pantoprazole
Brand names: Protonix
Pantoprazole is a drug that reduces stomach acid. It belongs to a class of drugs called proton pump inhibitors (PPIs).
Drug Pricing (NADAC)
Brand Price
$13.75/unit
Generic Price
$7.63/unit
Generic Savings
45%
Generic Available
Yes (27 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
This medicine treats gastroesophageal reflux disease (GERD) and erosive esophagitis (EE) in adults, for up to 10 days.
Common side effects
Headache, Diarrhea, Nausea
Key warnings
Pantoprazole can hide the symptoms of stomach cancer, so tell your doctor if your symptoms don't improve.
How It Works
Pantoprazole works by blocking the enzyme in the stomach that produces acid. This reduces the amount of acid your stomach makes. It helps to heal damage to the esophagus caused by acid reflux.
How to Take It
Pantoprazole is given through a vein (IV). For GERD and EE, the usual dose is 40 mg once a day for up to 10 days. For high acid conditions, the usual dose is 80 mg every 12 hours. Your doctor will switch you to an oral medicine as soon as you can take pills.
Pregnancy & Breastfeeding
Based on animal studies, this medicine may harm your unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.
Missed Dose
Since this medicine is given in a hospital or clinic, you are not likely to miss a dose. Contact your doctor immediately if you think you missed a dose.
Storage
Store at room temperature, away from light.
Side Effects (from patient reports)
Based on 155,667 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 240,800 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2003–2025.
Total Reports
240,800
Death-Related Reports
27,099
Hospitalization Reports
111,504
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | FATIGUE | 19,879 |
| 2 | OFF LABEL USE | 17,588 |
| 3 | NAUSEA | 16,988 |
| 4 | DIARRHOEA | 16,633 |
| 5 | DYSPNOEA | 16,592 |
| 6 | DRUG INEFFECTIVE | 16,477 |
| 7 | PAIN | 14,962 |
| 8 | HEADACHE | 12,661 |
| 9 | VOMITING | 12,157 |
| 10 | ARTHRALGIA | 11,725 |
| 11 | ACUTE KIDNEY INJURY | 11,212 |
| 12 | PYREXIA | 11,125 |
| 13 | ASTHENIA | 10,938 |
| 14 | CHRONIC KIDNEY DISEASE | 10,553 |
| 15 | DIZZINESS | 10,360 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Pantoprazole can hide the symptoms of stomach cancer, so tell your doctor if your symptoms don't improve. It may also increase your risk of diarrhea caused by a bacteria called *C. difficile*. Long-term use may increase your risk of bone fractures. This medicine may also cause kidney problems, lupus, low magnesium levels, and polyps in the stomach.
Known Drug Interactions
Clopidogrel Clinical Impact: Concomitant administration of pantoprazole sodium and clopidogrel in healthy subjects had no clinically important effect on exposure to the active metabolite of clopidogrel or clopidogrel-induced platelet inhibition [see Clinical Pharmacology (12.3) ]. Intervention: No dose adjustment of clopidogrel is necessary when administered with an approved dose of pantoprazole sodium.
Mechanism: These two drugs do not have a meaningful effect on each other when taken at the same time.
What to do: You do not need to change your dose of clopidogrel when taking it with this medication.
Warfarin Clinical Impact: Increased INR and prothrombin time in patients receiving PPIs, including pantoprazole sodium, and warfarin concomitantly. Dose adjustment of warfarin may be needed to maintain target INR range. See prescribing information for warfarin.
Mechanism: Pantoprazole can increase the effects of warfarin, which may make your blood too thin.
What to do: Your doctor may need to adjust your warfarin dose and check your blood clotting levels more often.
Methotrexate Clinical Impact: Concomitant use of PPIs with methotrexate (primarily at high dose) may elevate and prolong serum concentrations of methotrexate and/or its metabolite hydroxymethotrexate, possibly leading to methotrexate toxicities. No formal drug interaction studies of high-dose methotrexate with PPIs have been conducted [see Warnings and Precautions (5.14) ] . Intervention: A temporary withdrawal of pantoprazole sodium may be considered in some patients receiving high-dose methotrexate.
Mechanism: Pantoprazole can cause methotrexate to stay in your body longer, which can lead to harmful side effects.
What to do: Your doctor may tell you to stop taking pantoprazole for a short time while you are using high doses of methotrexate.
Drugs Dependent on Gastric pH for Absorption (e.g., iron salts, erlotinib, dasatinib, nilotinib, mycophenolate mofetil, ketoconazole/itraconazole) Clinical Impact: Pantoprazole can reduce the absorption of other drugs due to its effect on reducing intragastric acidity.
Mechanism: Pantoprazole reduces stomach acid, but ketoconazole needs acid to be absorbed into your bloodstream.
What to do: Talk to your doctor, as this combination may make the ketoconazole less effective at treating infections.
Drugs Dependent on Gastric pH for Absorption (e.g., iron salts, erlotinib, dasatinib, nilotinib, mycophenolate mofetil, ketoconazole/itraconazole) Clinical Impact: Pantoprazole can reduce the absorption of other drugs due to its effect on reducing intragastric acidity.
Mechanism: Pantoprazole lowers stomach acid, which itraconazole needs to be absorbed into your body. This can make the itraconazole less effective.
What to do: Your doctor may need to monitor your treatment or adjust how you take these medications.
Common Questions
Can I take pantoprazole if I am allergic to similar drugs?
How long can I take pantoprazole?
Can pantoprazole be taken with other medications?
What should I do if I experience side effects?
Does pantoprazole affect my bones?
Can pantoprazole cause kidney problems?
Is it safe to take pantoprazole during breastfeeding?
What if my symptoms come back after I stop taking pantoprazole?
Can pantoprazole cause diarrhea?
Are there any foods I should avoid while taking pantoprazole?
What are the common side effects of pantoprazole?
Does pantoprazole interact with other medications?
What drug class is pantoprazole?
Is there a generic version of pantoprazole?
Is pantoprazole safe during pregnancy?
Related Medications in Proton Pump Inhibitor (PPI)
Other drugs grouped near pantoprazole — same-class peers and common alternatives.
alosetron
Lotronex
Alosetron (Lotronex) is a medicine for women with severe diarrhea-predominant irritable bowel syndrome (IBS).
Compare with pantoprazole →
aprepitant
Emend
Aprepitant (Emend) is a medicine that helps prevent nausea and vomiting.
Compare with pantoprazole →
bisacodyl
Dulcolax
Bisacodyl is a medicine that helps you have a bowel movement.
Compare with pantoprazole →
bismuth subsalicylate
Pepto-Bismol
Bismuth subsalicylate (Pepto-Bismol) is a medicine that can treat diarrhea and upset stomach.
Compare with pantoprazole →
cimetidine
Tagamet
Cimetidine (Tagamet) reduces stomach acid.
Compare with pantoprazole →
Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
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Common Drug Interactions
Dangerous medication combinations and how to protect yourself
Related Health & Safety Data
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What the FDA Data Shows for pantoprazole
The FDA label for pantoprazole (sold under brand names such as Protonix) classifies it as a prescription-only medication in the Proton Pump Inhibitor (PPI) class. This medicine treats gastroesophageal reflux disease (GERD) and erosive esophagitis (EE) in adults, for up to 10 days. Official labeling lists 8 commonly reported side effects, including Headache, Diarrhea, Nausea.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 155,667 voluntary reports. The database also lists 5 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated minor severity. NADAC pricing from CMS shows a generic unit cost of $7.63 versus $13.75 for the brand — a 45% generic savings.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: June 27, 2025
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages