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Pantoprazole, oral tablet

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare professional who knows your medical history.

Pantoprazole Dosage

Medically reviewed by Drugs.com. Last updated on Dec 26, 2022.

Applies to the following strengths: 40 mg; 20 mg

Usual Adult Dose for:

  • Erosive Esophagitis
  • Gastroesophageal Reflux Disease
  • Zollinger-Ellison Syndrome
  • Pathological Hypersecretory Conditions

Usual Pediatric Dose for:

  • Erosive Esophagitis
  • Gastroesophageal Reflux Disease

Additional dosage information:

  • Renal Dose Adjustments
  • Liver Dose Adjustments
  • Dose Adjustments
  • Precautions
  • Dialysis
  • Other Comments

Usual Adult Dose for Erosive Esophagitis

Treatment: 40 mg orally once a day

  • Duration of therapy: 8 weeks
  • If patients are not healed after 8 weeks or erosive esophagitis (EE) recurs with the oral formulation, treatment for another 8 weeks may be considered.
  • Controlled studies using the oral formulation for maintenance did not extend beyond 12 months.
  • Short-term treatment in the healing and symptomatic relief of EE
  • Maintenance of healing of EE

Usual Adult Dose for Gastroesophageal Reflux Disease

Oral: 40 mg orally once a day

  • Duration of therapy: 8 weeks
  • Duration of therapy: 7 to 10 days
  • IV treatment should be discontinued once the patient is able to take an oral formulation.
  • Use of the IV formulation has not been studied for longer than 10 days.
  • Safety and efficacy for uses otherwise described (e.g., life-threatening gastrointestinal bleeds) are not available; however, use of this drug at 40 mg/day doses did not raise gastric pH to sufficient levels to contribute to the treatment of life-threatening conditions.
  • If patients are not healed after 8 weeks with the oral formulation, treatment for another 8 weeks may be considered.
  • Short-term treatment of gastroesophageal reflux disease (GERD) in patients with a history of erosive esophagitis
  • Reduction of relapse rates of daytime and nighttime heartburn symptoms in adult patients with GERD

Usual Adult Dose for Zollinger-Ellison Syndrome

Oral: 40 mg orally 2 times a day

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  • Maximum dose: 240 mg/day
  • Initial dose: 80 mg via IV infusion every 12 hours, given over at least 2 minutes OR over 15 minutes
  • Maintenance dose: 80 mg via IV infusion every 8 to 12 hours, given over at least 2 minutes OR over 15 minutes
  • Maximum dose: 240 mg/day
  • Maximum duration of therapy: 6 days
  • IV treatment should be discontinued once the patient is able to take an oral formulation.
  • Use of the IV formulation for longer than 6 days and/or with doses higher than 240 mg has not been adequately studied.
  • Patients may be vulnerable to increased acid production despite a short period of loss of effective inhibition.
  • Patients given the oral formulation should be continued on therapy for as long as clinically necessary.
  • Treatment of pathological hypersecretory conditions, including Zollinger-Ellison syndrome
  • Pathological hypersecretion conditions, including Zollinger-Ellison syndrome

Usual Adult Dose for Pathological Hypersecretory Conditions

Oral: 40 mg orally 2 times a day

  • Maximum dose: 240 mg/day
  • Initial dose: 80 mg via IV infusion every 12 hours, given over at least 2 minutes OR over 15 minutes
  • Maintenance dose: 80 mg via IV infusion every 8 to 12 hours, given over at least 2 minutes OR over 15 minutes
  • Maximum dose: 240 mg/day
  • Maximum duration of therapy: 6 days
  • IV treatment should be discontinued once the patient is able to take an oral formulation.
  • Use of the IV formulation for longer than 6 days and/or with doses higher than 240 mg has not been adequately studied.
  • Patients may be vulnerable to increased acid production despite a short period of loss of effective inhibition.
  • Patients given the oral formulation should be continued on therapy for as long as clinically necessary.
  • Treatment of pathological hypersecretory conditions, including Zollinger-Ellison syndrome
  • Pathological hypersecretion conditions, including Zollinger-Ellison syndrome
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Usual Pediatric Dose for Erosive Esophagitis

5 years and older:
15 to less than 40 kg: 20 mg orally once a day
40 kg and greater: 40 mg orally once a day
Duration of therapy: Up to 8 weeks

Comment: Safety has not been established in treatment beyond 8 weeks.

