Pantoprazole (pan-TOE-pra-zole)

Treats gastroesophageal reflux disease (GERD), a damaged esophagus, and conditions that cause your stomach to make too much acid, including Zollinger-Ellison syndrome. This medicine is a proton pump inhibitor (PPI).

Brand Name(s):

Protonix

When This Medicine Should Not Be Used:

How to Use This Medicine:

Packet, Tablet, Delayed Release Tablet, Long Acting Tablet

• Your doctor will tell you how much medicine to use. Do not use more than directed.
• Delayed-release tablet: Swallow the tablet whole. Do not crush, break, or chew it.
• Delayed-release packet: Take the medicine mixed in apple juice or applesauce at least 30 minutes before a meal. It may also be given using a nasogastric tube when mixed in apple juice only.
  • To prepare with applesauce:
    • Mix the packet contents with 1 teaspoon of applesauce. Do not mix with water or other liquids or food. Do not divide the packet contents to make smaller doses.
    • Swallow the mixture within 10 minutes after you mix it. Do not chew or crush the granules.
    • Sip some water after you take the mixture to make sure you swallow all of the medicine.
  • To prepare with apple juice:
    • Mix the packet contents with 1 teaspoon of apple juice in a small cup. Do not divide the packet contents to make smaller doses.
    • Stir for 5 seconds and drink the mixture immediately. Do not chew or crush the granules.
    • To make sure you get all of the medicine, add more apple juice to the cup. Drink it immediately.
  • To prepare for a feeding tube:
    • Pour the packet contents in a 2-ounce (60 milliliter [mL]) catheter-tip syringe.
    • Add 10 mL of apple juice to the syringe. Add the mixture to the tube. Gently tap or shake the barrel of the syringe to help empty it.
    • Add 10 mL of apple juice to the syringe and put it in the tube. Do this at least 2 times. There should be no granules left in the syringe.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use pantoprazole together with medicine that contains rilpivirine.
• Some medicines can affect how pantoprazole works. Tell your doctor if you are using any of the following:
  • Ampicillin, atazanavir, dasatinib, digoxin, erlotinib, itraconazole, ketoconazole, methotrexate, mycophenolate mofetil, nelfinavir, nilotinib, saquinavir
  • Blood thinner (including warfarin)
  • Diuretic (water pill)
  • Iron supplements

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, lupus, or osteoporosis.
• This medicine may cause the following problems:
  • Kidney problems, including acute tubulointerstitial nephritis
  • Increased risk of broken bones in the hip, wrist, or spine (more likely if used several times per day or longer than 1 year)
  • Serious skin reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, acute generalized exanthematous pustulosis, and drug reaction with eosinophilia and systemic symptoms (DRESS)
  • Lupus
  • Fundic gland polyps (abnormal growth in the upper part of your stomach)
• This medicine can cause diarrhea. Call your doctor if the diarrhea becomes severe, does not stop, or is bloody. Do not take any medicine to stop diarrhea until you have talked to your doctor. Diarrhea can occur 2 months or more after you stop taking this medicine.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, red skin rash
• Dry mouth, increased thirst, confusion, numbness and tingling around the mouth, fingertips, or feet
• Fever, swelling in your body, unusual weight gain, change in how much or how often you urinate, blood in the urine
• Joint pain, rash on your cheeks or arms that gets worse in the sun
• Seizures, dizziness, fast or uneven heartbeat, muscle cramps or twitching
• Severe diarrhea that does not go away, stomach cramps or pain, nausea, vomiting, loss of appetite, weight loss
• Unusual bleeding, bruising, tiredness, or weakness

If you notice these less serious side effects, talk with your doctor:

• Headache
• Trouble having an erection

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088