Pantoprazole • Acid blocker side effects

Pantoprazole is used very often against 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 lowers acid production in the stomach. There, gland cells form an acidic digestive secretion, the gastric juice. In some cases, the stomach produces too much acid, which then attacks the sensitive lining of the stomach. In such cases the drug can help.

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What is pantoprazole?

Pantoprazole belongs to the group of proton pump inhibitors (PPI, proton pump inhibitor). Like other active substances from this group, it acts on the parietal cells of the stomach. There, pantoprazole inhibits the formation of acid, which increases the pH value. The drug is not effective for acute symptoms, such as single heartburn after eating fatty foods. 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:

  • Omeprazol
  • Rabeprazole
  • Esomeprazole

As with other proton pump inhibitors, pantoprazole is usually administered as an enteric tablet: Although the acid blocker works on cells in the stomach, the active ingredient is first absorbed in the intestine and then transported to its target via the blood.

How pantoprazole works

The body produces around two liters of gastric juice per day. It consists of different components. The parietal cells of the gastric mucosa emit acid (in the form of hydrogen ions or protons). Acid gastric juice is necessary for digestion, and germs are also killed: it has a disinfectant effect. In order not to digest itself, the stomach protects itself with a thick layer of mucus.

When sober, 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.

A wrong diet, stress, illness or the use of medication can change the composition of the gastric juice and its pH value, for example if too much acid is produced by the parietal cells. This can attack the lining of the stomach, and the acid can also rise up into the esophagus and lead to unpleasant heartburn.

Areas of application: when is pantoprazole taken?

Pantoprazole is a pharmacy-only drug that is available in different dosages. In the lower dose of 20 milligrams (mg) 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 complaints such as:

  • Inflammation of the esophagus caused by rising stomach acid (reflux esophagitis)
  • heartburn
  • Magengeschwüren
  • Duodenal ulcer
  • Inflammation of the lining of the stomach (gastritis)

Pantoprazole is also used for inflammation of the stomach lining. This is often triggered by a bacterial pathogen: Helicobacter pylori. Pantoprazole or another proton pump inhibitor are often used as a combination of three drugs for chronic inflammation of the gastric mucosa, when Helicobacter has been proven. In addition to pantoprazole, a combination of antibiotics such as amoxicillin and clarithromycin are used for a few days.

In addition, the active ingredient is often administered preventively during long-term pain therapy with nonsteroidal 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?

As a rule, pantoprazole is taken in the morning on an empty stomach with some water, about half an hour before breakfast. In the case of very severe symptoms, 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 also irritates the stomach and worsens the symptoms; on the other hand, because it can lead to stronger side effects.

Pantoprazole: acid blocker side effects

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:

If side effects occur as a result of ingestion, the drug should be discontinued and medical help should be sought.

Long-term treatment with pantoprazole can lead to further symptoms, such as an increase in liver values. The intake of some minerals and vitamins can also be reduced, so in some cases there is a magnesium deficiency and as a result osteoporosis and bone fractures. Elderly people in particular are at risk from long-term use. A vitamin B12 deficiency can also occur when taking proton pump inhibitors.

Interactions between pantoprazole and other drugs

Due to the changed acid content in gastric juice, the absorption of some medications can be reduced, and some agents against fungal infections such as ketoconazole can no longer work properly. The active ingredient atazanavir, which is used to treat AIDS, can often not work properly if pantoprazole is taken at the same time, or it can be absorbed by the blood in a reduced concentration. A joint intake is therefore not recommended.

In addition, the blood level of fluvoxamine (antidepressant) may increase as a result of taking it, and the dose may then have to be adjusted. A medical consultation should always take place. The same applies to the active ingredient methotrexate, which is used to treat psoriasis, cancer and rheumatoid arthritis.

An interaction between pantoprazole and vitamin K antagonists (coagulation inhibitors) has so far been observed very rarely. People who take drugs like warfarin or phenprocoumon should then have their coagulation values ​​checked more often.

When should pantoprazole not be taken?

Children under 12 years of age are not allowed to take pantoprazole; if you are pregnant or breastfeeding it should be discussed with a doctor. 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. If you are hypersensitive or allergic to pantoprazole, the drug must not be taken.

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Source: Lifeline | Das Gesundheitsportal by

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