  • Short-term treatment in the healing and symptomatic relief of EE
  • Short-term treatment of GERD in patients with a history of EE

Usual Pediatric Dose for Gastroesophageal Reflux Disease

5 years and older:
15 to less than 40 kg: 20 mg orally once a day
40 kg and greater: 40 mg orally once a day
Duration of therapy: Up to 8 weeks

Comment: Safety has not been established in treatment beyond 8 weeks.

  • Short-term treatment in the healing and symptomatic relief of EE
  • Short-term treatment of GERD in patients with a history of EE

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

IV: Data not available

Oral: Doses over 40 mg/day have not been studied in patients with liver impairment. No adjustment recommended.

Dose Adjustments

CYP450 2C19 Poor Metabolizers:
Adults: No adjustment recommended.
Pediatric patients: Oral dose reductions should be considered.

Pathological Hypersecretion (including Zollinger-Ellison syndrome):

  • Acid output target range: Less than 10 mEq/h

Precautions

CONTRAINDICATIONS:

  • Hypersensitivity to the active component, substituted benzimidazoles, or any of the ingredients
  • Patients receiving rilpivirine-containing products

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

  • Tablet formulations should be swallowed whole, without crushing/chewing; tablets may be taken with or without food.
  • For patients unable to swallow a 40 mg tablet, two 20 mg tablets may be taken; however, the 40 mg oral suspension packet formulation should not be divided to create two-20 mg dosages.
  • Oral suspension/granule formulations should be taken on an empty stomach, preferably 30 to 60 minutes before a meal.
  • The granule formulation may be sprinkled into applesauce or mixed into a small volume of either apple juice or orange juice and swallowed immediately. This drug may be mixed with apple juice and administered via nasogastric tube.

Reconstitution/preparation techniques: The manufacturer product information should be consulted.

IV compatibility: The manufacturer product information should be consulted.

  • This drug may be used concomitantly with antacids without affecting the absorption.
  • Reflux symptoms may take 2 to 3 days to improve after initiation.
  • Rapid acid control may be achieved within an hour at an IV dose of 160 mg.
  • HEPATIC: Liver function tests, especially in patients with impaired liver function
  • METABOLIC: Magnesium levels, especially in patients taking other drugs that could result in hypomagnesemia or those on long-term therapy; Vitamin B12 levels, especially in patients on long-term therapy
  • MUSCULOSKELETAL: Bone fractures, especially in patients at high-risk for osteoporosis-related events
  • RENAL: Renal function tests
  • Advise patients to avoid taking concomitant proton pump inhibitors and/or H2 antagonists during treatment.
  • If using this drug to treat H pylori, tell patients that it is important to complete the full regimen.
  • Instruct patients to seek medical attention if signs/symptoms of hypersensitivity, Clostridium difficile, or systemic cutaneous lupus erythematosus occur.
  • Patients should be told that treatment may not provide immediate relief and that they should not take this drug for prophylaxis. Symptomatic relief may occur after 1 day of treatment, but patients should continue treatment for the full duration to achieve complete symptom control.
  • Inform patients that this drug may cause dizziness or blurred vision, and they should avoid driving or operating machinery if these side effects occur.
  • Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.
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Frequently asked questions

  • Pantoprazole vs. omeprazole: What’s the difference between them?
  • Can you take pantoprazole 40 mg twice a day?
  • How long can I take pantoprazole?
  • Does pantoprazole cause bloating?

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Patient resources

  • Drug Information
  • Pantoprazole (Advanced Reading)
  • Pantoprazole Intravenous (Advanced Reading)
  • Pantoprazole Delayed-Release Tablets
  • Pantoprazole Delayed-Release Granules
  • Pantoprazole Injection

Other brands

Professional resources

Related treatment guides

  • Barrett’s Esophagus
  • Dumping Syndrome
  • Erosive Esophagitis
  • Duodenal Ulcer

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Pantoprazole, oral tablet

Pantoprazole oral tablet is a prescription drug that’s available as the brand-name drug Protonix. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in all strengths or forms as the brand-name drug.

Pantoprazole comes in three forms: an oral tablet, an oral liquid suspension, and an intravenous (IV) form that’s injected into your vein by a healthcare professional.

Why it’s used

Pantoprazole oral tablet is used to reduce the amount of stomach acid your body makes. It helps treat painful symptoms caused by conditions such as gastroesophageal reflux disease (GERD). With GERD, gastric juices flow upward from your stomach and into the esophagus.

Pantoprazole oral tablet is also used to treat other conditions in which the stomach makes excess acid, such as Zollinger-Ellison syndrome.

