What is pantoprazole?
Pantoprazole is a proton pump inhibitor (PPI) for the treatment of acid-related diseases of the stomach and the esophagus. It is available under the name Pantozol® and as numerous generics.
The particular advantage of pantoprazole compared to omeprazole lies in the lower interaction potential. It affects the enzyme CYP2C19 to a lesser extent and is therefore better combinable with other medicines – especially with the clopidogrel blood platelet inhibitor.
Pantoprazole is one of the most prescribed medicines in Germany.
Active Ingredients & Mechanism of Action
Active ingredient: Pantoprazol
Pantoprazole irreversibly inhibits the proton pump in the document cells:
Active mechanism:
- Prodrug activated in the acidic environment of the document cell
- Covalent binding to the H+/K+-ATPase
- Blocks the gastric acid secretion at the final step
- Acid reduction by up to 90%
Pharmacokinetics:
- Bioavailability approx. 77% (higher than omeprazole)
- Full effect after 2-3 days of regular intake
- Low CYP interaction potential
**Compared to Omeprazole:* * Pantoprazole has a lower affinity to CYP2C19 and CYP3A4, which leads to fewer drug interactions.
Who is it suitable for?
Pantoprazole is suitable for:
- Gastroesophageal reflux disease (GERD)
- Refluxeophagitis
- Gastrointestinal ulcers
- Helicobacter-pylori-Eradikation (combination therapy)
- Gastric protection for NSAID/ASS therapy
- Patients taking Clopidogrel (preferably PPI)
- Zollinger-Ellison Syndrome
Especially suitable for:
- Patients with many accompanying medications (lower risk of interaction)
Available Dosages
Available starches:
- 20 mg (free of prescription)
- 40 mg (prescribed)
Other dosages:
- Sodburning/light reflux: 20 mg 1x daily
- Refluxesophagitis: 40 mg 1x daily for 4-8 weeks
- Gastric protection at NSAID: 20 mg 1x per day
- Helicobacter Eradication: 40 mg 2x daily (with antibiotics)
- Maintenance therapy: 20 mg 1x daily
How to Take
Intake:
- Morning, 30 minutes before breakfast
- Swallow tablet with water
- Gastric juice resistant tablets do not divide
Long-term therapy:
- Regular medical check
- Aim for the lowest effective dose
- In case of flake: gradually reduce dose over 2-4 weeks
**
- Can also be administered intravenously (hospital)
- For liver failure: max. 20 mg daily
Contraindications
**Pantoprazole must not be taken at:* *
- hypersensitivity to pantoprazole or other PPIs
- Simultaneous intake of Atazanavir (HIV drug)
Preview at:
- Heavy liver failure (max. 20 mg, control liver values)
- Long-term use (same risks as other PPIs)
- Suspicion of stomach cancer (Symptome can be masked)
Pregnant period: Limited data. Use only for clear indication.
Possible Side Effects
Acid (1-10%):
- Headaches
- Oversized pain
- diarrhea
- Blocking
- Blowing
Occasionally:
- nausea, vomiting
- Squeeze
- Sleep disorders
- joint pain
For long-term use:
- Magnesium deficiency (muscle cramps, cardiac arrhythmias)
- Increased fracture risk
- Vitamin B12 deficiency
- Possible risk for Clostridium difficile infections
** Side effect profile comparable to other PPIs. Long-term risks affect all proton pump inhibitors alike.
Interactions
Low interaction potential – main advantage of pantoprazole.
Reduced absorption by pH increase:
- Ketoconazole, Itraconazole
- Iron preparations
- Erlotinib
No relevant interaction with:
- Clopidogrel (proportion over omeprazole!)
- Metoprolol
- Nifedipine
- Diazepam
Contraint with:
- Atazanavir (HIV-Protease inhibitor) – loss of effect
Frequently Asked Questions
Similar Medications
Is pantoprazole right for you?
A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.
Important Notice
This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor or pharmacist.
Important Safety Information
This service operates under German pharmaceutical law (HWG). For risks and side effects, read the package leaflet and consult your doctor or pharmacist. All medications are dispensed from a licensed pharmacy in Germany.