Pantoprazole

What is pantoprazole?

Pantoprazole is a proton pump inhibitor (PPI) that functions by decreasing the production of stomach acid. It is available in tablet form – typically in strengths of 20mg or 40mg – and is prescribed for various conditions associated with excess stomach acid. All types of pantoprazole are available on prescription, but you can get lower strength 20mg tablets from pharmacies for heartburn or acid reflux in adults over 18 for a maximum of 4 weeks[1]. 

What is pantoprazole used for?

Pantoprazole is commonly prescribed to treat acid-related stomach and oesophagus conditions. These can include heartburn and acid reflux, gastro-oesophageal reflux disease (GORD), stomach ulcers, and Zollinger-Ellison syndrome – a rare condition where a tumour causes the stomach to produce too much acid[1]. 

How does pantoprazole work?

Pantoprazole blocks proton pumps in the stomach lining, reducing gastric acid production. This helps relieve symptoms, prevents stomach lining damage, and allows ulcers or inflammation to heal[1]. 

Who can take pantoprazole?

Most adults and children aged 12 and over can safely take pantoprazole. However, it may not be suitable for everyone, especially those who[1]: 

• Are allergic to pantoprazole or any of the ingredients listed as part of the medication 

• Have had an allergic reaction to other proton pump inhibitors in the past 

• Have severe liver problems 

• Have low levels of magnesium or vitamin B12 (pantoprazole may cause these levels to decrease further) 

• Are pregnant, trying to get pregnant, or breastfeeding 

• Are scheduled to have an endoscopy, as pantoprazole can affect the results 

Please tell your doctor or pharmacist about any conditions you may have or medication you take before you start treatment, and always follow the instructions in the Patient Information Leaflet[2].  

How do you take pantoprazole?

You’ll generally take pantoprazole once daily, preferably in the morning, approximately one hour prior to a meal. The tablet must be swallowed whole with a glass of water and should not be chewed, crushed, or split. If pantoprazole is prescribed to be taken twice daily, the first dose should be taken in the morning and the second dose in the evening, adhering to the same guidelines[1]. 

What is the typical dosage of pantoprazole?

Each tablet contains either 20mg or 40mg of pantoprazole. The usual dose depends on the condition being treated. It’s typically prescribed at between 20 to 40mg per day, although this may be higher for some conditions. Your doctor or pharmacist may adjust your dosage if you have liver problems or depending on how you respond to treatment[1]. 

Can you stop taking pantoprazole suddenly?

It’s important not to stop taking pantoprazole suddenly, especially if you have been using it long-term. This is because stopping abruptly may lead to rebound acid production – where your stomach starts producing more acid than before. Symptoms can return if this happens. Instead, your doctor may advise reducing the dose gradually[1]. 

What should you do if you take too much pantoprazole?

If you accidentally take more pantoprazole than prescribed, you may experience side effects such as headache, nausea, dizziness, or stomach discomfort. Taking too much is unlikely to cause serious harm, but you should contact NHS 111 or speak to your doctor for advice if you are concerned or feel unwell[1]. 

What should you do if you forget a dose of pantoprazole?

If you miss a dose of pantoprazole, you should take it as soon as possible. But if it's almost time for your next dose, skip the missed one. Never double up doses[1].  

What medicines should you avoid while taking pantoprazole?

Pantoprazole can interact with some other medicines, including antidepressants such as fluvoxamine, certain HIV treatments, rifampicin, methotrexate, a herbal remedy called St John’s wort, and warfarin, which may increase the risk of bleeding. Some antifungal medicines, including ketoconazole, may not work as well when taken with pantoprazole.. Iron supplements may likewise be less effective if taken with pantoprazole[1].  

Always inform your doctor or pharmacist about all medications and supplements you take before you start a new medicine, and follow the instructions in the Patient Information Leaflet[2]. 

What are the side effects of pantoprazole?

Pantoprazole can cause several common but mild side effects, such as[1]: 

• Headaches 

• Nausea and vomiting  

• Stomach pain 

• Constipation 

• Dry mouth 

• Feeling tired  

Serious side effects of pantoprazole are rare but may include[1]: 

• Severe diarrhoea and stomach pains 

• A severe rash and joint pains (may be symptoms of subacute cutaneous lupus erythematosus) 

• Yellowing of the skin and eyes, or dark urine may be signs of liver problems 

• Low magnesium levels (symptoms include a raised pulse, dizziness, muscle twitches, and fatigue) 

• Weakening of the bones (osteoporosis) and an increased risk of bone fractures with prolonged use  

You should contact your GP if you experience any of these symptoms. In rare cases, the medicine may cause a serious allergic reaction (anaphylaxis). You should call 999 or visit A&E immediately if you believe this is happening[1]. 

Symptoms of anaphylaxis include[1]:  

• Difficulty breathing  

• Tightness in throat and chest  

• Swelling of the tongue or throat  

• Feeling faint or dizzy  

• Blue/grey skin or lips  

• Loss of consciousness 

If you experience any side effects, including those not listed, you are encouraged to report them via the Yellow Card Scheme or contact your doctor, pharmacist, or nurse. This information is intended as a summary for general awareness and does not replace professional medical advice. 

The information provided in the side effects section is not a comprehensive list of all possible side effects associated with this medication. For a complete list of side effects, please refer to the Patient Information Leaflet (PIL) provided with your medication or consult your healthcare professional[2]. 

Frequently asked questions about pantoprazole

How long does pantoprazole take to work? 

Pantoprazole can start to relieve symptoms in two to three days after you start taking it. It might, however, take up to four weeks to feel the full effect[1]. 

Can I take pantoprazole long term? 

Yes, pantoprazole can be taken long term, but this should always be under medical supervision to monitor for potential risks[1]. 

Is pantoprazole safe during pregnancy? 

Pantoprazole is not usually recommended during pregnancy unless it’s been advised by your doctor. You should always discuss the risks and benefits before starting treatment[1]. 

Can I drink alcohol while taking pantoprazole? 

Yes, you can drink alcohol while taking pantoprazole. Bear in mind that alcohol may worsen symptoms of acid reflux, so it is best to limit or avoid it if it does affect you[1]. 

Can I take antacids with pantoprazole? 

You can usually take antacids along with pantoprazole, but they should be taken at a different time of day. As a rule, leave at least two hours between taking pantoprazole and an antacid, and speak to your doctor or pharmacist if you have any questions[1]. 

Is pantoprazole the same as omeprazole? 

Pantoprazole and omeprazole are both proton pump inhibitors – but they are different drugs. A medical professional should suggest the most suitable option for you based on your condition and how you respond[1]. 

Can I take pantoprazole with food? 

Pantoprazole is generally best taken on an empty stomach, ideally about an hour before eating, for the best effect. You should avoid taking it with grapefruit or grapefruit juice[1]. 

Can I buy over the counter? 

You can usually buy 20mg pantoprazole tablets over the counter for short-term treatment of reflux symptoms in adults over 18 only. However, if your symptoms last longer than two weeks, you should speak to a doctor or pharmacist for personal advice[1]. 

For the official NHS guide to pantoprazole, visit their website.