- What is pantoprazole (Protonix)? How does it work (mechanism of action)?
- What are the uses for Protonix?
- What are the side effects of Protonix?
- What is the dosage for Protonix?
- Which drugs or supplements interact with Protonix?
- Is Protonix safe to take if I'm pregnant or breastfeeding?
- What else should I know about Protonix?
What is pantoprazole (Protonix)? How does it work (mechanism of action)?
Pantoprazole is in a class of drugs called proton pump inhibitors (PPIs), which block the production of acid by the stomach. Other drugs in the same class include lansoprazole (Prevacid), omeprazole (Prilosec) and rabeprazole (Aciphex). Proton pump inhibitors are used for the treatment of stomach conditions such as duodenal and peptic ulcers, gastroesophageal reflux disease (GERD), and Zollinger-Ellison syndrome that are 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, and this allows the stomach and esophagus to heal.
The FDA approved Pantoprazole in February 2000.
What are the side effects of Protonix?
Pantoprazole like other PPIs is well tolerated. The most common side effects are:
- Stomach pain
- Gas (flatulence)
- Joint pain
- Sensitivity to sunlight (phototoxic)
Rare side effects include:
Other reported side effects include:
High doses and long-term use (1 year or longer) of pantoprazole may increase the risk of osteoporosis-related fractures of the hip, wrist, or spine. Therefore, it is important 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 fractures of the hip, wrist, or spine. Prolonged use also reduces 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 important to use the lowest doses and shortest duration of treatment necessary for the condition being treated.
What is the dosage for Protonix?
- Pantoprazole used for treatment 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 generally is recommended that tablets be taken approximately 30 minutes prior to meals for maximal effectiveness. Tablets should be swallowed whole and should not be crushed, split or chewed.
Which drugs or supplements interact with Protonix?
- Pantoprazole is less likely than omeprazole (Nexium) to interact with other drugs.
- The absorption of certain drugs may be affected by stomach acidity, and, as a result, pantoprazole and other PPIs that reduce stomach acid also reduce the absorption and concentration in blood of ketoconazole (Nizoral) and increase the absorption and concentration in 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.
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Is Protonix safe to take if I'm pregnant or breastfeeding?
Use of pantoprazole in pregnant women has not been adequately evaluated.
Pantoprazole has not been studied in females who are nursing.
What else should I know about Protonix?
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, and is available over the counter (OTC) or by a prescription from your doctor.
Pantoprazole, brand name Protonix, is a drug that belongs to the class of drugs called proton pump inhibitors (PPIs). Protonix is used for the treatment of GERD (gastroesophageal reflux disease), stomach (peptic) and duodenum ulcers, and Zollinger-Ellison syndrome.
Side effects of Protonix include phototoxicity (sensitivity to light) dizziness, rash, nausea, vomiting, diarrhea constipation, headaches, stomach pain, gas, dizziness, and joint pain. Serious side effects of Protonix are live damage, rhabdomyolysis (muscle breakdown), pancreatitis, and reduces levels of blood cells.
Adverse effects and risks of Protonix used in high doses and long-term (one year or longer) include osteoporosis, C. diff infection, low levels of magnesium, and heart attacks.
The Dosage for Protonix depends on the stomach condition being treated. Pantoprazole is available over the counter (OTC) and by prescription in higher doses from a doctor. The safety of using Protonix during pregnancy and breastfeeding has not been established. Discuss all supplements and drugs that you are taking with your doctor.
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Related Disease Conditions
GERD (Acid Reflux, Heartburn)
GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid contents of the stomach backs up into the esophagus. The symptoms of uncomplicated GERD are: heartburn, regurgitation, and nausea. Effective treatment is available for most patients with GERD.
H. pylori (Helicobacter Pylori) Infection
Helicobacter pylori (H. pylori) is a bacteria that causes chronic inflammation (gastritis) of the inner lining of the stomach, and also is the most common cause of ulcers worldwide. About 50% of people in the world carries or is infected with H. pylori. Common symptoms of H. pylori infection are occasional abdominal discomfort, bloating, belching or burping, and nausea and vomiting. H. pylori infection is difficult to eradicate, and treatment is with two or more antibiotics.
