Pantoprazole (By mouth)

Introduction

Pantoprazole (pan-TOE-pra-zole)

Treats gastroesophageal reflux disease (GERD) in people who have had damage to the lining of the esophagus. Also treats high levels of acid in the stomach that is caused by a tumor (such as in Zollinger-Ellison syndrome). This medicine is a proton pump inhibitor (PPI).

Brand Name(s)

Protonix, Protonix TR

When This Medicine Should Not Be Used

How to Use This Medicine

Packet, Delayed Release Tablet, Long Acting Tablet

• Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
• Swallow the delayed-release tablet whole. Do not split, crush, or chew it. You may take the tablet with or without food. It may also be taken at the same time with antacids.
• The delayed-release oral suspension granules should only be mixed with applesauce or apple juice. Do not mix the granules with water, other liquids, or food. Do not chew or crush the granules. Take the mixture at least 30 minutes before a meal. If you have a nasogastric feeding tube, make sure the tube is not clogged before you put this medicine in the tube with apple juice.

If a dose is missed:

• If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine

• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.
• Keep all medicine away from children and never share your medicine with anyone.

Drugs and Foods to Avoid

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

• Make sure your doctor knows if you are also using ampicillin (Omnipen®, Polycillin®, Principen®, Totacillin®), atazanavir (Reyataz®), iron supplements (Feosol®, Fer-In-Sol®), ketoconazole (Nizoral®), or a blood thinner such as warfarin (Coumadin®).
• Make sure your doctor knows if you are also using digoxin (Lanoxin®), a diuretic or "water pill" (such as bumetanide, chlorothiazide, ethacrynic acid, furosemide, hydrochlorothiazide [HCTZ], indapamide, metolazone, torsemide, Bumex®, Demadex®, Diuril®, Edecrin®, Lasix®, Lozol®, or Zaroxolyn®), or certain medicines to treat high blood pressure (such as atenolol, enalapril, lisinopril, losartan, metoprolol, olmesartan, valsartan, Accupril®, Cozaar®, Diovan®, Lotrel®, Toprol®, or Zestril®).

Warnings While Using This Medicine

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have bone problems (such as osteoporosis), or a history of low magnesium in the blood or seizures.
• This medicine may increase your risk of having fractures of the hip, wrist, and spine. This is more likely if you are 50 years of age and older, if you receive high doses of this medicine, or use it for one year or more.
• This medicine may cause hypomagnesemia (low magnesium in the blood). This is more likely to occur if you are taking this medicine for more than one year, or if you are taking this medicine together with digoxin (Lanoxin®) or certain diuretics or "water pills". Stop using this medicine and check with your doctor right away if you have convulsions (seizures); fast, racing, or uneven heartbeat; muscle spasms (tetany); tremors; or unusual tiredness or weakness.
• Make sure any doctor or dentist who treats you knows that you are using this medicine. This medicine may affect the results of certain medical tests.
• If you will be taking this medicine for a long time, it may make it harder for your body to absorb vitamin B-12. Tell your doctor if you have concerns about vitamin B-12 deficiency.
• Do not stop using this medicine suddenly without asking your doctor. You may need to slowly decrease your dose before stopping it completely.
• Your doctor will need to check your progress at regular visits while you are using this medicine. Be sure to keep all appointments. Blood tests may be needed to check for unwanted effects.

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, or loosening of the skin.
• Convulsions (seizures), muscle spasms (tetany), or tremors.
• Dark-colored urine or pale stools.
• Difficulty with breathing or swallowing.
• Fast, pounding, or uneven heartbeat.
• Increase in how much or how often you urinate.
• Increased hunger or thirst.
• Unusual tiredness or weakness.
• Yellowing of your skin or the whites of your eyes.

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

• Bloating and gas.
• Diarrhea, nausea, vomiting, or stomach pain.
• Headache.
• Mild skin rash.
• Trouble with sleeping.

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