Pantoprazole

What is Pantoprazole?

Pantoprazole belongs to a class of medications called proton pump inhibitors. These drugs reduce the amount of acid that the stomach produces. 

Pantoprazole Tablet Uses

Pantoprazole is used to lower the amount of acid the stomach produces. It’s often given to treat several acid-related conditions of the stomach and intestine, including gastro-oesophageal reflux disease (GORD), heartburn, stomach ulcers, and Zollinger-Ellison syndrome.

Pantoprazole can also be taken to help heal damage to the oesophagus and stomach caused by excess acid production and to prevent ulcer formation. You may also be prescribed a proton pump inhibitor to take alongside an anti-inflammatory, such as naproxen. This combination helps to prevent stomach irritation, ulcers, and bleeding that non-steroidal anti-inflammatory drugs (NSAIDs) can cause.

How Do Pantoprazole Gastro-Resistant Tablets Work?

Pantoprazole works by reducing the amount of acid the stomach produces. It is a proton pump inhibitor (PPI), which means it blocks tiny pumps, called proton pumps, in the lining of your stomach that produce acid. Reducing stomach acid can relieve heartburn and acid reflux while allowing inflammation or ulcers in your oesophagus, stomach, or upper intestine time to heal.

The gastro-resistant coating protects pantoprazole from being broken down by stomach acid before it can be absorbed in your intestine. Once it is absorbed, it targets the specific enzyme system responsible for producing stomach acid, providing effective relief.

How Long Does Pantoprazole Take to Work?

Pantoprazole is not designed to provide immediate relief. You should usually start to feel better within 2 to 3 days, although it can take up to 4 weeks to fully control your symptoms. You may still experience some heartburn or acid reflux during the first few weeks of treatment.

Continue taking pantoprazole as directed, even if it does not work straight away. If you bought it without a prescription and your symptoms have not improved after 2 weeks, or they have worsened, speak to your doctor before taking any more. Do not take non-prescription pantoprazole for longer than 4 weeks without medical advice.

How Effective is Pantoprazole For Heartburn?

Pantoprazole is an effective proton pump inhibitor (PPI). One review found that healing rates after 4 weeks of pantoprazole 40 mg were between 54 and 95.1%, compared with 20 to 66.7% for ranitidine, a histamine H2-blocker that reduces stomach acid production.

Another meta-analysis concluded that 45% of people taking pantoprazole 40 mg once daily were healed after 4 weeks, and 70% after 8 weeks. The same analysis found that pantoprazole is well tolerated, with 90% of people experiencing no side effects during treatment. 

How to Take Pantoprazole Tablets 

Take pantoprazole tablets 1 hour before a meal and swallow them whole with water. You must not chew or break them. Your clinician will tell you exactly how to take them and what dose you need.

The usual dose for pantoprazole depends on why you are taking it. The table below shows the different doses for different conditions. If you are unsure about how much pantoprazole to take, speak to your doctor or pharmacist.

If you have kidney or liver problems, you must not take pantoprazole to eradicate H. pylori, and if you have severe liver problems, you should not take more than one 20 mg pantoprazole tablet per day.

If You Forget to Take Pantoprazole

If you forget to take pantoprazole, take your next normal dose at the usual time. Do not take a double dose to make up for a missed dose. 

If You Take Too Many Pantoprazole Tablets 

Although there are no known symptoms of overdose with pantoprazole, you should contact your doctor or pharmacist if you take too much.

Pantoprazole Side Effects and Cautions

There is the potential for pantoprazole to cause side effects in some people. It is important to read the Patient Information Leaflet that comes with the medication and discuss any concerns with your clinician. Understanding what adverse effects pantoprazole may cause will better equip you to manage them and help you recognise when you may need medical attention.

Potential Side Effects of Pantoprazole

Not everyone who takes pantoprazole will get side effects. One study found that 90% of people who took it experienced no adverse effects. However, if you do get side effects, most are mild, temporary, and easy to manage at home. If you experience adverse reactions that are difficult to manage, get worse, or concern you, speak to your doctor for advice.

