pantoprazole

Pantoprazole is in a class of drugs called proton pump inhibitors (PPIs), which block acid production by the stomach. Other drugs in the same class include lansoprazole (Prevacid), omeprazole (Prilosec) and rabeprazole (Aciphex). Proton pump inhibitors are used to treat stomach conditions such as duodenal and peptic ulcers, gastroesophageal reflux disease (GERD), and Zollinger-Ellison syndrome caused by stomach acid.

Pantoprazole, like other proton-pump inhibitors, blocks the enzyme in the wall of the stomach that produces acid. By blocking the enzyme, the production of acid is decreased, allowing the stomach and esophagus to heal.

The FDA approved Pantoprazole in February 2000.

Pantoprazole is approved for:

• Treating gastroesophageal reflux disease (GERD)
• Treating ulcers of the stomach (peptic) and duodenum
• Healing erosive esophagitis
• Treating Zollinger-Ellison syndrome

Pantoprazole like other PPIs is well tolerated.

The most common side effects are:

• Diarrhea
• Nausea
• Vomiting
• Constipation
• Rash
• Headaches
• Stomach pain
• Gas (flatulence)
• Joint pain
• Dizziness
• Sensitivity to sunlight (phototoxic)

Rare side effects include:

• Nervousness
• Abnormal heartbeat
• Muscle pain
• Weakness
• Leg cramps
• Water retention

Other reported side effects include:

• Pancreatitis
• Reduced levels of blood cells
• Muscle breakdown (rhabdomyolysis)
• Liver damage

High doses and long-term use (1 year or longer) of pantoprazole may increase the risk of osteoporosis-related hip, wrist, or spine fractures. Therefore, it is essential to use the lowest doses and shortest duration of treatment necessary for the condition being treated.

Proton pump inhibitors may increase the risk of Clostridium difficile infection. High doses and long-term use (1 year or longer) may increase the risk of osteoporosis-related hip, wrist, or spine fractures. Prolonged use also reduces the absorption of vitamin B12 (cyanocobalamin).

Long-term use of PPIs has also been associated with low levels of magnesium (hypomagnesemia). Analysis of patients taking PPIs for long periods showed an increased risk of heart attacks.

Therefore, it is essential to use the lowest doses and shortest duration of treatment necessary for the condition being treated.

• Pantoprazole is used for treating GERD and healing erosive esophagitis the recommended dose for adults is 40 mg daily for 4-8 weeks.
• The dose for treating Zollinger-Ellison syndrome is 40 mg twice daily.
• It is recommended that tablets be taken approximately 30 minutes before meals for maximal effectiveness. Tablets should be swallowed whole and not crushed, split, or chewed.

• Pantoprazole is less likely than omeprazole (Nexium) to interact with other drugs.
• The absorption of certain drugs may be affected by stomach acidity. As a result, pantoprazole and other PPIs that reduce stomach acid also reduce the absorption and concentration in the blood of ketoconazole (Nizoral) and increase the absorption and engagement in the blood of digoxin (Lanoxin). This may lead to reduced effectiveness of ketoconazole or increased digoxin toxicity, respectively.
• Pantoprazole may increase blood level of methotrexate (Trexall, Methotrexate).
• Proton pump inhibitors reduce blood levels of atazanavir (Reyataz) or nelfinavir (Viracept), reducing their effect.
• Proton pump inhibitors may also increase the action of warfarin (Coumadin. Jantoven), increasing the risk of bleeding.
• False positive urine screening tests for tetrahydrocannabinol (THC) may occur in patients receiving proton pump inhibitors. An alternative confirmatory method should be considered to verify positive results.

The use of pantoprazole in pregnant women has not been adequately evaluated.

Pantoprazole has not been studied in females who are nursing.

Protonix is available as:

• Tablets (Delayed Release): 20, 40 mg.
• Suspension: 40 mg.
• Injection: 40 mg

Pantoprazole should be stored at room temperature, 15 C to 30 C (59 F to 86 F). Keep away from moisture.

Pantoprazole is available in generic form over the counter (OTC) or by a prescription from your doctor.