What Is Pantoprazole and What Is It Used For?

Pantoprazole is a medicine used to reduce excess stomach acid. It belongs to a group of drugs called proton pump inhibitors (PPI) and is commonly used to treat:

• Conditions like acid reflux and heartburn - known also as gastroesophageal reflux disease (GORD)

• Stomach and duodenal ulcers

• Erosive oesophagitis caused by acid damage

• Zollinger-Ellison syndrome (a rare condition causing overproduction of acid)

Pantoprazole reduces the amount of acid your stomach produces. It does this by blocking a specific enzyme in the stomach known as a proton pump.

Pantoprazole can be prescribed for both short-term and long-term use depending on the symptoms you are experiencing.

How Does Pantoprazole Work?

Pantoprazole and other proton pump inhibitors work by blocking an enzyme in the stomach reducing acid production.

The resultant benefits are many, especially when the amount of acid the stomach produces is in excess or the acid is causing damage:

Pantoprazole can relieve symptoms of gastro oesophageal reflux disease (GORD) by reducing the burning sensation in the throat caused by acid reflux. As less acid reaches the throat, there is less throat irritation, reducing a cough or sore throat.

It can also help heal the underlying causes of acid-related problems and prevent further damage. By reducing acid, it allows ulcers to heal, reduces the risk of oesophageal cancer and reduces inflammation of the oesophagus (oesophagitis).

Chronic acid reflux can sometimes cause changes in oesophageal lining, known as Barrett's oesophagus, and using pantoprazole to treat acid reflux can help minimise the risk of these changes occurring.

Long term exposure to acid can scar the oesophagus, narrowing it (strictures). Reducing acid by taking pantoprazole can help prevent this.

Less acid irritation and acid reflux can help improve sleep and overall quality of life.

Benefits of Pantoprazole

Pantoprazole is an effective proton pump inhibitor with multiple benefits. It provides long-lasting relief from heartburn and acid reflux disease by reducing stomach acid production. It can also help to heal and prevent stomach ulcers, reducing the risk of further damage.

By decreasing the acid that causes discomfort at night, it can improve sleep by reducing night-time acid symptoms.

Pantoprazole tablets are suitable for adults and children over 12 years (under medical supervision) and is available as 20mg and 40mg tablets, as well as in an injectable form.

Who Can Take Pantoprazole?

Suitable For

Pantoprazole can be taken by adults and children over 12 years and is used to treat conditions caused by too much acid in the stomach. This includes for gastroesophageal reflux disease and heartburn.

Pantoprazole, as a proton pump inhibitor (PPI), prevents too much acid being produced in the stomach. As a result, it can protect the lining of the stomach and food pipe helping symptoms.

People who regularly take NSAIDs, such as ibuprofen or naproxen may be at an increased risk of stomach ulcers. Pantoprazole can help reduce these complications by reducing acid production.

Not Suitable For

If you are having a serious allergic reaction to pantoprazole, seek immediate medical attention.

Whilst pantoprazole tablets can safely be taken by most people, they must not be taken by anyone who is allergic to pantoprazole or other proton pump inhibitors (PPIs).

Signs of a severe allergic reaction include swelling of the throat or tongue, difficulty breathing, wheezing or coughing, blue or pale skin, lips or tongue. If you think you are having an allergic reaction whilst taking pantoprazole, stop treatment and call 999. You may need to speak to your doctor for ongoing treatment requirements if it is confirmed you have an allergy to pantoprazole.

Other people who should not take pantoprazole include those with severe liver problems. As it is broken down in the liver, those with liver disease may not break down the drug properly, leading to higher levels in the blood and an increased risk of side effects.

Individuals with low magnesium levels should speak to their healthcare provider before taking pantoprazole. When used in the long-term, pantoprazole can reduce magnesium levels, leading to tiredness, confusion, muscle twitches and an irregular heartbeat

Any patients presenting with alarm symptoms such as unexplained weight loss, difficult swallowing, vomiting blood or persistent stomach pain must speak to their doctor before starting pantoprazole. These are signs of gastric cancer which need to be ruled out before starting treatment.

Speak to Your Doctor If You

You should talk to your doctor before taking pantoprazole if you are pregnant. They may recommend an alternative acid reflux medication called omeprazole as there is more safety information available.

It is not known how much pantoprazole passes into breast milk so you should talk to your doctor to assess the benefits of the treatment against the potential risk of passing to the feeding infant.

Some medicines rely on acid to be absorbed properly. Because pantoprazole reduces the amount of acid the stomach produces, you should speak to your doctor before starting it if you are taking:

1. Antifungal medicines, such as ketoconazole or itraconazole. These medicines need stomach acid for absorption, so reducing acid may lower their effectiveness, requiring a dose adjustment.

2. HIV treatments, such as atazanavir or nelfinavir. Their absorption also depends on an acidic environment, which pantoprazole may affect.

