Easy-to-read medicine information about pantoprazole – what it is, how to take it safely and possible side effects.
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What is pantoprazole?
Pantoprazole reduces the amount of acid produced in your stomach. It belongs to a group of medicines known as proton pump inhibitors (PPIs). They are used to treat a number of conditions associated with high stomach acid affecting your stomach and gut, such as indigestion, reflux and ulcers. Pantoprazole can prevent ulcers from forming, or help the healing process where damage has already occurred.
Pantoprazole can also:
- be given together with antibiotics to get rid of Helicobacter pylori, a bacteria found in the stomach that can cause ulcers.
- be used to prevent ulcers caused by medicines such as non-steroidal anti-inflammatory drugs (NSAIDs). Examples of NSAIDs are diclofenac, ibuprofen and naproxen.
In New Zealand pantoprazole is available as tablets.
- The usual dose of pantoprazole is 20 to 40 mg once a day.
- Your doctor will advise you how long to take pantoprazole for (usually for 2 to 4 weeks). Some people may need to take it for longer.
- It is best to take the lowest effective dose, for the shortest possible time.
- The pharmacy label on your medicine will tell you how much pantoprazole to take, how often to take it and any special instructions.
How to take pantoprazole
- Take pantoprazole at the same time each day, usually in the morning.
- Swallow your tablet whole with a glass of water. Do not crush or chew – the medicine doesn't work properly if the tablet is crushed or chewed.
- Pantoprazole can be taken before or after food, although taking it before food is best.
- If you forget to take your dose, take it as soon as you remember. But, if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.
Avoid long-term use – choose wisely
If you don’t need them, PPIs like pantoprazole should not be taken long term, because of the possible side effects. There may be a small increased risk of bone fractures, chest infections, kidney problems and nutrient deficiencies such as low magnesium and low vitamin B12. If you’ve been taking a PPI for reflux for longer than 4 to 8 weeks, and your symptoms seem to be well managed, it’s a good idea to talk to your healthcare provider about reviewing your medicine. They may recommend stepping down your treatment. This could include:
- reducing your daily dose of pantoprazole
- taking pantoprazole only when you experience the symptoms of heartburn and reflux (also known as on-demand therapy)
- stopping treatment completely, as your symptoms may not return. It may be best to reduce the dose over a few weeks before stopping.
Read more about PPIs for heartburn and reflux Choosing Wisely, NZ
Precautions – before starting pantoprazole
- Are you pregnant, planning a pregnancy or breastfeeding?
- Do you have problems with your kidneys or liver?
- Are taking any other medicines? This includes any medicines you are taking which you can buy without a prescription, as well as herbal and complementary medicines.
If so, it’s important that you tell your doctor or pharmacist before you start pantoprazole. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.
Possible side effects
Like all medicines, pantoprazole can cause side effects, although not everyone gets them. Often side effects improve as your body adjusts to the new medicine.
Rebound acid secretion
When pantoprazole is stopped, a common side effect is rebound acid secretion, where the acid secretion in your stomach increases significantly. This should return to normal within 2 weeks. Because the symptoms of rebound acid secretion are the same as for reflux (such as indigestion, discomfort and pain in your upper stomach and chest, feeling sick and an acid taste in your mouth), it can form an ongoing loop where stopping pantoprazole treatment creates the need to start it again.
Rather than restart pantoprazole, your doctor may advise you to use medicines that contain both an antacid and an anti-foaming agent, such as Acidex oral liquid or Gaviscon Double Strength tablets. Alternatively, ranitidine tablets could be used. These can be effective for treating rebound acid secretion. You can use these medicines to relieve the symptoms when they occur.
Talk to your doctor or pharmacist about how to manage rebound acid secretion.
Other side effects
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Pantoprazole may interact with a few medications and herbal supplements, so check with your doctor or pharmacist before starting pantproazole or before starting any new medicines.
New Zealand Formulary Patient Information: Pantoprazole
- Stopping proton pump inhibitors in older people BPAC, NZ 2019
- Proton pump inhibitors – when is enough, enough? BPAC, NZ, 2014
- Proton pump inhibitors and the risk of acute kidney injury BPAC, NZ, 2016
- Pantoprazole New Zealand Formulary