How pantoprazole works
The human stomach produces gastric acid (the main component of which is hydrochloric acid) to digest food. However, to prevent it from digesting itself, the gastric mucosa also releases a viscous secretion that protects the cells of the mucosa from the aggressive acid. The mucous membrane in the oesophagus is protected from the highly irritating stomach acid by a sphincter muscle at the entrance to the stomach (oesophageal sphincter).
If too much acid is produced and/or the sphincter does not function properly, the stomach acid may enter the oesophagus and attack the mucous membrane there. This leads to pain (heartburn) and inflammatory reactions (esophagitis). The same can affect the stomach lining.
Stomach acid can also be to blame if an existing stomach ulcer does not heal or heals only very slowly by constantly irritating the tissue.
Proton pump inhibitors
The active ingredient pantoprazole inhibits the so-called proton pumps, which are responsible for the secretion of stomach acid in the gastric mucosa. To do this, it has to be transported to the stomach via the bloodstream. Only there is it converted into the active form by the acidic environment in the stomach cells (parietal cells), which then inhibits the proton pumps.
The effect of pantoprazole does not immediately relieve the symptoms due to its mechanism of action. The maximum effect is usually achieved after two to three days. This should be borne in mind when self-medicating.
When is pantoprazole used?
Pantoprazole is used to reduce the body’s own stomach acid production. This is necessary in cases of heartburn, inflammation of the oesophagus caused by rising stomach acid (reflux oesophagitis) and to promote the regression of stomach ulcers.
Combinations of pantoprazole and antibiotics are also commonly used to treat an infection with the bacterium Helicobacter pylori. It often causes inflammation of the stomach lining (type B gastritis). If left untreated, the stomach germ can lead to stomach ulcers and even stomach cancer.
Pantoprazole is also often used as an accompanying therapy in long-term treatment with non-steroidal anti-inflammatory drugs (NSAIDs). These painkillers can cause stomach acid-associated side effects. Pantoprazole can protect against this.
The proton pump inhibitor is used both for short-term therapy and for longer-term treatment, the latter, however, only if prescribed by a doctor.
How pantoprazole is used
Pantoprazole is usually administered as an enteric-coated tablet, less frequently as a solution for injection.
In rare cases, several tablets per intake may be necessary – for example in Zollinger-Ellison syndrome (gastrinoma). In this case, gastrin-producing tumor cells produce too much stomach acid. This results in mucosal damage (ulcers).
What side effects does pantoprazole have?
In general, few side effects occur during treatment with pantoprazole. However, up to ten percent of those treated experience gastrointestinal complaints such as diarrhea, constipation or flatulence. Headaches and dizziness are also possible.
Long-term use of the proton pump inhibitor (one year or longer) in particular can cause an increase in liver enzyme levels, vitamin B12 deficiency, magnesium deficiency and bone fractures (especially in older patients and those at risk of osteoporosis). Side effects such as these also occur with other proton pump inhibitors.
Symptoms of overdose are not known in humans.
What should be considered when taking pantoprazole?
Pantoprazole should not be used in children under 12 years of age due to a lack of experience.
Pantoprazole can change the absorption rate of other medications. Strongly effective medications in particular (such as opiates like morphine) can be absorbed from the intestine unusually quickly, leading to higher blood levels. Therefore, a doctor or pharmacist should be consulted before using pantoprazole and other medications at the same time.
How to obtain medication with pantoprazole
In Germany, Austria and Switzerland, the active ingredient pantoprazole can only be obtained from pharmacies.
In all three countries, tablets containing up to 20 milligrams of pantoprazole are available over the counter, but only in packs of 7 and 14 tablets. This is to prevent patients from taking the proton pump inhibitor long-term on their own initiative. Higher-dose tablets (40 milligrams) and injection solutions require a prescription.
History
The active ingredient pantoprazole only came onto the market after omeprazole (the first proton pump inhibitor). It is an analog preparation, which means that the areas of application and mode of action are almost identical.
Further interesting information
Taking Pantoprazole can produce a false positive result in a rapid test for THC, the psychoactive component of marijuana/cannabis.