Chemical Name: pantoprazole (as pantoprazole sodium sesquihydrate)
Drug Type: proton pump inhibitors

Call your doctor at once if you have symptoms of a serious side effect: decreased urination, blood in your urine, severe stomach pain, watery or bloody diarrhea, or new or worsening symptoms of joint pain or a skin rash that worsens in sunlight.

Pantoprazole may increase your risk of bone fracture in the hip, wrist, or spine, especially if you take this medicine long term or at high doses.

Pantoprazole is a proton pump inhibitor that decreases the amount of acid produced in the stomach.

Pantoprazole is used to treat erosive esophagitis (damage to the esophagus from stomach acid), and other conditions involving excess stomach acid such as Zollinger-Ellison syndrome.

Pantoprazole is not for immediate relief of heartburn symptoms.

Pantoprazole may also be used for purposes not listed in this medication guide.

Heartburn is often confused with the first symptoms of a heart attack. Seek emergency medical attention if you have chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, and a general ill feeling.

You should not use this medicine if:

  • you are allergic to pantoprazole or to similar medicines such as lansoprazole (Prevacid), esomeprazole (Nexium), omeprazole (Prilosec, Zegerid), or rabeprazole (AcipHex); or
  • you also take medicine that contains rilpivirine (Edurant, Complera, Odefsey).

To make sure pantoprazole is safe for you, tell your doctor if you have:

  • severe liver disease;
  • low levels of magnesium in your blood;
  • lupus;
  • osteoporosis; or
  • low bone mineral density (osteopenia).

Taking a proton pump inhibitor such as pantoprazole may increase your risk of bone fracture in the hip, wrist, or spine. This effect has occurred mostly in people who have taken the medicine long term or at high doses, and in those who are age 50 and older.

It is not known whether this medicine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Pantoprazole can pass into breast milk and may harm a nursing baby. You should not breast-feed while using this medicine.

Pantoprazole is not approved for use by anyone younger than 5 years old.

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Pantoprazole tablets can be taken with or without food. Pantoprazole oral granules should be taken 30 minutes before a meal.

Do not crush, chew, or break the tablet. Swallow it whole.

The oral granules should be mixed with applesauce or apple juice. Do not use any other type of liquid or soft food. Sprinkle the granules directly onto 1 teaspoon of applesauce or apple juice. Stir for 5 seconds and swallow this mixture right away without chewing. Do not save the mixture for later use.

To give pantoprazole granules through a nasogastric (NG) feeding tube:

  • Attach a 60-milliliter syringe to the NG tube and remove the plunger. Hold the syringe high enough to prevent any bends in the tube.
  • Empty the pantoprazole granules into the syringe barrel and mix in 2 teaspoons of apple juice.
  • Add 2 more teaspoons of apple juice to the syringe to rinse the granules through. Tap or shake the syringe as the juice empties into the tube.
  • Rinse with 2 teaspoons of apple juice at least twice more to make sure there are no granules remaining in the syringe or NG tube.

Take this medicine for the full prescribed length of time. Your symptoms may improve before the condition is fully treated.

If you use pantoprazole for longer than 3 years, you could develop a vitamin B-12 deficiency. Talk to your doctor about how to manage this condition if you develop it.

Call your doctor if your symptoms do not improve or if they get worse while you are taking this medicine.

If you use pantoprazole for longer than 3 years, you could develop a vitamin B-12 deficiency. Talk to your doctor about how to manage this condition if you develop it.

This medicine can cause you to have a false positive drug screening test. If you provide a urine sample for drug screening, tell the laboratory staff that you are taking pantoprazole.

Store at room temperature away from moisture and heat.

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

This medicine can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • severe stomach pain, nausea, vomiting, and weight loss;
  • diarrhea that is watery or bloody;
  • seizure (convulsions);
  • bruising or swelling where the medicine was injected;
  • new or worsening symptoms of lupus--joint pain or swelling with a butterfly-shaped skin rash on your cheeks and nose (worsens in sunlight);
  • kidney problems--urinating less than usual, blood in your urine, swelling, rapid weight gain; or
  • symptoms of low magnesium--dizziness; fast heartbeats; tremors (shaking) or jerking muscle movements; feeling jittery; muscle cramps, muscle spasms in your hands and feet; cough or choking feeling.

Common side effects may include:

  • headache, dizziness;
  • mild diarrhea;
  • stomach pain, gas, nausea, vomiting;
  • fever;
  • cold symptoms such as stuffy nose, sneezing, sore throat;
  • rash; or
  • joint pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • ketoconazole;
  • methotrexate;
  • mycophenolate mofetil;
  • warfarin (Coumadin, Jantoven);
  • HIV or AIDS medicine--atazanavir, nelfinavir; or
  • iron-containing medicines--ferrous fumarate, ferrous gluconate, ferrous sulfate, and others.

This list is not complete. Other drugs may interact with pantoprazole, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Your pharmacist can provide more information about pantoprazole.