohol with Pantoprazole?
No, it is not recommended to drink alcohol with Pantoprazole. Alcohol by itself does not affect how Pantoprazole works, but it may increase acid production, and this may worsen your symptoms.
Q: Does Pantoprazole cause muscle pain?
Yes, Pantoprazole can cause muscle pain, which is mentioned in its side effects, and with prolonged use it can reduce the absorption of magnesium, which can cause calcium deficiency and muscle pain. Also, prolonged use of Pantoprazole can affect the absorption of vitamin D, and thus can It causes calcium deficiency and muscle pain.
Q: Does long-term use of Pantoprazole affect sexual performance?
Pantoprazole has no side effects on fertility or sexual performance. Side effects of prolonged use of Pantoprazole include the following:
- Low level of magnesium in the blood, which leads to muscle spasms, tachycardia, dizziness, and a lack of concentration.
- Decreased absorption of calcium and vitamin D, which leads to an increased risk of bone fractures.
- Vitamin B12 deficiency, which leads to anemia, a feeling of numbness and tingling in the body, and general weakness in the body.
Q: When does Pantoprazole start to work? And how long does the effect last?
Mostly, the effect of the drug begins within 30 to 90 minutes after taking the tablet, and the effect of the drug lasts for about 24 hours, so the dose is usually once a day, or in severe cases, once every 12 hours.
Q: Is Pantoprazole safe for children?
It is not recommended to use it for children under 12 years of age. However, sometimes the doctor may prescribe this medicine for children of 10 years or less, for a specific period of time to overcome increased stomach acid secretions.
Therapeutic indications
For Pantoprazole 20 mg:
Adults and adolescents 12 years of age and above
- Symptomatic gastro-esophageal reflux disease.
- For long-term management and prevention of relapse in reflux esophagitis.
Adults
- Prevention of gastro duodenal ulcers induced by non-selective non-steroidal anti-inflammatory drugs (NSAIDS) in patients at risk with a need for continuous NSAID treatment.
For Pantoprazole 40 mg:
Adults and adolescents 12 years of age and above
- Reflux esophagitis.
Adults
- Eradication of Helicobacter pylori (H. pylori) in combination with appropriate antibiotic therapy in patients with H. pylori associated ulcers.
- Gastric and duodenal ulcer.
- Zollinger-Ellison-Syndrome and other pathological hypersecretory conditions.
Posology and method of administration
For Pantoprazole 20 mg:
Recommended dose for Adults and adolescents 12 years of age and above
Symptomatic gastro-oesophageal reflux disease
The recommended oral dose is one Pantoprazole 20 mg gastro-resistant tablet per day. Symptom relief is generally accomplished within 2-4 weeks. If this is not sufficient, symptom relief will normally be achieved within a further 4 weeks.
When symptom relief has been achieved, reoccurring symptoms can be controlled using an on-demand regimen of 20 mg once daily, when required. A switch to continuous therapy may be considered in case satisfactory symptom control cannot be maintained with on-demand treatment.
Long-term management and prevention of relapse in reflux oesophagitis
For long-term management, a maintenance dose of one Pantoprazole 20 mg gastro-resistant tablet per day is recommended, increasing to 40 mg Pantoprazole per day if a relapse occurs. Pantoprazole 40 mg is available for this case. After healing of the relapse the dose can be reduced again to 20 mg Pantoprazole.
Recommended dose for Adults
Prevention of gastro-duodenal ulcers induced by non-selective non-steroidal anti-inflammatory drugs (NSAIDs) in patients at risk with a need for continuous NSAID treatment. The recommended oral dose is one Pantoprazole 20 mg gastro-resistant tablet per day.
Recommended dose for Special populations
Children below 12 years of age
Pantoprazole is not recommended for use in children below 12 years of age due to limited data on safety and efficacy in this age group.
Hepatic Impairment
A daily dose of 20 mg Pantoprazole should not be exceeded in patients with severe liver impairment.
Renal Impairment
No dose adjustment is necessary in patients with impaired renal function.
Elderly
No dose adjustment is necessary in elderly patients.
Method of administration
Tablets should not be chewed or crushed, and should be swallowed whole 1 hour before a meal with some water.
For Pantoprazole 40 mg:
Recommended dose for Adults and adolescents 12 years of age and above
Reflux oesophagitis
One tablet of Pantoprazole 40 mg tablets per day. In individual cases the dose may be doubled (increase to 2 tablets Pantoprazole tablets daily) especially when there has been no response to other treatment. A 4-week period is usually required for the treatment of reflux oesophagitis. If this is not sufficient, healing will usually be achieved within a further 4 weeks.
