Pantoprazole
About pantoprazole
Pantoprazole reduces the amount of acid your stomach makes.
It's used for heartburn, acid reflux and gastro-oesophageal reflux disease (GORD) – GORD is when you keep getting acid reflux. It's also taken to prevent and treat stomach ulcers.
Sometimes, pantoprazole is taken for a rare condition caused by a tumour in the pancreas or gut called Zollinger-Ellison syndrome.
Pantoprazole comes as tablets.
All types of pantoprazole are available on prescription. You can also buy lower-strength 20mg tablets from pharmacies for heartburn or acid reflux.
Key facts
- You'll usually take pantoprazole once a day in the morning.
- The most common side effects are headaches and diarrhoea. These tend to be mild and go away when you stop taking the medicine.
- You should start to feel better in 2 to 3 days, but it may take up to 4 weeks for pantoprazole to fully control your symptoms.
- If you've bought pantoprazole without a prescription and your symptoms do not improve after 2 weeks, see a doctor before taking any more.
- Pantoprazole is not usually recommended during pregnancy.
Who can and cannot take pantoprazole
Adults and children aged 12 years and over can take pantoprazole.
Pantoprazole is not suitable for some people. To make sure it's safe for you, tell your doctor if you:
- have ever had an allergic reaction to pantoprazole or any other medicine
- have liver problems
- are pregnant, trying to get pregnant or breastfeeding
- are due to have an endoscopy
If you're going to have an endoscopy, ask your doctor if you should stop taking pantoprazole a few weeks before your procedure. This is because pantoprazole may hide some of the problems that would usually be spotted during an endoscopy.
How and when to take pantoprazole
You'll usually take pantoprazole once a day, first thing in the morning.
If you take pantoprazole twice a day, take 1 dose in the morning and 1 dose in the evening.
Dosage and strength
Each tablet contains 20mg or 40mg of pantoprazole.
You can buy pantoprazole 20mg tablets from pharmacies. These are suitable for the short-term treatment of heartburn and acid reflux in adults.
The usual dose to treat:
- heartburn and acid reflux is 20mg a day
- gastro-oesophageal reflux disease is 20mg to 40mg a day
- stomach ulcers is 20mg to 40mg a day
- Zollinger-Ellison syndrome is 40mg to 80mg a day – this can increase to 160mg a day depending on how well it works for you
Doses are usually lower for people with liver problems.
How to take it
It's best to take pantoprazole an hour before a meal. Swallow tablets whole with a drink of water.
Changes to your dose
Sometimes your doctor will increase your dose of pantoprazole if it's not working well enough.
Depending on the reason you take pantoprazole, you may take a higher dose to begin with, usually for a month or 2. After this, your doctor may recommend that you take a lower dose.
How long to take it for
If you buy pantoprazole from a pharmacy, you can usually take it for up to 2 weeks.
After 2 weeks:
- if your symptoms have improved, you can take it for another 2 weeks
- if your symptoms have not improved or they are worse, speak to a doctor before taking any more pantoprazole
Do not take pantoprazole for more than 4 weeks without speaking to your doctor first. If your symptoms have not improved, you may need some tests to find out what's causing them.
If you take pantoprazole on prescription, you may only need to take it for a few weeks or months, depending on your condition. Sometimes your doctor may advise you to take it for longer, even for many years.
Some people do not need to take pantoprazole every day and take it only when they have symptoms. Once you feel better (often after a few days or weeks), you can stop taking it.
Taking pantoprazole just on days when you have symptoms is not suitable for everyone. Speak to your doctor about what's best for you.
If you forget to take it
If you usually take pantoprazole:
- once a day – take the missed dose as soon as you remember, unless your next dose is due in less than 12 hours in which case skip the missed dose and take the next one at the usual time
- twice a day – take the missed dose as soon as you remember, unless your next dose is due in less than 4 hours in which case skip the missed dose and take the next one at the usual time
Never take a double dose to make up for a forgotten one.
If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember to take your medicine.
If you take too much
It is very unlikely that taking extra doses of pantoprazole will cause any problems. But if you're concerned, contact your doctor.
Side effects
Most people who take pantoprazole do not have any side effects. If you do get a side effect, it is usually mild and will go away when you stop taking pantoprazole.
These side effects happen in 1 in 100 people. Talk to your pharmacist or doctor if these side effects bother you or do not go away:
- headaches
- diarrhoea
Serious side effects
Serious side effects are rare and happen in less than 1 in 1,000 people.
Call a doctor or call 111 straight away if you have:
- joint pain along with a red skin rash, especially on parts of your body exposed to the sun, such as your arms, cheeks and nose (this may be less noticeable on brown or black skin) – these can be signs of a rare condition called subacute cutaneous lupus erythematosus. This can happen even if you've been taking pantoprazole for a long time
- stomach pain that gets worse, the whites of your eyes turn yellow or your skin turns yellow (this may be less obvious on brown or black skin), or dark pee – these can be signs of liver problems
- pain when you pee, peeing less than usual, lower back pain, swollen ankles, and rash or a high temperature – these can be signs of a kidney problem
- severe or persistent diarrhoea – this can be a sign of an inflamed bowel
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to pantoprazole.
These are not all the side effects of pantoprazole. For a full list see the leaflet inside your medicine packet.
How to cope with side effects of pantoprazole
What to do about:
- headaches – make sure you rest and drink plenty of fluids. It's best not to drink too much alcohol. Ask your pharmacist to recommend a painkiller. Headaches usually go away after the first week of taking pantoprazole. Talk to your doctor if they last longer than a week or are severe.
- diarrhoea – drink plenty of water or squash by having small, frequent sips to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor. If diarrhoea does not get better, talk to your doctor.
Pregnancy and breastfeeding
Pantoprazole and pregnancy
Pantoprazole is not usually recommended if you're pregnant because there is little information about its use during pregnancy. Your doctor may recommend a similar medicine called omeprazole instead as there is more safety information available.
You may wish to try to treat your symptoms without taking medicine. You can try eating smaller meals more often, and avoiding fatty and spicy foods. Sit up straight when you eat, as this will take the pressure off your stomach.
If you get symptoms at night, you could prop your head and shoulders up when you go to bed. This helps to stop stomach acid coming up while you sleep.
Pantoprazole and breastfeeding
If your doctor or health visitor says your baby is healthy, it's OK to take pantoprazole while you're breastfeeding.
There is a little information available which shows that pantoprazole passes into breast milk in tiny amounts and your baby will not absorb a lot into their body from the breast milk.
It is unlikely that pantoprazole will cause any side effects in your baby.
Cautions with other medicines
Some medicines and pantoprazole can affect each other and make you more likely to have side effects or stop one of the medicines working as well.
Tell your doctor if you're taking any of these medicines before you start pantoprazole treatment:
- antifungal medicines such as itraconazole, ketoconazole, posaconazole and voriconazole
- fluvoxamine, an antidepressant
- methotrexate, a medicine used to treat cancer, psoriasis and rheumatoid arthritis
- HIV medicines
- rifampicin, an antibiotic
- medicines that hep to prevent blood clots, such as warfarin
Mixing pantoprazole with herbal remedies and supplements
Do not take St John's wort, the herbal remedy for depression, while you're taking pantoprazole. St John's wort may stop pantoprazole working as well as it should.
There's not enough information to say that other complementary medicines and herbal remedies are safe to take with pantoprazole. They're not tested in the same way as pharmacy and prescription medicines. They're generally not tested for the effect they have on other medicines.