Pantoprazole is often used to treat heartburn and stomach ulcers. The active ingredient from the group of proton pump inhibitors reduces acid formation in the stomach and thus protects the sensitive mucous membrane. Which side effects are common and when should the acid blocker not be taken.
Pantoprazole reduces acid production in the stomach. There, glandular cells form an acidic digestive secretion, the gastric juice. In some cases, the stomach produces too much acid, which then attacks the sensitive stomach lining. In such cases, the drug can help.
At a glance:
What is pantoprazole?
Pantoprazole is one of the proton pump inhibitors (PPI, proton pump inhibitor). Like other active substances from the group, it acts on the parietal cells of the stomach. There pantoprazole inhibits the formation of acid, causing the pH value to rise. The drug does not work for acute symptoms, such as one-time heartburn after greasy food. Effects only become noticeable after about a day, when acid production has been reduced for some time and the gastric mucosa can recover.
Other proton inhibitors include:
- omeprazole
- Rabeprazole
- esomeprazole
As with other proton pump inhibitors, pantoprazole is usually administered as an enteric-coated tablet: the acid blocker acts on cells in the stomach, but the active substance is first absorbed in the intestine and then transported to its site of action via the blood.
Mode of action of pantoprazole
The body produces about two liters of gastric juice per day. It consists of different components. The parietal cells of the gastric mucosa release acid (in the form of hydrogen ions or protons). An acidic gastric juice is necessary for digestion, and germs are also killed: it has a disinfecting effect. In order not to digest itself, the stomach protects itself with a tough layer of mucus.
When you are fasting, the pH value is lower – i.e. more acidic – than after eating. In order to lower the pH value again after the meal, the parietal cells have to become active and produce more acid.
The composition of the gastric juice and its pH value can change with an incorrect diet, stress, illness or the intake of medication, for example if too much acid is produced by the parietal cells. This can attack the mucous membrane of the stomach, and the acid can also rise up into the esophagus and cause unpleasant heartburn there.
Areas of application: When is pantoprazole taken?
Pantoprazole is a pharmacy-only drug that is available in different dosages. A low dose of 20 milligrams (mg) of pantoprazole is available without a prescription, the higher dose (40 mg) is only available with a doctor’s prescription.
The proton inhibitor can be prescribed and taken for long-lasting gastric acid-related symptoms such as:
- Inflammation of the esophagus due to rising stomach acid (reflux esophagitis)
- heartburn
- stomach ulcers
- duodenal ulcers
- Inflammation of the stomach lining (gastritis)
Pantoprazole is also used for gastric mucosal inflammation. The trigger for this is often a bacterial pathogen: Helicobacter pylori. Pantoprazole or another proton pump inhibitor is often used as a three-drug combination for chronic gastritis when Helicobacter has been detected. In addition to pantoprazole, a combination of antibiotics such as amoxicillin and clarithromycin are then used for a few days.
In addition, the active ingredient is often administered preventively during long-term pain therapy with non-steroidal anti-inflammatory drugs ( NSAIDs ), since drugs such as ibuprofen or acetylsalicylic acid make the stomach more susceptible to acid-related damage.
How is pantoprazole taken?
Pantoprazole is usually taken in the morning on an empty stomach with some water, about half an hour before breakfast. If the symptoms are very severe, the dose can be increased on medical advice and one tablet can also be swallowed in the evening before dinner.
You should avoid alcohol when taking the drug: On the one hand, because it irritates the stomach and increases the symptoms; on the other hand, because it can lead to stronger side effects.
Pantoprazole: side effects of the acid blocker
If pantoprazole is only taken for a short time, the drug is usually very well tolerated, but in a few cases there are side effects such as:
- Diarrhea
- constipation
- headache
- stomach pain
- dizziness
- fatigue
- malaise
- weakness
- sleep disorders
- rash and itching
If side effects occur as a result of ingestion, the drug should be discontinued and medical advice should be sought.
During long-term treatment with pantoprazole, other symptoms can also occur, which can lead to an increase in liver values . The absorption of some minerals and vitamins can also be reduced, which in some cases leads to a magnesium deficiency and as a result to osteoporosis and bone fractures. Older people are particularly at risk from long-term use. A vitamin B12 deficiency can also occur when taking proton pump inhibitors.
Interactions of pantoprazole and other drugs
Due to the changed acidity in the gastric juice, the absorption of some medications can be reduced, and some antifungal agents such as ketoconazole can then no longer work properly. The active ingredient atazanavir, which is used to treat AIDS , often does not work properly when taken at the same time as pantoprazole, or it can be absorbed into the blood in reduced concentrations. A joint intake is therefore not recommended.
In addition, the blood level of fluvoxamine (antidepressant) can increase when it is taken, and the dose may then have to be adjusted. A doctor’s consultation should be made in any case. The same applies to the active ingredient methotrexate , which is used to treat psoriasis , cancer and rheumatoid arthritis .
So far, interactions between pantoprazole and vitamin K antagonists (anticoagulants) have been observed very rarely. People who take medications like warfarin or phenprocoumon should then have their coagulation levels checked more frequently.
When should pantoprazole not be taken?
Children under the age of 12 must not take pantoprazole; if you are pregnant or breastfeeding, you should consult a doctor before taking it. There are indications that the active substance can pass into breast milk.
In addition, caution is advised in the event of a vitamin B12 deficiency or poor liver values. In case of hypersensitivity or allergy to pantoprazole, the drug should not be taken.