Pantoprazole: Uses, adverse effects & precautions!

Pantoprazole is a proton pump inhibitor that is used for the treatment of acidity & related symptoms, diseases & complications.


  • Gastroesophageal reflux disease (GERD) erosive or non-erosive.
  • Erosive esophagitis
  • Zollinger-Ellison syndrome
  • Barett Esophagitis
  • Dyspepsia
  • Stomach ulcers
  • Peptic ulcers
  • In combination with other antibiotics to treat H.Pyroli infection
  • Given along with NSAIDs to prevent ulcer formation & acidosis.


Dosage forms available:

  • Tablet: 20 mg, 40 mg
  • Capsule: 20 mg, 40 mg
  • IV dose (Lyophilized powder): 40 mg

Dosage guidelines:

  • GERD: 20-40 mg once daily, depending on severity, for 8 weeks.
  • Peptic Ulcer: For bleeding ulcer, loading IV dose of 80 mg, followed by 40 mg every 12 hours.
  • Zollinger-Ellison syndrome: 80 mg twice daily, can also be increased to 240 mg per day, till condition is in control.

Missed dose: 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.

a) Administration of gastric lavage
b) Dialysis & hydration therapy


  • Headache,
  • Dizziness,
  • Stomach pain,
  • Gas,
  • Nausea,
  • Vomiting,
  • Diarrhea,
  • Joint pain,
  • Fever,
  • Rash,
  • Cold symptoms (most common in children).


  • Facial edema
  • Increased serum triglycerides
  • Decreased WBC count
  • Decreased platelet count
  • Steven-Johnson syndrome
  • Elevated liver enzyme levels & CK
  • Muscle disorders
  • C.Difficile infection
  • Intestinal nephritis
  • Rhabdomyolysis
  • Decreased absorption of Vitamin B12 from foods
  • Magnesium deficiency
  • Osteoporosis & bone fractures.


Pantoprazole is contraindicated & precaution is advised in patients with following conditions:

  • Autoimmune deficiency
  • Existing B12 deficiency
  • Existing Magnesium deficiency
  • Anemia
  • Liver impairment
  • Renal impairment
  • People who are on treatment of fungal infections
  • Osteoporosis
  • Osteomyelitis
  • In patients with ongoing antiviral therapy of rilpirivine
  • Hypersensitivity to PPI drugs.


  • Proton Pump Inhibitors may increase the absorption of Amphetamine.
  • Pantoprazole may decrease the serum concentration of Atazanavir.
  • The serum concentration of cefpodoxime may be decreased in the presence of pantoprazole.
  • Proton pump inhibitors may decrease the bioavailability of doxycycline.
  • The absorption of iron containing products decreases in the presence of PPIs
  • PPIs like Pantoprazole can decrease the absorption & serum concentration, & thus decrease the therapeutic effect of anti fungal drugs like itraconazole & ketoconazole.
  • Proton Pump Inhibitors may increase the serum concentration of Methotrexate.
  • Pantoprazole can decrease the serum concentration of multivitamins & minerals.
  • The serum concentration & therapeutic effect of anti viral drug saquinavir is decreased in presence of pantoprazole.


  • Pregnancy: Pantoprazole is a pregnancy category C drug an its relationship with pregnancy is not completely established.
  • Breast Feeding: The drug is excreted in breast milk & therefore is not recommended in nursing mothers.
  • Children: Pantoprazole is safe to use in children for GERD & esophagitis.