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 uses for Protonix?
Pantoprazole is approved for:
- Treating gastroesophageal reflux disease (GERD)
- Treating ulcers of the stomach (peptic) and duodenum
- Healing erosive esophagitis
- Treating Zollinger-Ellison syndrome
What are the side effects of Protonix?
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 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.
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.