Pantoprazole (By mouth)


Pantoprazole (pan-TOE-pra-zole)

Treats gastroesophageal reflux disease (GERD), damage to the esophagus, and high levels of acid in the stomach. This medicine is a proton pump inhibitor (PPI).

Brand Name(s)

Protonix, Protonix TR

When This Medicine Should Not Be Used

How to Use This Medicine

Packet, Tablet, Delayed Release Tablet, Long Acting Tablet

  • Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
  • Delayed-release tablet: Swallow the tablet whole. Do not crush, break, or chew it. You may take this medicine at the same time you take an antacid.
  • Delayed-release packet:
    • Mix the packet contents with 1 teaspoon of applesauce or apple juice only. Do not mix with water, other liquids, or food.
    • Swallow the mixture at least 30 minutes before a meal. Take it within 10 minutes after you mix it.
    • If you mixed with apple juice, put more apple juice into the cup after you swallow the mixture. Drink this juice, too, to make sure you get all of the medicine.
    • If you mixed with applesauce, sip some water after you swallow the mixture. This will make sure all of the granules get all the way to your stomach.
    • Do not chew or crush the granules. Do not divide the packet contents to make smaller doses.
  • Feeding tube: Mix the packet contents in apple juice only. Mix the medicine in a 2-ounce syringe. Clear any clogs from the feeding tube before you put this medicine mixture into the tube.
  • This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
  • Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Some drugs and foods can affect how pantoprazole works. Tell your doctor if you are using any of the following:
    • Digoxin
    • Diuretic (water pill)
    • Methotrexate
    • Atazanavir
    • Nelfinavir
    • Blood thinner, such as warfarin
    • Ampicillin
    • Iron supplement
    • Ketoconazole

Warnings While Using This Medicine

  • Tell your doctor if you are pregnant or breastfeeding.
  • This medicine may cause the following problems:
    • Low magnesium levels in the blood
    • Clostridium difficile colitis (severe diarrhea, also called C diff)
    • Broken bones in the hip, wrist, or spine, especially if you take high doses or take it for longer than 1 year
    • Low vitamin B12 levels in the blood, with long-term use
  • This medicine can cause diarrhea. Call your doctor if the diarrhea becomes severe, does not stop, or is bloody. Do not take any medicine to stop diarrhea until you have talked to your doctor. Diarrhea can occur 2 months or more after you stop taking this medicine.
  • Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
  • Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Blistering, peeling, red skin rash
  • Dizziness, seizures, fast or pounding heartbeat, or muscle spasms or cramps
  • Paleness, weakness, tiredness, trouble breathing
  • Severe diarrhea that does not go away, stomach pain, fever
  • Severe stomach pain, vomiting, weight loss

If you notice these less serious side effects, talk with your doctor:

  • Headache
  • Mild diarrhea, nausea, or stomach pain

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Version Info

  • Last reviewed on 8/4/2014

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