Articles, DRUGS

Pantoprazole – Uses, Dosage, Side Effects & Interactions

Pantoprazole is categorically placed in a group of drugs that are commonly termed proton pump inhibitors. The common name assigned to the drug is Protonix and the uses of this medication are to decrease the amount of the acid that the stomach produces usually. Pantoprazole is also used in the treatment of the erosion of oesophagus owing to the stomach acids, a phenomenon commonly known as esophagitis. The other conditions like Zollinger-Ellison Syndrome and acid refluxes are also treated with the medication.

The main uses of Pantoprazole are to treat certain types of stomach issues. These may include acid refluxes as well as other issues that are reduced altogether by bringing in a decrease in the amount of acid that your stomach produces. The medication is aimed towards releasing symptoms such as heartburn, cough which is persistent and difficulty in swallowing. The acid damage done to the stomach is healed as well. Ulcers and oesophageal cancer prevention are other benefits of Pantoprazole.

Other uses of the drug include prevention of both stomach and intestinal ulcers by changing the amount of acid on a whole. The few things to keep in mind are that there might be side effects and general reactions like chest pain or heartburn. Do not confuse these as heart attack. If you feel the nausea and sweating alongside, call the doctor right away.


Do make sure to get in touch with your doctor if you come down with issues like liver diseases, low magnesium levels, or are proven allergic to medications like Prevacid, Nexium, Omeprazole or Rabeprazole. Osteoporosis is another condition where you should avoid the medication, since Pantoprazole uses proton pump inhibitor which might lead to an increased risk to a bone fracture in the hip, spine or wrist. Although not harmful to your baby, do make sure you mention your doctor about your pregnancy as there might be a chance that the Pantoprazole dosage can pass through breast milk. Which is probably why, the medicine is not approved for use to anyone less than 5 years of age.


It would be wise to use Pantoprazole as prescribed by your governing doctor. Directions and usage details are usually maintained on the label of the prescription and you need to make sure you are not taking it in amounts more than recommended. An empty stomach isn’t a requirement and hence the medicine tablet can be taken with food or without it. The oral granules however should be consumed at least half an hour before taking in a meal. When taking in the medicine, do not chew the tablet and swallow it at one go on a whole without breaking it. Mixing the granule with applesauce should make it easier to avoid the taste without any wrong interaction. Use of other liquids is not advisable.

To use granules, sprinkle it or mix it with applesauce directly. 1 teaspoon of the sauce should be enough. Stir the mixture and swallow it whole without involving any chewing. Do make sure to consume it at one go without storing it for future use.

If you however want to take in Pantoprazole through an NG feeding tube, the following steps are necessary:

  • Attach a 60 mm syringe first to the tube and then remove the plunger. Once done, hold the syringe and check for bends in the tube.
  • Empty the granules into the barrel of the syringe and do make sure to mix 2 teaspoons of apple juice this time instead of one
  • Tap the syringe and empty the contents into the tube
  • Rinse with apple juice for 2 times to ensure there have been no granules left behind in the tube or the syringe.
  • The medicine should be taken as prescribed and continued till the end of term even if there is an improvement in the symptom soon after.
  • Using the granules for more than a span of 3 years can lead to a B-12 deficiency. Converse with your doctor about the risks and how to manage it if you develop the condition.
  • Another wise thing to do would be to contact your doctor if your conditions start to get worse after taking the medicine. This probably means you are allergic to it and need further checks to get back on the prescribed doses.
  • A false positive in the drug test can be led on by the medicine. Do talk to the laboratory staff stating clearly your condition and showing your prescription to avoid confusion on a whole.

It so happens that sometimes you might need antacid alongside the usual medication. So check for interactions and take the two medicines at a gap of at least 30 minutes. Try to use the medicine without missing dosage and at the same time each day that you take it.


The dosage of Pantoprazole involves an usual adult dose and special cases. Let’s take a look into it.

Usual Adult Dose for Erosive Esophagitis:

For erosive esophagitis, the dosage is Pantoprazole 40 mg orally to be taken every day once for at least 8 weeks. An addition of another 8 weeks can be considered if the patient hasn’t gotten better even after the initial treatment. Safety is to be a central point when the therapy extends any further beyond 16 weeks and an improvement has still not been noticed.

Maintenance of Healing of Erosive Esophagitis:

Controlled Pantoprazole therapy is recommended in this case and 40mg is allowed as a dose once a day. There should be an improvement in the condition else a change in medication is usually the way out.

Usual Adult Dose for Gastroesophageal Reflux Disease:

Parenteral dosage prescribed is 40mg daily for up to 7 to 10 days, which is administered through the use of intravenous infusion in duration of 15 minutes. This therapy should be however discontinued as soon as the patient can resume his oral therapy.

