Pantoprazole helps with heartburn

Every second German knows the painful feeling that occurs with  heartburn  (reflux disease) when the stomach acid flows back into the esophagus. The active ingredient pantoprazole can help here, as it reduces acid production in the stomach. Pantoprazole is therefore also used for ulcers in the stomach and duodenum and for abnormal overproduction of gastric acid, the so-called Zollinger-Ellison syndrome. As with other medications, taking pantoprazole is also associated with side effects.

How pantoprazole works

Pantoprazole belongs to the  proton pump inhibitor group,  which also includes the active substances esomeprazole, lansoprazole,  omeprazole  and rabeprazole. Proton pump inhibitors reduce the production of acid in the stomach.

From a chemical point of view, gastric acid is hydrochloric acid, which is made up of positively charged hydrogen protons and negatively charged chloride ions. However, only the hydrogen protons are important for the acidic properties of the gastric juice. As the name suggests, the proton pump inhibitors hinder the work of the proton pumps and thus ensure that fewer protons get into the stomach. As a result, the concentration of gastric acid decreases and the pH value in the stomach increases.

Compared to the other proton pump inhibitors, pantoprazole is characterized by a rapid onset of action and a long-term effectiveness. Because of its  rapid effect  , pantoprazole can also be used spontaneously for heartburn when the symptoms appear.

Treat ulcers with pantoprazole

However, pantoprazole is effective not only for  heartburn  , but also helps patients suffering from ulcers in the gastrointestinal tract. In the affected areas, the mucous membrane is often severely damaged by the stomach acid, which can lead to severe  stomach pain  . As a result of the damaged gastric mucosa, the layers of tissue beneath the mucosa are exposed and are usually also damaged. Pantoprazole speeds up the healing of ulcers by stopping the cause of the damage, stomach acid. It also helps relieve cramping pains that occur especially when the digestive tract is active.

Proton pump inhibitors such as pantoprazole are also used when drugs are taken that can cause damage to the gastrointestinal tract, for example from the group of non-steroidal anti-inflammatory drugs (NSAIDs). In such cases, pantoprazole as a gastric  protector can prevent the development of ulcers  or heal ulcers that have already formed.

Ulcers are often caused by the bacterium Helicobacter pylori, which is present in over 80 percent of all patients who suffer from an ulcer. To combat this germ, pantoprazole is often taken together with  antibiotics for a week  . This treatment method is called  eradication therapy  .

Dosing of pantoprazole

This is to be considered when dosing pantoprazole:

  • In the case of acute symptoms, a dose of 40 mg pantoprazole can be taken over a longer period of time.
  • If it is only used preventively, a dose of 20 mg is sufficient. Pantoprazole is taken as a preventive measure to prevent inflammation in the stomach, duodenum and esophagus.
  • From a dose of 80 mg, pantoprazole should be taken twice a day. This dosage is recommended, for example, for long-term therapy of the Zollinger-Ellison syndrome or in eradication therapy for the therapy of Helicobacter pylori.

Low-dose medicines with the active ingredient pantoprazole are now   available in pharmacies without a prescription . In general, however, the dosage of pantoprazole should always be agreed with the doctor treating you.

Pantoprazole side effects

As with other medications, pantoprazole can also have side effects when taking the active ingredient. Pantoprazole is generally considered to be well tolerated.

These side effects can occur when taking pantoprazole:

However, particular attention should be paid to kidney inflammation. This side effect is particularly insidious as its symptoms are similar to those that led to the ingestion of pantoprazole. If nausea and vomiting continue to occur during treatment, kidney inflammation should definitely be considered as a possible cause. Permanent damage to the kidneys can only be avoided if the intake of pantoprazole is stopped in good time and the kidneys are then treated.

Very rarely  , taking pantoprazole can also lead to other serious side effects such as liver damage or severe skin reactions. For a detailed list of the side effects of pantoprazole, please refer to the  package leaflet.

Is long-term use of pantoprazole dangerous?

The long-term use of pantoprazole and other proton pump inhibitors is controversial because they may impede the absorption of vitamins and nutrients and promote intestinal infections and are associated with various other side effects. However, a 2019 study suggests that these fears are unfounded in the case of pantoprazole.

Nevertheless, it is advisable not to take the drug permanently without necessity or consultation with the treating doctor.

Pantoprazole: Interactions

To date, only a few interactions of pantoprazole with other drugs have been identified. Taking pantoprazole changes the acidity in the stomach. This can impair the absorption of certain active substances into the bloodstream. These active ingredients include, for example, the AIDS active ingredient atazanavir and the active ingredients ketoconazole and itraconazole, which are used to treat fungal diseases.

Interactions with pantoprazole can also occur with medicines that  affect blood clotting  : When taking anticoagulants such as warfarin, care must be taken to ensure that blood clotting is checked regularly by a doctor. Pantoprazole, like all other active ingredients from the group of proton pump inhibitors, also impedes the effectiveness of the blood thinner clopidogrel. Therefore, these two active ingredients should not be taken together if possible.

 An increase in the level of the active substance in the blood has also been observed with simultaneous treatment with high doses of the active substance  methotrexate  (a drug used, for example, to treat cancer and  psoriasis ). It may therefore be advisable to stop treatment with pantoprazole in such cases, in consultation with the doctor.

Pantoprazole: contraindications and precautions

In the following cases, special caution is required when taking pantoprazole or it is even discouraged from using it altogether:

  • As with other medicines, pantoprazole should  not be taken if you are hypersensitive  to the active ingredient.
  • Liver enzyme values ​​must be checked regularly in patients with severely impaired liver function  If the doctor treating you notices an increase in the values, treatment with pantoprazole must be discontinued.
  • The effects of taking pantoprazole during  pregnancy and lactation  have not yet been adequately researched. In an animal experiment, however, it was found that a high dose of pantoprazole can cause harm to the unborn child. Therefore, the active ingredient should only be used in urgent cases. The active ingredient omeprazole is considered the best-studied alternative.
  • The  drug should also not be used in children  , as there is not enough knowledge about possible side effects.
  • In general, when taking pantoprazole, it should be noted that the active ingredient can mask the symptoms of  stomach cancer  . Therefore, this diagnosis must first be ruled out by a doctor before therapy with pantoprazole can begin.
  • In the case of  long-term  use, one should also bear in mind that the reduced acidity of the gastric juice can lead to a  vitamin B12  deficiency.


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