What is Pantoprazole?
Pantoprazole is a medication to treat GERD, esophagitis: inflammation of your esophagus
as well as a rarer disease called Zollinger Ellison syndrome. This syndrome is characterized
by increased gastric acid production by tumors in your gut or pancreas. This increases the
chance of your stomach developing ulcers. This medication can also be used off label
for another disease called Barret’s esophagus. It can also be used off label for functional
dyspepsia.That’s just a fancy word for indigestion.It can also be used to eradicate a bug called
Helicobacter pylori with an appropriate combination of antibiotics.It is also used in the treatment
of stomach ulcers, also called peptic ulcer disease.
How does Pantoprazole work?
Pantoprazole belongs to a family of medications called Proton Pump Inhibitors. Imagine your
inner stomach is lined up with a lot of tiny pumps. These produce acid to help you digest
food. Pantoprazole blocks these pumps. In this way Pantoprazole decreases the amount
of acid made in your stomach. If less stomach acid is made there is decreased irritation
of your esophagus meaning you will have less heart burn symptoms.
What are other names for this medication?
In the USA the brand name is Protonix. In the UK the brand name is Pantoloc Control.
How much Pantoprazole can you take in a day?
The dosing for GERD is 20mg once a day.If the symptoms are not well controlled it can
be increased to 40mg after 4-8 weeks. Indigestion is treated similarly.
The starting dose for Zollinger Ellison syndrome is 80 mg twice daily.
If you have stomach ulcers the recommended dose is usually 40mg daily.
You can take these tablets with or without food.If the 40mg tablet is too large, you
can take two 20mg tablets.
What is the best time to take Pantoprazole? You can take it in the morning before breakfast.
If you are unable to take the medication in the morning you can take it any time of the
day, around the same time during the day, preferably just before your meal.
If you are taking the oral suspension form of Protonix you will have to take it about
30 minutes before your meal. You can mix the suspension with some applesauce or juice.
Do not mix it with any other food otherwise the way the medication works will be affected.
How long before Pantoprazole starts working?
You should start feeling better within a few days. Unlike other medications such as Tums(an
antacid) which provides immediate relief, Pantoprazole will take about 2-3 days for
its effect. The full effect of the medication may take up to about 4 weeks.
What are the most common side effects of Pantoprazole? (source fda.gov)
All drugs may cause side effects. The goal of this channels is to educate you, if you
are on drug, how it works and what you might expect in terms of common side effects. There
will always be some people who have no or only mild side effects. If you do have side
effects, call your Doctor ASAP. Do not suddenly stop any medication without consulting your
health care provider. If you are interested in other medications
with side effects, click right here.
Headache 12.2% Diarrhea 8.8%
Nausea 7.0% Abdominal pain 6.2%
Vomiting 4.3% Flatulence 3.9%
Dizziness 3.0% Arthralgia (joint pain) 2.8%
Eight side effects to WATCH out for! ( 3 Bonus Tips)
1.Can Pantoprazole cause bone loss?
If you take Pantoprazole for a longer period of time ( a year or longer) you may be at
risk of osteoporosis related fractures. The risk was higher with people on multiple doses
and higher doses. If you are on a Proton Pump Inhibitor, in conversation with your health
care provider take it at the lowest dose and for the shortest period of time for the disease
you are being treated for.
2.Can long term use of Pantoprazole cause C. difficile colitis?
C.diff colitis is an infection of the Colon presenting with abdominal pain and severe
diarrhea often requiring hospitalization. Proton Pump Inhibitors may increase the chance
of these infections. If you are having persistent diarrhea a C diff diagnosis should be considered.
If you are interested in another stomach medication and its effects, click on this link above.
3.Can older adults take Proton Pump inhibitors?
These drugs have been identified as potentially inappropriate medications for older adults
per Beers Criteria because of an increased risk for bone fractures and bone loss as well
as C.difficile infection.If you are a patient who has Barret’s disease, Zollinger Ellison
disease, are on chronic steroids or NSAIDS or have progressive esophagitis the recommendation
is to continue this medication as the benefits outweigh the risks.
4.Can Proton Pump Inhibitors (Pantoprazole) cause lupus?
This can happen, but is very rare. Usually it is the kind of lupus associated with your
skin. If you do have lupus and you are on a PPI it might worsen your symptoms.
5.Can Proton pump inhibitors cause low magnesium levels?
Long term use (usually after a year) of this medication can cause low magnesium levels.
Your health care provider will be checking your magnesium levels on occasion. Symptoms
of low magnesium are fatigue, weakness, muscle cramps, tremors,seizures, irregular heart
rate.
6.Can Proton Pump Inhibitors cause low B12 levels?
If you are on this medication for longer than 3 years you are at an increased risk for
B12 deficiency.Your health care provider can check your B12 levels.
7.Can Proton Pump Inhibitors like Pantoprazole affect your kidney?
In rare cases a kidney disease called acute interstitial nephritis can occur.If you have
trouble urinating, feel tired of have a swelling of your legs and ankles discuss these symptoms
with your health care provider.He or she will be checking your kidney parameters.This can
occur within 3 months of treatment but is reversible.
8.Can Pantoprazole cause skin irritation?
Although rare it can cause a severe skin reaction called Stevens Johnson Syndrome or toxic epidermal
necrolysis.Symptoms may be as follows: red skin, skin peeling off, blisters You might
have following symptoms such a redness of yThis is an emergency and you would need to
go to the ER ASAP.
3 Bonus tips:
1)If you are on a medication called Methotrexate and a PPI it can temporarily cause increased
level of Methotrexate and your health care provider would have to reduce the dose of
the medication.
2) Long term use can cause gastric polyps. These polyps form as a response to longer
periods of decreased acid production which can be cancerous with some patients. Use these
drugs as directed by your health care provider, preferably for the shortest period for your
condition.
3) Do not STOP this medication without talking to your provider. What might happen is that
you are faced with Rebound acid hypersecretion(RAHS). In RAHS there is a recurrence of symptoms
after stopping PPI therapy due to an increase in stomach acid secretion even above pre-treatment
levels. Pantoprazole should be prescribed at the lowest
dose and for the shortest duration for the specific medical condition. It was never intended
for lifelong treatment to minimize side effects unless you have high risk medical conditions
explained earlier in this video.
Here are some more videos you can check out. Have a good day and Think Your Health.