Every second German knows the aching feeling that occurs during heartburn (reflux disease), when the stomach acid flows back into the esophagus. Here, the active ingredient Pantoprazole can provide relief, as this causes a reduction in acid production in the stomach. For this reason, Pantoprazole is also used to treat ulcers in the stomach and duodenum, as well as an abnormal overproduction of stomach acid known as Zollinger-Ellison syndrome. As with other medications, however, taking pantoprazole is associated with side effects.
How pantoprazole works
Pantoprazole belongs to the group of proton pump inhibitors, which also includes esomeprazole, lansoprazole, omeprazole, and rabeprazole. Proton pump inhibitors cause a reduction in gastric acid production. Chemically, gastric acid is hydrochloric acid composed of positively charged hydrogen protons and negatively charged chloride ions. However, only the hydrogen protons are important for the acidic properties of gastric juice. As the name suggests, proton pump inhibitors hinder the work of the proton pumps and thus ensure that fewer protons enter the stomach. As a result, the concentration of gastric acid decreases and the pH in the stomach increases. Compared to the other proton pump inhibitors, Pantoprazole is characterized by a rapid onset of action as well as a long-lasting efficacy. Because of its rapid onset of action, pantoprazole can be used for heartburn even spontaneously at the onset of symptoms.
Treating ulcers with pantoprazole
However, Pantoprazole is not only effective for heartburn, but also helps patients suffering from ulcers in the gastrointestinal tract. In the affected areas, the mucosa is often severely damaged by stomach acid, which can lead to severe stomach pain. As a result of the damaged gastric mucosa, the layers of tissue underneath the mucosa are exposed and usually damaged as well. Pantoprazole accelerates the healing of the ulcers by eliminating the cause of the damage, gastric acid. It also helps relieve cramping pain, especially when the digestive tract is active. Proton pump inhibitors such as Pantoprazole are also used when taking medications that may cause damage to the gastrointestinal tract, such as those from the group of non-steroidal anti-inflammatory drugs (NSAIDs). In such cases, Pantoprazole can be used as a gastroprotective agent to prevent the development of ulcers or to heal ulcers that have already developed. The trigger of ulcers is often the bacterium Heliobacter pylori, which is present in more than 80 percent of all patients suffering from ulcers. To combat this germ, pantoprazole is often taken for a week along with antibiotics. This treatment method is called eradication therapy.
Dosage of pantoprazole
Here’s what to consider when dosing pantoprazole:
- For acute symptoms, a dose of 40 mg pantoprazole can be taken over a longer period of time.
- If it is used only preventively, on the other hand, a dose of 20 mg is sufficient. Preventive Pantoprazole is taken to prevent inflammation of the stomach and duodenum and esophagus.
- From a dose of 80 mg, Pantoprazole should be taken twice daily. This dosage is recommended, for example, for long-term therapy of Zollinger-Ellison syndrome or in eradication therapy for therapy of Heliobacter pylori.
Low-dose drugs with the active ingredient pantoprazole are now available over the counter in pharmacies. In general, however, the dosage of pantoprazole should always be coordinated with the attending physician.
Side effects of pantoprazole
As with other medications, it is also true for Pantoprazole that taking the active ingredient can be associated with side effects. In general, however, pantoprazole is considered to be well tolerated. These side effects may occur when taking pantoprazole:
- The most common side effects include headache, as well as constipation, bloating and diarrhea.
- Occasionally, nausea and vomiting may also occur, as well as dizziness and allergic skin reactions.
- The rather rare side effects of pantoprazole include joint pain, dry mouth and kidney inflammation.
However, especially the inflammation of the kidneys should be given special attention.This side effect is particularly insidious, as its symptoms are similar to those that led to the intake of pantoprazole. If nausea and vomiting continue to occur during treatment, kidney inflammation should definitely be considered as a possible cause. This is because permanent damage to the kidneys can only be avoided if the intake of Pantoprazole is stopped in time and the kidneys are subsequently treated. Very rarely, taking Pantoprazole may also cause other serious side effects such as liver damage or severe skin reactions. For a detailed list of side effects of Pantoprazole, please see the package insert.
Is long-term use of pantoprazole dangerous?
Controversy surrounds long-term use of pantoprazole and other proton pump inhibitors, as they could potentially interfere with the absorption of vitamins and nutrients and promote intestinal infections, and have been linked to several 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 physician.
Pantoprazole: drug interactions
To date, few interactions of pantoprazole with other medications have been noted. Taking pantoprazole changes the acidity of the stomach. This may interfere with the absorption of certain active ingredients into the bloodstream. These agents include, for example, the AIDS agent atazanavir and the agents ketoconazole and itraconazole, which are used to treat fungal infections. Interactions with Pantoprazole can also occur with medications that affect blood clotting: for example, when taking anticoagulants such as warfarin, care should be taken to ensure that blood clotting is checked regularly by a doctor. Likewise, pantoprazole, like all other active ingredients from the group of proton pump inhibitors, also impairs the effectiveness of the blood thinner clopidogrel. For this reason, these two agents should not be taken together if possible. In addition, an increase in the level of the active substance in the blood has been observed in simultaneous treatment with high doses of the active substance methotrexate (a drug used, for example, in cancer and psoriasis). Therefore, it may be advisable to discontinue treatment with pantoprazole in such cases in consultation with the physician.
Pantoprazole: contraindications and precautions.
In the following cases, special caution should be exercised when taking pantoprazole or its use should even be completely discouraged:
- As with other medications, Pantoprazole should not be taken in case of hypersensitivity to the active ingredient.
- In patients suffering from severely impaired liver function, liver enzyme levels must be monitored regularly. If the attending physician detects an increase in the values, treatment with pantoprazole must be discontinued.
- The effects of taking pantoprazole during pregnancy and lactation have not been adequately studied. However, in an animal experiment, it was found that a high pantoprazole dosage can lead to damage in the unborn child. For this reason, the active ingredient should only be used in urgent cases. The active ingredient omeprazole is considered the best-studied alternative.
- Also in children, the drug should not be used if possible, because even here there is not yet 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, it should also be remembered that the lowered acidity of the gastric juice can lead to a vitamin B12 deficiency.
