Protonix (Pantoprazole)

(℞) Prescription Required - Protonix is also marketed as Pantpas and Somac

Protonix (Pantoprazole) Dosage and Side Effects

PROTONIX is a prescription drug used as a short-term treatment for gastroesophageal reflux disease (GERD). PROTONIX may also be used for a longer period of time for maintenance or healing of erosive esophagitis, and to treat conditions where the stomach produces too much acid, such as Zollinger-Ellison syndrome.

Warnings and Precautions

PROTONIX shouldn't be used for the immediate relief of heartburn symptoms.

Don't take PROTONIX if you're allergic to any other benzimidazole medications such as albendazole (Albenza) or mebendazole (Vermox).

Long-term use of PROTONIX may make it harder for your body to absorb vitamin B-12, which could result in a B-12 deficiency.

PPI use may also increase your risk for fractures in your wrists, hips, or spine. In 2010, however, the FDA decided that there was not enough evidence of fracture risk to merit a warning.

Extended use of PROTONIX has been shown to cause stomach cancer in animal studies, but researchers are unsure if the medication has the same effects in humans.

PROTONIX may be used in children five years of age and older for up to eight weeks to heal acid-related damage to the esophagus. It's not known if the drug is safe for longer than eight weeks of use in children.

Tell your doctor if you are allergic to any of the ingredients in PROTONIX. You can ask your pharmacist for a list of the ingredients.

PROTONIX and Magnesium

Low magnesium levels can also occur in people on PROTONIX for at least three months.

Tell your doctor if you have ever had low magnesium in your blood or if you have ever tested positive for the bacteria H. pylori.

Low magnesium levels can result in serious adverse events such as:

  • Muscle spasms
  • Irregular heartbeat
  • Seizures

If you have low magnesium levels while using PROTONIX, your doctor may advise you to take a magnesium supplement or discontinue treatment.

PROTONIX and Pregnancy

Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding before taking PROTONIX.

Although there is no evidence suggesting that PROTONIX use is harmful during pregnancy, it's recommended that the drug only be used during pregnancy as needed, when no other options are available.

Research indicates that PROTONIX and its metabolites are excreted in the milk of rats, and that they may be excreted in human breast milk as well.

The manufacturer recommends that due to the potential for serious adverse reactions in breastfeeding infants, mothers using PROTONIX may want to discontinue breastfeeding or discontinue use of the drug.

Side Effects

The most common side effects of PROTONIX include:

  • Headache
  • Diarrhea
  • Nausea
  • Vomiting
  • Gas
  • Joint pain
  • Constipation

You should call your doctor immediately or get emergency medical help if you experience any of the following side effects:

  • Blistering or peeling skin
  • Rash
  • Hives
  • Itching
  • Swelling of the eyes, face, lips, mouth, throat or tongue
  • Muscle spasms
  • Uncontrollable shaking of a body part
  • Seizures
  • Difficulty breathing or swallowing
  • Hoarseness
  • Irregular, fast, or pounding heartbeat
  • Excessive tiredness
  • Dizziness
  • Lightheadedness
  • Severe diarrhea
  • Stomach pain
  • Fever

Interactions with this medication

Before taking PROTONIX, tell your doctor and pharmacist about all medications you are taking (including vitamins and herbal supplements).

PROTONIX shouldn't be taken with atazanavir (Reyataz) or nelfinavir (Viracept), which are medications used to treat HIV and AIDS.

Other drugs that may interact with PROTONIX include:

  • Ampicillin (Omnipen, Principen, Amcill)
  • Warfarin (Coumadin, Jantoven)
  • Digoxin (Lanoxin, Lanoxicaps)
  • Diuretics (water pills)
  • Antifungals such as ketoconazole (Nizoral), itraconazole (Sporanox), and voriconazole (Vfend)
  • Iron supplements/ferrous sulfate (Feosol, Mol-Iron, Fergon, Femiron)
  • Methotrexate (Trexall)
  • Delavirdine (Rescriptor)

Unless otherwise instructed, you can continue a normal diet and normal activities while taking PROTONIX.

Proper Use of this medication

PROTONIX is supplied as a granule for delayed-release oral suspension, available in one strength (40 mg), and as a delayed-release tablet, available in two strengths (20 mg and 40 mg).

It's also available in an intravenous (IV) solution for hospital use.

Typically, your doctor will prescribe 40 mg daily for four to eight weeks of treatment. The medication should be taken around the same time each day.

Take PROTONIX for the full prescribed length of time as your symptoms may improve before your condition is completely treated.

Delayed-Release PROTONIX

The tablet form of PROTONIX is released in the intestine to prevent breakdown of the medication by stomach acids.

The tablets are usually taken with or without food one or two times daily.

Swallow the tablets whole. Do not split, chew, or crush them.

Delayed Release Granules for Suspension

The packets of delayed-release granules for oral suspension must be mixed with applesauce or apple juice and taken by mouth or given through a feeding tube.

The oral suspension is usually taken 30 minutes before a meal, once or twice daily.


Evidence on the effects of PROTONIX overdose in humans is limited.

Symptoms of overdose in studies of PROTONIX in rats, mice, and dogs included:

  • Hypoactivity
  • Ataxia
  • Tremor

If you suspect an overdose, you should seek emergency medical attention or call the Poison Help Line.

PROTONIX Missed Dose

If you miss a dose of PROTONIX, take it as soon as you remember.

You should skip the missed dose if it is almost time for your next scheduled dose.

Don't take extra doses of this drug.

Other related products

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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