Recommended dose for Adults
Eradication of H. pylori
Eradication of H. pylori in combination with two appropriate antibiotics in H. pylori positive patients with gastric and duodenal ulcers, eradication of the germ by a combination therapy should be achieved. Considerations should be given to official local guidance (e.g. national recommendations) regarding bacterial resistance and the appropriate use and prescription of antibacterial agents. Depending upon the resistance pattern, the following combinations can be recommended for the eradication of H. pylori:
| A | B | C |
| Twice daily one tablet Pantoprazole tablets + twice daily 1000 mg amoxicillin+ twice daily 500 mg clarithromycin |
Twice daily one tablet Pantoprazole tablets + twice daily 400-500 mg metronidazole (or 500 mg tinidazole) + twice daily 250 – 500 mg clarithromycin |
Twice daily one tablet Pantoprazole tablets + twice daily 1000 mg amoxicillin + twice daily 400-500 mg metronidazole (or 500 mg tinidazole) |
In combination therapy for eradication of H. pylori infection, the second Pantoprazole tablets tablet should be taken 1 hour before the evening meal. The combination therapy is implemented for 7 days in general and can be prolonged for a further 7 days to a total duration of up to two weeks. If, to ensure healing of the ulcers, further treatment with Pantoprazole is indicated, the dose recommendations for duodenal and gastric ulcers should be considered.
If combination therapy is not an option, e.g. if the patient has tested negative for H. pylori, the following dose guidelines apply for Pantoprazole tablets monotherapy.
Treatment of gastric ulcer
One tablet of Pantoprazole tablets per day. In individual cases the dose may be doubled (increase to 2 tablets Pantoprazole tablets daily) especially when there has been no response to other treatment. A 4-week period is usually required for the treatment of gastric ulcers. If this is not sufficient, healing will usually be achieved within a further 4 weeks.
Treatment of duodenal ulcer
One tablet of Pantoprazole tablets per day. In individual cases the dose may be doubled (increase to 2 tablets Pantoprazole tablets daily) especially when there has been no response to other treatment. A duodenal ulcer generally heals within 2 weeks. If a 2-week period of treatment is not sufficient, healing will be achieved in almost all cases within a further 2 weeks.
Zollinger-Ellison-Syndrome and other pathological hypersecretory conditions
For the long-term management of Zollinger-Ellison-Syndrome and other pathological hypersecretory conditions patients should start their treatment with a daily dose of 80 mg (2 tablets of Pantoprazole tablets 40 mg). Thereafter, the dose can be titrated up or down as needed using measurements of gastric acid secretion to guide. With doses above 80 mg daily, the dose should be divided and given twice daily. A temporary increase of the dose above 160 mg Pantoprazole is possible but should not be applied longer than required for adequate acid control.
Treatment duration in Zollinger-Ellison syndrome and other pathological hypersecretory conditions is not limited and should be adapted according to clinical needs.
Special populations
Children below 12 years of age
Pantoprazole tablets are not recommended for use in children below 12 years of age due to limited data on safety and efficacy in this age group.
Hepatic Impairment
A daily dose of 20 mg pantoprazole (1 tablet of 20 mg pantoprazole) should not be exceeded in patients with severe liver impairment. Pantoprazole tablets must not be used in combination treatment for eradication of H. pylori in patients with moderate to severe hepatic dysfunction since currently no data are available on the efficacy and safety of Pantoprazole tablets in combination treatment of these patients.
Renal Impairment
No dose adjustment is necessary in patients with impaired renal function. Pantoprazole tablets must not be used in combination treatment for eradication of H. pylori in patients with impaired renal function since currently no data are available on the efficacy and safety of Pantoprazole tablets in combination treatment for these patients.
Elderly
No dose adjustment is necessary in elderly patients.
Method of administration
Tablets should not be chewed or crushed, and should be swallowed whole 1 hour before a meal with some water.
Side effects
Approximately 5% of patients can be expected to experience adverse drug reactions (ADRs). The most commonly reported ADRs are diarrhoea and headache, both occurring in approximately 1% of patients. Side effects of Pantoprazole may include:
- Sleep disorders
- Fundic gland polyps (benign)
- Headache; Dizziness
- Diarrhoea;
- Nausea /vomiting;
- Abdominal distension and bloating
- Abdominal pain and discomfort Flatulence
- Constipation;
- Dry mouth;
- Liver enzymes increased
- Rash;
- Pruritus
Product reference code: A02BC02.