Peptic Ulcer (Stomach Ulcer)
Peptic or stomach ulcers are ulcers are an ulcer in the lining of the stomach, duodenum, or esophagus. Ulcer formation is related to H. pylori bacteria in the stomach, use of anti-inflammatory medications, and cigarette smoking. Symptoms of peptic or stomach ulcers include abdominal burning or hunger pain, indigestion, and abdominal discomfort after meals. Treatment for stomach ulcers depends upon the cause.
Reflux Laryngitis (Diet, Home Remedies, Medicine)
Reflux laryngitis is caused by acid refluxing back up through the esophagus and voice box. Reflux laryngitis causes irritation and inflammation of the lining of the esophagus, larynx, and throat; and can lead to symptoms, signs, and other problems like esophagitis, sinusitis, strictures, throat clearing, swallowing problems, asthma, chronic cough, and growths on the vocal cords. Typical symptoms of reflux laryngitis include heartburn, hoarseness, or a sensation of a foreign body in the throat. Reflux laryngitis can be treated with diet chanes, OTC medication, prescription medication, and lifestyle changes.
Barrett's esophagus occurs as a complication of chronic gastroesophageal reflux disease (GERD), primarily in white males. GERD refers to the reflux of acidic fluid from the stomach into the esophagus (the swallowing tube), and is classically associated with heartburn. Learn the symptoms, causes, and treatments for Barrett's esophagus.
Pregnancy and Drugs (Prescription and OTC)
Taking prescription medications or over-the-counter drugs or supplements should be discussed with your doctor. There are some medications that have been found to cause no problems in pregnancy, however, medications such as Accutane for acne, should never be taken during pregnancy.
Indigestion (Dyspepsia, Upset Stomach Pain)
Indigestion (dyspepsia) can be caused by diseases or conditions that involve the gastrointestinal (GI) tract, and also by some diseases and conditions that do not involve the GI tract. Indigestion can be a chronic condition in which the symptoms fluctuate in frequency and intensity. Signs and symptoms that accompany indigestion include pain in the chest, upper abdominal pain, belching, nausea, bloating, abdominal distention, feeling full after eating only a small portion of food, and rarely, vomiting.
Esophagitis (Pain, Symptoms, Causes, Grades, and Cure)
Esophagitis is caused by an infection or irritation of the esophagus. Infections that cause esophagitis include candida yeast infection of the esophagus as well as herpes. Signs and symptoms of esophagitis include cough, mouth sores, chest pain, bad breath, sore throat, heartburn, and difficulty swallowing. Treatment of esophagitis includes diet, lifestyle changes, and medication depending upon the cause.
GERD and GER (Acid Reflux) in Infants and Children
GERD (gastroesophageal reflux disease) is the upward movement of stomach content, including acid, into the esophagus and sometimes into or out of the mouth. Common symptoms of GERD in children include colic, feeding problems, poor growth, frequent vomiting or coughing, heartburn, regurgitation, recurrent wheezing, pneumonia, choking, or gagging. Treatment may involve elevating the child's bed, keeping the child upright after eating, limiting foods that seem to make the reflux worse, encouraging your child to exercise, and serving several small meals a day.
Eosinophilic esophagitis is an inflammation of the esophagus. Eosinophilic esophagitis has many causes including acid reflux, heartburn, viruses, medications that become stuck in the esophagus, allergy, asthma, hay fever, allergic rhinitis, and atopic dermatitis. Eosinophilic esophagitis symptoms include difficulty swallowing food, abdominal pain, chest pain, and heartburn.