3. Blood thinners like warfarin or clopidogrel. Using pantoprazole alongside these treatments may be at an increased risk of bleeding.

4. Other medication like methotrexate or tacrolimus. Pantoprazole may increase the levels of these in the blood, requiring a temporary cessation of pantoprazole or dose adjustment of other treatments.

5. Do not take pantoprazole with St John's wort, a herbal remedy for depression as this may affect how it works. Other herbal medicines should also be avoided alongside treatment as there is not enough evidence to confirm safety.

If you are due to have an endoscopy, talk to your doctor as you may need to stop taking pantoprazole a few weeks before your procedure. This is because pantoprazole may hide some of the issues that would usually be seen during an endoscopy.

How to Take Pantoprazole

Recommended Dosage

The usual dose for an adult is one 20mg tablet once daily. This dose is usually sufficient for mild heartburn or acid reflux and helps to relieve symptoms whilst promoting healing of the oesophagus.

For more severe symptoms, the dose can be increased to 40mg once daily. This higher dose provides greater acid suppression, required for healing ulcers and preventing further damage.

How to Take

Pantoprazole tablets should be taken once daily, before a meal and preferably in the morning. The tablets should be swallowed whole with water and should not be crushed or chewed. This can affect the coating on the tablets and reduce its effectiveness.

For those unable to swallow tablets, pantoprazole is available as a solution for injection if appropriate. Alternatively, your healthcare provider may prescribe an alternate treatment such as lansoprazole, available as a disintegrating tablet, suitable for administration through feeding tubes.

Missed or Double Dose

In the case of a missed dose of pantoprazole, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a missed dose, as taking too much pantoprazole may increase the risk of side effects.

Maintaining a regular daily schedule helps to ensure pantoprazole works as intended.

How Long Does Pantoprazole Take to Work?

Whilst taking pantoprazole, you should start to feel better within 2-3 days, though it may take up to 4 weeks for it to work fully.

If you are using pantoprazole for ulcer healing or chronic reflux, continue treatment for 4-8 weeks or as advised by your GP.

Possible Side Effects of Pantoprazole

Common Side Effects

As with all medicines, pantoprazole can cause side effects though not everyone gets them. The most common are headache, nausea, vomiting, diarrhoea or constipation, stomach pain or bloating or dizziness. These are generally mild and often improve as you adjust to the treatment.

Less Common or Serious Side Effects

Less common but potentially severe side effects include a skin rash, joint pain, muscle pain and low magnesium levels. Low levels of magnesium can lead to tiredness and muscle cramps.

Rarely, some people may develop yellow skin or eyes, indicating a liver problem or swelling of the lids, face, throat or difficulty breathing. These are signs of a serious allergic reaction which require immediate medical attention.

Long-Term Use Risks

When pantoprazole is taken for more than 3 months, the levels of magnesium in your blood can fall. Low magnesium may increase tiredness and cause muscle cramps and twitches. For this reason, it must be used with caution in individuals with already low levels.

When taken for over a year, pantoprazole can increase the risk of bone fractures, gut infections and vitamin B12 deficiency. Symptoms of B12 deficiency can include feeling tired, a sore and red tongue, ulcers in the mouth and pins and needles.

If you require long-term use, you should speak to your doctor to weigh the benefits against potential risks.

What to Avoid While Taking Pantoprazole

You should not take pantoprazole alongside other medicines that work in the same way, such as other PPIs or H2 receptor antagonists (such as ranitidine or famotidine). Combining these treatments may alter their effectiveness or increase the risk of side effects.

Avoid fatty foods, spicy foods and too much alcohol or caffeine whilst on pantoprazole. These can affect how much acid is in the stomach and worsen acid reflux symptoms. Smoking should also be avoided as nicotine can also increase acid, reducing effectiveness of treatment and making symptoms worse.

Over the counter antacids or herbal treatments may interfere with how pantoprazole works so you should check with your pharmacist before using at the same time as pantoprazole.

Pantoprazole vs Other PPIs – What’s the Difference?

Other PPIs include lansoprazole, esomeprazole and omeprazole. These all work in the same way as pantoprazole by reducing excess stomach acid. All have similar side effects.

If you feel pantoprazole is not working for you as intended, your provider may suggest an alternative PPI.

Buying Pantoprazole Online from Quick Meds

Quick Meds is a GPhC-registered UK pharmacy, providing safe and reliable access to authentic, UK-sourced medication. You can easily buy pantoprazole tablets online on our user friendly website and benefit from quick, discreet nationwide delivery.

Before purchase you can receive an online consultation with a qualified pharmacist to answer any queries you may have. The clinicians can offer evidence-based lifestyle advice on how to help reduce symptoms by addressing if you drink alcohol, smoke, or dietary advice to prevent weight gain, further preventing symptoms.

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