It’s important to be aware that the above table does not include a full list of possible Pantoprazole side effects. More details, including adverse reactions identified in blood tests and those with unknown frequencies, can be found in the Patient Information Leaflet that accompanies the medication.

If you experience any side effects while taking Pantoprazole, you can report them to your clinician or via the MHRA’s Yellow Card Scheme. 

When to Stop Taking Pantoprazole

In some cases, pantoprazole can cause serious side effects. If you get any of the following, stop taking pantoprazole and speak to your doctor straight away. In an emergency, call 999 or get someone to take you to A&E:

• Allergic reaction: symptoms include swelling of the tongue and/or throat, difficulty swallowing or breathing, dizziness, very fast heartbeat, and heavy sweating.
• Serious skin conditions: blistering of the skin, skin sensitivity, or rash, red, target-like patches on the trunk, widespread rash, fever, and swollen lymph nodes.
• Jaundice: yellowing of the skin or whites of the eyes.
• Kidney inflammation: fever, rash, enlarged kidneys, and sometimes painful urination.

Pantoprazole Warnings and Interactions

Pantoprazole may not be suitable for everyone, as there are certain health conditions and medications that can make it unsuitable or unsafe. Tell your clinician about any medications or health conditions during your consultation so they can confirm pantoprazole is safe for you.

Do not take pantoprazole if you are:

• Allergic to pantoprazole or any other ingredients listed in the medication
• Allergic to any other proton pump inhibitor medications

Precautions Before Taking Pantoprazole

Before taking pantoprazole, tell the clinician if you:

• Have severe liver problems
• Have reduced body stores or risk factors for low vitamin B12 levels and receive long-term pantoprazole treatment
• Get any symptoms such as fatigue, involuntary muscle contractions, disorientation, convulsions, dizziness, or an increased heart rate, as these could be a sign of low magnesium
• Have ever had a skin reaction after a treatment similar to pantoprazole to lower stomach acid
• Get a skin rash, especially on areas of the body that are exposed to the sun
• Get a serious skin reaction after taking pantoprazole, including Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms (DRESS) and erythema multiforme
• Are due to have a specific blood test called Chromogranin A

Tell the clinician before or after taking pantoprazole if you notice any of the following symptoms, which could be a sign of another, more serious disease:

• An unintentional loss of weight
• Vomiting, particularly if repeated
• Vomiting blood that looks like dark coffee grounds 
• You notice blood in your stools, which may be black or tarry in appearance
• Difficulty in swallowing or pain when swallowing
• You look pale and feel weak (anaemia)
• Chest pain
• Stomach pain
• Severe and/or persistent diarrhoea, because this medicine has been associated with a small increase in infectious diarrhoea

Pantoprazole and Other Medications

Before taking pantoprazole, you must let the clinician know if you are taking any other medication, including any that are prescribed, over-the-counter, or herbal, because they may interact with pantoprazole. Tell the clinician before taking pantoprazole if you are taking:

• Medications to treat a fungal infection, such as ketoconazole, itraconazole, and posaconazole
• Erlotinib for treating certain cancers
• Warfarin or phenprocoumon, which can affect the thickening or thinning of the blood
• Medications to treat HIV, including atazanavir
• Methotrexate for rheumatoid arthritis, psoriasis, and cancer
• Fluvoxamine for depression and other psychiatric diseases
• Rifampicin to treat infections
• St John’s wort, a herbal remedy to treat mild depression

Pregnancy and Breastfeeding

If you are pregnant, think you might be pregnant, trying to get pregnant, or breastfeeding, speak to a doctor or pharmacist before taking pantoprazole. There is not enough data to know the full effects of pantoprazole in pregnant women. Pantoprazole can pass into your breast milk if you are breastfeeding.

You should only take pantoprazole if you are pregnant or breastfeeding and your doctor has told you to. 

Frequently Asked Questions About Pantoprazole