Pantoprazole 20 Mg

[Jennifer Downey]

Pantoprazoleis used to treat damage from gastroesophageal reflux disease (GERD), a condition in which backward flow of acid from the stomach causes heartburn and possible injury of the esophagus (the tube between the throat and stomach) in adults and children 5 years of age and older. Pantoprazole is used to allow the esophagus to heal and prevent further damage to the esophagus in adults with GERD. It is also used to treat conditions where the stomach produces too much acid, such as Zollinger-Ellison syndrome in adults. Pantoprazole is in a class of medications called proton-pump inhibitors. It works by decreasing the amount of acid made in the stomach.

Pantoprazole comes as a delayed-release (releases the medication in the intestine to prevent break-down of the medication by stomach acids) tablet and as delayed-release granules to take by mouth. The packets of delayed-release granules must be mixed with applesauce or apple juice and taken by mouth or given through a feeding tube. For the treatment and maintenance of GERD, pantoprazole is usually taken once a day. For the treatment of conditions where the stomach produces too much acid, pantoprazole is usually taken twice a day. The delayed-release tablets are usually taken with or without food, and the granules are usually taken 30 minutes before a meal. Take pantoprazole at around the same time(s) every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take pantoprazole exactly as directed. Do not take more or less of it or take it more often or for a longer period of time than prescribed by your doctor.

Swallow the tablets whole; do not split, chew, or crush them. If your doctor has prescribed the 40 mg tablet and it is too big for you to swallow, ask your doctor to prescribe two of the 20 mg tablets instead.

To take the granules, open the packet and either sprinkle the granules onto one teaspoonful of applesauce or into a cup containing one teaspoonful of apple juice. Do not mix the granules with water, other liquids, or other foods. Use all of the granules in the packet; do not divide the granules into smaller doses. If you sprinkle the granules into apple juice, stir the mixture for 5 seconds. Swallow the mixture of applesauce or apple juice and medication right away (within 10 minutes) without chewing or crushing the granules. If you sprinkled the granules on applesauce, take several sips of water to wash the granules down to your stomach. If you sprinkled the granules into apple juice, rinse the cup once or twice with apple juice and drink the apple juice right away to be sure you swallow any leftover granules.

Take the missed dose as soon as you remember it. However, if it is almost time for your next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed dose.

People who take proton pump inhibitors such as pantoprazole may be more likely to fracture their wrists, hips, or spine than people who do not take one of these medications. People who take proton pump inhibitors may also develop fundic gland polyps (a type of growth on the stomach lining). These risks are highest in people who take high doses of one of these medications or take them for one year or longer. Talk to your doctor about the risks of taking pantoprazole.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website ( ) for more information if you do not have access to a take-back program.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

There may be other side effects of pantoprazole that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

Kidney problems. A type of kidney problem called acute tubulointerstitial nephritis can happen at any time during treatment with pantoprazole. If you notice a decrease in the amount of your urine or see blood in your urine, call your doctor right away.

Severe Skin Reactions. Pantoprazole can cause severe skin reactions, such as Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), that can lead to death if not treated. If you develop a rash, stop pantoprazole and call your healthcare provider right away. Get emergency help right away if you have any of the following symptoms of SJS or TEN.

Severe Allergic Reaction called DRESS. Pantoprazole can cause a specific type of allergic reaction called DRESS. DRESS stands for Drug Reaction with Eosinophilia and Systemic Symptoms. It is also sometimes called multi-organ hypersensitivity. This is a reaction that can affect multiple parts of the body including your liver, kidneys, and heart. Stop using the medicine and get help right away if you have any of the following symptoms of this serious allergic reaction.

Lupus. Some medicines, such as pantoprazole, can cause certain types of lupus or cause worsening of lupus you already have. Lupus is an autoimmune disorder where your immune cells attack other cells or organs in your body. Tell your provider right away if you have new or worsening joint pain or a rash on your arms or cheeks.

Vitamin B-12 deficiency. Pantoprazole can cause you to absorb less vitamin B-12 than usual, which can cause low vitamin B-12 levels. You have a higher risk of this if you take pantoprazole for a long time (3 years or longer). Stop using pantoprazole and call your healthcare provider if you have any of the following symptoms.

Hypomagnesemia. Pantoprazole can cause low magnesium levels, also known as hypomagnesemia, which can be serious. Decreased magnesium levels can cause seizures or heart rhythm problems. Some people have a higher risk of this, including people who take the pantoprazole for a long time or those that take other medicines that can cause low magnesium. Stop using pantoprazole and call your healthcare provider if you have any of the following symptoms.

Bone loss and fractures. Pantoprazole may cause bone loss and increase your risk for fractures. The risk is higher in older adults and people taking pantoprazole for a long time or taking a high dose.

Injection site reaction. Pantoprazole injection can cause pain and inflammation around the area where the infusion was given. Tell your healthcare provider if you have pain, swelling, or redness in the area pantoprazole was administered.

Severe Allergic Reactions. Pantoprazole may cause allergic reactions, which can be serious. Stop using pantoprazole and get help right away if you have any of the following symptoms of a serious allergic reaction.

Drug Interactions. Pantoprazole should not be taken while you are using certain other medicines. Before taking pantoprazole, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if pantoprazole is right for you.

Other Medicines and Supplements. Pantoprazole may interact with other medicines and supplements. Before using pantoprazole, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Breastfeeding. Pantoprazole passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take pantoprazole while breastfeeding.

Pantoprazole is used to treat certain conditions in which there is too much acid in the stomach. It is used to treat erosive esophagitis or "heartburn" caused by gastroesophageal reflux disease (GERD), a condition where the acid in the stomach washes back up into the esophagus. This medicine may also be used to treat Zollinger-Ellison syndrome, a condition where the stomach produces too much acid.

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

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