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 Barrett’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 40 mg 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 article 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.
- 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.
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 Barrett’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 Vitamin B12 levels?
If you are on this medication for longer than 3 years you are at an increased risk for Vitamin 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 .This 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 article.
Have a good day and Think Your Health.
Sources:
- Freedberg DE, Haynes K, Denburg MR, et al. Use of proton pump inhibitors is associated with fractures in young adults: a population-based study. Osteoporos Int. 2015;26(10):2501-7. doi:10.1007/s00198-015-3168-0 [PubMed 25986385]
- Lam JR, Schneider JL, Zhao W, Corley DA. Proton pump inhibitor and histamine 2 receptor antagonist use and vitamin B12 deficiency. JAMA. 2013;310(22):2435-2422. [PubMed 24327038]
- https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020987s045lbl.pdf