Gastritis Symptoms, Causes, Diet, Home Remedies, Treatment, and Cure
Gastritis (acute and chronic) is an inflammation of the lining of the stomach Some people have no gastritis symptoms, but when they do occur they may include bloating, belching, loss of appetite, nausea, and vomiting. H. pylori infection and nonsteroidal anti-inflammatory drugs (NSAIDs) are the two main causes of gastritis. Alcohol, caffeine, and high-fat foods also can cause gastritis. Fried, fatty, and spicy foods, and alcohol aggravate gastritis symptoms. Other stomach lining irritants that aggravate symptoms include cigarette smoking, acidic juices, caffeine, tomato products, peppers, and chili powder. Foods that sooth gastritis symptoms, and that help reduce and stop H. pylori infection growth in the stomach include apples, onions, garlic, teas, green leafy vegetables, coconut water, and wheat bran. Gastritis is diagnosed with endoscopy, blood tests, or stool tests. Some people get relief from gastritis symptoms with prescription and non-prescription antacids, histamine blockers like famotidine (Pepcid AC) or ranitidine (Zantac 75), or proton pump inhibitors (PPIs) like omeprazole (Prilosec) and esomeprazole (Nexium). These drugs will not cure gastritis. Complications of gastritis include gastric cancers, MALT lymphoma, renal problems, and death.
Heartburn is a burning sensation experienced from acid reflux (GERD). Symptoms of heartburn include chest pain, burning in the throat, difficulty swallowing, the feeling of food sticking in the throat, and a burning feeling in the chest. Causes of heartburn include dietary habits, lifestyle habits, and medical causes. Treatments for heartburn include lifestyle changes, OTC medication,prescription medication, and surgery.
Heartburn vs. Acid Reflux (Differences and Similarities)
Heartburn and acid reflux are not the same thing. Heartburn is actually a symptom of acid reflux. Heartburn gets its name because it feels like a burning sensation around the heart. Another symptom that occurs with heartburn is a bitter or sour taste in the mouth, usually when you eat or lye down. Heartburn affects more than 60 million people in the US at least once a month. Acid reflux, or GERD, occurs when stomach acid backs up into the esophagus, which irritates it. Heartburn is just one symptom of acid reflux. Other symptoms of acid reflux include: Belching Nausea after eating A feeling of fullness during or after eating Abdominal bloating Upset stomach Belching Wheezing Reflux laryngitis A tightness in the throat Problems swallowing Indigestion In some people, vomiting Causes of acid reflux and heartburn include: Being obese Slouching (poor posture) Medications like calcium channel blockers, theophylline, nitrates, and antihistamines Foods and drinks like caffeine, citrus fruits and vegetables, alcohol, and chocolate Pregnancy Diabetes Increase in stomach acid Eating a heavy meal Eating before bed The treatment for heartburn and acid reflux is to treat the underlying cause, for example, GERD, with over-the-counter (OTC) medicine, prescription medicine, natural remedies, and lifestyle changes like a eating a healthy, less fatty, spicy diet, not eating big meals, not eating before bed, and getting regular exercise to improve your posture.Sometimes a heart attack can mimic heartburn and acid reflux because they feel very similar. If you have symptoms of chest pain, tightness in the chest, heartburn, acid reflux, jaw, tooth, or head pain; shortness of breath, nausea, vomiting, sweating, discomfort in the upper middle of the abdomen, arm or upper back pain, or the general feeling of being ill, go to the nearest Emergency Department immediately because these are the symptoms of a heart attack.REFERENCES:American College of Gastroenterology. "Acid Reflux." 2017.<http://patients.gi.org/topics/acid-reflux/> familydoctor.org. "Heartburn." Updated: Mar 2014.<https://familydoctor.org/condition/heartburn/> National Library of Medicine; PubMed Health. "Heartburn and GERD: Treatment options for GERD." Updated: Nov 18, 2015.<https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072436/>
Heart Attack vs. Heartburn (Differences between Symptoms and Signs)
Heartburn is a symptom of another disease or medical problem and can be described as a feeling of burning in the chest accompanied by symptoms of nausea, vomiting, or a sour taste or food stuck in the back of the throat. Heart attack occurs when an artery in the heart is completely blocked by a blood clot, which causes that portion of heart muscle to die. Heart attack also has symptoms of chest pain, nausea, and vomiting, however, other warning signs and symptoms of a heart attack are unusual weakness or fatigue, and persistent and/or increased severity of symptoms over a few minutes. Heart attack is a life threatening emergency. If you think you or someone you are with is having a heart attack, call 911 immediately for urgent medical treatment. It may save your life.
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