Warnings

Pantoprazole Sodium

Medically Reviewed by HaVy Ngo, Pharm.D.

Last Reviewed: Jun 07, 2022

Warnings

What are the risks of taking pantoprazole?

Pantoprazole can cause serious health problems in certain groups of people. You should talk to your healthcare provider if you have any concerns or other treatment options.

Osteoporosis and bone fractures:
Risk factors: taking more than one dose daily; long-term use (1 year or longer); people who are 65 or older; existing high risk of bone fractures
Proton pump inhibitor (PPI) therapy may increase the risk of osteoporosis (weakened bones) of the hip, wrist, and spine (back). This risk increases in people who take multiple daily doses and long-term proton pump inhibitor therapy (a year or longer). PPIs should be used at the lowest dose with the shortest duration of treatment that is appropriate for the condition being treated. If you are at high risk for fractures or osteoporosis, your doctor will help you manage the risk of weakened bones and fractures while you are taking pantoprazole
Lupus:
Risk factors: existing lupus
Lupus is an autoimmune disorder; this is a condition where your immune system attacks your own body. If you already have lupus, taking pantoprazole can worsen it. The hallmark symptoms of lupus are butterfly rash on your face, rash on your body that worsens in sunlight, joint pain, fatigue, fever, muscle pain. Thus, proton pump inhibitor therapy should be used at the lowest dose with the shortest duration of treatment that is appropriate for the condition being treated.
Clostridium difficile-associated diarrhea (CDAD):
Risk factors: being hospitalized
Clostridium difficile (C.diff) is a bacteria. It’s rare, but pantoprazole can cause a life-threatening infection associated with the C.diff bacteria. Symptoms of this infection include bloody, watery diarrhea, severe stomach pain, cramps that do not go away, and fever. This infection can happen as late as two months after the last dose of pantoprazole. You should let your doctor know right away if you experience any of these symptoms. Similar to the risk of osteoporosis, these side effects can be lessened by taking pantoprazole at the lowest dose with the shortest duration of therapy possible.
Kidney problems:
Risk factors: existing kidney problems
It’s very rare, but pantoprazole can cause damage to your kidneys. If you notice body swelling, blood in urine, or decreased urination, you should let your doctor know right away.
Low vitamin B-12 levels:
Risk factors: taking pantoprazole for more than 3 years
Taking pantoprazole over a long time (more than three years) can cause malabsorption of vitamin B-12, leading to anemia (low red blood cells). Your doctor will order blood tests and help you manage this risk while you take pantoprazole.
Low magnesium levels:
Risk factors: taking digoxin (Lanoxin); taking diuretics (water pills)
If you take pantoprazole for 3 months or longer, it can cause low magnesium levels in your blood. Symptoms of low magnesium are muscle cramps/weakness, fast/irregular heartbeat. You should let your doctor know right away if you experience any of these symptoms.

What should I tell my doctor before starting pantoprazole?

Pantoprazole is not approved to be used by children younger than 5 years old.

Let your doctor know if you are allergic to pantoprazole or any proton pump inhibitor. Ask your doctor or pharmacist if you are unsure if your medicines are proton pump inhibitors.

Before starting pantoprazole treatment, let your doctor know if you have:

Low magnesium level in your blood
Osteoporosis (weakened bones)
Lupus
If you are pregnant or planning to get pregnant. It is not known if pantoprazole will harm your unborn baby.
If you are breastfeeding or planning to breastfeed, pantoprazole may pass into breast milk.

Early symptoms of a heart attack can be similar to symptoms of heartburn. You should seek emergency medical care if you have chest pain that spreads to your jaw or shoulder with anxiousness and lightheadedness.

If you are 50 years or older and have to take pantoprazole long-term more than once daily, you should talk to your doctor about the different ways to keep your bones healthy to prevent fractures.

What proper medical care should I take while on pantoprazole?

Pantoprazole can cause Clostridium Difficile (C. diff) associated diarrhea (CDAD), a rare but serious bacterial infection. Let your doctor know if you have bloody, watery diarrhea, severe stomach pain that does not go away.

Keep all doctor and blood test appointments. Your doctor will order blood tests to monitor your magnesium levels, bone health and ensure the safety and efficacy of pantoprazole therapy.

Ask your doctor or pharmacist if you have any questions about your proton pump inhibitor therapy.

What drugs can interact with pantoprazole?

Tell your doctor and pharmacist about all the medicines you take, especially if you take:

Digoxin
Warfarin (Coumadin)
Ketoconazole (Nirozal)
Atanazavir (Reyataz), nelfinavir (Viracept)
Iron supplements
Ampicillin antibiotics
Methotrexate
A diuretic or “water pill”

This is not a complete list. Other drugs, including prescriptions, over-the-counter products, herbal supplements, and vitamins, may interact with pantoprazole. Not all potential drug interactions are listed in this guide. It is highly recommended to keep a list of all the drug products you are using (prescriptions, over-the-counter products, herbal supplements, natural products, and vitamins) and share it with your doctor and pharmacist.

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