How it works

Pantoprazole belongs to a class of drugs called proton pump inhibitors. It works to shut off the acid-pumping cells in your stomach. It reduces the amount of stomach acid and helps to reduce painful symptoms related to conditions such as GERD.

Pantoprazole oral tablet does not cause drowsiness. However, it can cause other side effects.

More common side effects

The more common side effects that can occur with pantoprazole include:

  • headache
  • diarrhea
  • stomach pain
  • nausea or vomiting
  • gas
  • dizziness
  • joint pain

Serious side effects

Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Low magnesium levels. Using this drug for 3 months or longer can cause low magnesium levels. Symptoms can include:
    • seizures
    • abnormal or fast heart rate
    • tremors
    • jitteriness
    • muscle weakness
    • dizziness
    • spasms of your hands and feet
    • cramps or muscle aches
    • loss of taste
    • Vitamin B12 deficiency. Using this drug for longer than 2 years can make it harder for your body to absorb vitamin B12. Symptoms can include:
    • nervousness
      • neuritis (inflammation of a nerve)
      • numbness or tingling in your hands and feet
      • poor muscular coordination changes in menstruation
      • watery stool
      • stomach pain
      • fever that doesn’t go away
      • flank pain (pain in your side and back)
      • changes in urination
      • rash on the skin and nose
      • raised, scaly, red, or purple rash on your body
      • fever
      • tiredness
      • weight loss
      • blood clots
      • heartburn

      Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare professional who knows your medical history.

      Pantoprazole oral tablet can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk with your doctor or pharmacist.

      To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk with your doctor or pharmacist.

      Examples of drugs that can cause interactions with pantoprazole are listed below.

      HIV drugs

      Taking certain HIV drugs with pantoprazole is not recommended. Pantoprazole may significantly decrease the amount of these drugs in your body. This can reduce their ability to control HIV infection. These drugs are:

      Anticoagulant

      Some people taking warfarin with pantoprazole can experience increases in INR and prothrombin time (PT). This can lead to an increased risk of severe bleeding. If you take these drugs together, your doctor should monitor you for increases in INR and PT.

      Drugs affected by stomach pH

      Pantoprazole affects stomach acid levels. As a result, it can reduce your body’s absorption of certain drugs that are sensitive to the effects of decreased stomach acid. This effect can make these drugs less effective.

      Examples of these drugs include:

      • ketoconazole
      • ampicillin
      • atazanavir
      • iron salts
      • erlotinib
      • mycophenolate mofetil

      Cancer drug

      Taking methotrexate with pantoprazole may increase the amount of methotrexate in your body. If you’re taking high doses of methotrexate, your doctor may have you stop taking pantoprazole during your methotrexate therapy.

      Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare professional about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you’re taking.

      Pantoprazole oral tablet comes with several warnings.

      Allergy warning

      Though it’s rare, pantoprazole can cause an allergic reaction. Symptoms may include rash, swelling, or breathing problems.

      This allergic reaction can progress to interstitial nephritis, a kidney disorder that can lead to kidney failure. Symptoms of this condition include:

      • nausea or vomiting
      • fever
      • rash
      • confusion
      • blood in your urine
      • bloating
      • elevated blood pressure

      If you experience any of these symptoms, call your doctor right away. If your symptoms seem severe or life threatening, go to an emergency room or call 911.

      Warnings for people with certain health conditions

      For people with osteoporosis: Pantoprazole can increase a person’s risk for osteoporosis, a condition that causes bones to become brittle. Tell your doctor if you have a history of osteoporosis.

      For people with low blood magnesium (hypomagnesemia): Pantoprazole can decrease the amount of magnesium in your body. Tell your doctor if you have a history of hypomagnesemia.

      For people being tested for neuroendocrine tumors: Pantoprazole can cause incorrect results in these tests. For this reason, your doctor will have you stop taking this drug at least 14 days before you have this testing. They may also have you repeat the testing if needed.

      Warnings for other groups

      Pregnant people: If you’re pregnant or plan to become pregnant, speak with your doctor about this drug.

      Studies of the drug in pregnant animals have shown risk to the fetus. There aren’t enough studies of pregnant people to show that the drug poses a risk to the fetus.

      Those who are breastfeeding: Pantoprazole may pass through breast milk and could be passed to a breastfeeding baby. Talk with your healthcare professional about other treatment options while breastfeeding.

      For children: Pantoprazole is sometimes used for short-term treatment of erosive esophagitis in children ages 5 and older. This condition is associated with GERD. It causes irritation and damage to the throat from stomach acid. Your child’s doctor will provide the correct dose.

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