Symptomatic Gastro-Oesophageal Reflux Disease:

The dosage of Pantop 40 mg is not recommended for reflux diseases. In such cases, an oral dose of Pantoprazole 20 mg is prescribed per day. The symptom relief normally takes about a duration of 2-4 weeks. If the medication regime of 20mg does not work even further the duration 0f 4 weeks, dosage in increased while an attention at symptom control is paid.

Long-term Management and Prevention of Relapse in Reflux Oesophagitis:

Maintenance dose of Pantoprazole 20 mg is used per day for 2 weeks, there after the increase to Pantop 40mg takes place. A tablet is available for both cases if a relapse occurs. Selective treatment is the key to go and your doctor will advice on what is best. The dosage is again reduced to 20 mg once an improvement is noticed.

Since Pantoprazole dosage varies and the drug is a selective inhibitor, the medicine acts by reducing how much of the stomach acid is generated. It can be effective, but an overdose is most certainly not welcome, especially when it involves already disturbed intestines and the stomach.


Talking of overdose, if you see symptoms like relapse and breathing difficulties, it can either mean an allergy or overdose and there is no way to determine which is what. You need to do an allergy test by taking a small amount of medication without any food to check for adverse reactions. Call your doctor right away. In case you overdose on the drug otherwise, contact the poison control center so they can come to your rescue as soon as possible. Do not share your medication with other or take a dose that has been recommended to someone else. Your dose might vary and this can often lead to disruptions in both your medical session.

In case you have been advised by the doctor for a periodic monitor, keep it regularly checked and managed. Use a diary if feasible to not down the changes and missed doses to make it easier to examine for your doctor. Check for magnesium level ups and downs and record vitamin B-12 levels as well to maintain a straight detailed progress report.

Missed Dose:

In case you miss the dose, take it when you remember if the next dose is after a long time. However, if the time for your next dose is near, it is better to skip the dose you missed and resume with the next one in your schedule. This lowers the risk of overdose and also makes sure that there is no doubling up of the medicine intake.


Store the Pantoprazole tablets at room temperature always keeping the factors like light and moisture in mind. There shouldn’t be too much of either. So avoid places like a balcony or the bathroom storage. Keep the medicine away from the reach of your children and even pets.
Take proper care to not flush the extra medicines down the toilet. The drain should not be picked as a means of disposing the tablets off either. It should be properly discarded when no longer needed or the expiry date has been reached.


There are a lot of medicines that interact with Pantoprazole dosage. However the common ones are Ampicillin, Methotrexate, Ketoconazole, Mycophenolate mofetil, Warfarin. Medicines that contain iron are also known to have an adverse effect when taken along with Pantoprazole. It is a smart move to tell your doctor about all the prior medications that you have been using so he can advise you on what to continue and what to stop using for the time being.

The 3 categories that the interactions can be of are severe, serious and moderate. The medications that fall under the severe category are never taken as a dose along with Pantoprazole tablets.

The ones that are a part of the serious interaction with Pantoprazole need to be cautiously used as they can have serious consequences as well, however the ones with moderate risk can be taken if the timing between the two medicine doses is well managed. Consult your doctor about the same.


  • Tell your doctor from beforehand if you are allergic to Pantoprazole or similar medicines like Omeprazole. Inactive ingredients should be checked for once in case you are allergic to almost everything. Your medical history should be known to your doctor.
  • A few of the symptoms might be signs to a coming serious issue. Getting the right help as soon as possible would be the ideal thing to do. The symptoms include sweating, jaw pain, body soreness, shortness of breath, unexplained loss of weight.
  • Bone fracture risks are increased by medicines like Pantoprazole tablets. Talk to your doctor about the need of calcium supplements.
  • When pregnant, medicines are to be usually avoided, so clearly mention about your situation if you have conceived.
  • The medicine passes to the baby through the breast milk. So, do consult your physician once.


There are a few side effects to having Pantoprazole as a prescribed medicine for the next few days, weeks or months depending on the dosage. You can get used to the headache or diarrhea that commonly occurs. But in case the symptoms are grave and the side effects puts your life in danger by lowering the pulse or pressure level, which is most certainly something to worry about, especially if the condition persists or gets worse.

  • Low magnesium in your blood might result in an irregular heartbeat, which can be either too fast or slow depending on the muscles and the effect on them.
  • The intestinal condition might get worse first before improving because of the bacterial infections internally. To stay clear, keep your distance from anti-diarrheic products unless advised by the doctor.
  • Blood and mucus on your stool can be a side effect and a quick check with your physician should be the right thing to do in such cases.
  • Pantoprazole uses proton pump inhibitors and hence unusual weakness can be a major side effect.

There are obviously side effects to using Pantoprazole, but the common and the most generic ones can always be avoided. Feel free to talk to your doctor if your condition does not improve and the negative effects continue to grow.