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Pantoprazole (By mouth)

Pantoprazole (pan-TOE-pra-zole)

Treats gastroesophageal reflux disease (GERD) and damage to the esophagus. Also treats high levels of acid in the stomach caused by a tumor (such as Zollinger-Ellison syndrome). This medicine is a proton pump inhibitor (PPI).

Brand Name(s):

Protonix, Protonix TR

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

Do not use this medicine if you have had an allergic reaction to pantoprazole.

How to Use This Medicine:

Packet, Tablet, Delayed Release Tablet, Long Acting Tablet

  • Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
  • Delayed-release tablet: Swallow the tablet whole. Do not crush, break, or chew it. You may also take it at the same time with antacids.
  • Delayed-release packet: Mix the packet contents only with applesauce or apple juice. Do not mix the granules with water, other liquids, or food. Do not chew or crush the granules. Swallow the mixture at least 30 minutes before a meal.
  • Feeding tube: Clear any clogs from the feeding tube before you put this medicine mixture into the tube.
  • Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.

If a dose is missed:

  • Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Tell your doctor if you also use ampicillin (Omnipen®, Principen®), atazanavir (Reyataz®), an iron supplement (Feosol®, Fer-In-Sol®), ketoconazole (Nizoral®), methotrexate (Rheumatrex®, Trexall®), nelfinavir (Viracept®), or a blood thinner (such as warfarin, Coumadin®, or Jantoven®).
  • Make sure your doctor knows if you also use digoxin (Lanoxin®, Digitek®) or a diuretic (water pill, such as hydrochlorothiazide (HCTZ), furosemide, torsemide, Lasix®, Demadex®, spironolactone, triamterene, Aldactone®, chlorthalidone, indapamide, Zaroxolyn®, metolazone).

Warnings While Using This Medicine:

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have osteoporosis, seizures, or a history of low magnesium levels in your blood.
  • People of Asian race may react differently to this medicine.
  • This medicine may cause hypomagnesemia (low magnesium in the blood). This is more likely to occur if you take this medicine longer than 1 year or if you take it with digoxin or certain diuretics (water pills). Tell your doctor right away if you have seizures, dizziness, a fast or pounding heartbeat, or muscle spasms.
  • Tell your doctor right away if you have diarrhea that does not go away, stomach pain, and fever while you are taking this medicine.
  • You may be at risk for Clostridium difficile colitis (also called C diff) if you take this medicine. C diff is an inflammation of your large intestine that causes diarrhea. You have a higher risk of this condition if you are also using antibiotics, are elderly, or have other health conditions.Ask your doctor before you take any medicine to stop severe diarrhea.
  • This medicine may increase your risk of broken bones in the hip, wrist, and spine. This is more likely if you are older than 50, you receive high doses of this medicine, or you use it for 1 year or longer.
  • It may be harder for your body to absorb vitamin B12 if you take this medicine for a long time. Tell your doctor if you have concerns about vitamin B12 deficiency.
  • Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
  • Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.You may need blood or other lab tests to check for unwanted effects.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Blistering, peeling, red skin rash
  • Dizziness, seizures, fast or pounding heartbeat, or muscle spasms or cramps
  • Severe diarrhea that does not go away, stomach pain, fever

If you notice these less serious side effects, talk with your doctor:

  • Diarrhea, nausea, or stomach pain
  • Headache
  • Mild skin rash

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Last Updated: 4/4/2014

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