Pantoprazole is used to treat certain conditions in which there is too much acid in the stomach. It is used to treat erosive esophagitis or "heartburn" caused by gastroesophageal reflux disease (GERD), a condition where the acid in the stomach washes back up into the esophagus. This medicine may also be used to treat Zollinger-Ellison syndrome, a condition where the stomach produces too much acid.

Pantoprazole is a proton pump inhibitor (PPI). It works by decreasing the amount of acid produced by the stomach.

This medicine is available only with your doctor's prescription.

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine comes with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Swallow the delayed-release tablet whole. Do not split, crush, or chew it. You may take the tablet with or without food.

For delayed-release oral suspension granules:

Applesauce method:
1. Open packet.
2. Mix the packet contents with 1 teaspoonful of applesauce. Do not mix with water, other liquids, or food.
3. Swallow the mixture at least 30 minutes before a meal. Take it within 10 minutes after you mix it.
4. Sip some water after you swallow the mixture. This will make sure all of the granules get all the way to your stomach.
5. Do not chew or crush the granules. Do not divide the packet contents to make smaller doses.

Apple juice method:
1. Open packet.
2. Mix the packet contents with 1 teaspoon of apple juice in a small cup or container.
3. Stir for 5 seconds (granules will not dissolve) and swallow it immediately or take it at least 30 minutes before a meal.
4. Rinse the container with apple juice to make sure you get all of the medicine. Swallow it immediately.
5. Do not chew or crush the granules. Do not divide the packet contents to make smaller doses.

Feeding tube:
1. Pour the packet contents in a 2-ounce (60 mL) catheter-tip syringe.
2. Clear any clogs from the feeding tube before you put this medicine mixture into the tube.
3. Add 10 mL of apple juice into the syringe. Gently tap or shake the barrel of the syringe to help rinse the syringe and tube.
4. Repeat with an additional 10 mL of apple juice. No granules should remain in the syringe.
5. Take this medicine at least 30 minutes before a meal.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Less common

Blurred vision

dry mouth

flushed, dry skin

fruit-like breath odor

increased hunger

increased thirst

increased urination

nausea

stomach pain

sweating

troubled breathing

unexplained weight loss

vomiting

Incidence not known

Absence of or decrease in body movements

blindness

blistering, peeling, or loosening of the skin

bloating

bloody or cloudy urine

bloody, black, or tarry stools

blurred vision

chills

clay-colored stools

constipation

continuous ringing or buzzing or other unexplained noise in the ears

cough

dark urine

decreased vision

diarrhea

difficulty with speaking

difficulty with swallowing

dizziness or lightheadedness

drowsiness

fast heartbeat

feeling of constant movement of self or surroundings

fever

general feeling of tiredness or weakness

greatly decreased frequency of urination or amount of urine

headache

hearing loss

high fever

hives, itching, or skin rash

indigestion

joint pain

large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals

light-colored stools

loss of appetite

mood or mental changes

muscle cramp, pain, or stiffness

muscle spasms (tetany) or twitching

pains in the stomach, side, or abdomen, possibly radiating to the back

pale skin

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

red skin lesions, often with a purple center

red, irritated eyes

seizures

sensation of spinning

sore throat

sores, ulcers, or white spots on the lips or in the mouth

stomach pain, continuing

swelling of the feet or lower legs

swollen glands

tightness in the chest

trembling

unexplained bleeding or bruising

unpleasant breath odor

unusual tiredness or weakness

vomiting of blood

yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common

Belching

bloated or full feeling

excess air or gas in the stomach or bowels

passing gas

trouble sleeping

Incidence not known

Increased watering of the mouth

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

It is very important that your doctor check your and your child's progress at regular visits to make sure this medicine is working properly. Blood, urine, and other laboratory tests may be needed to check for unwanted effects.

Do not use pantoprazole together with medicines containing rilpivirine (eg, Complera®, Edurant®, Odefsey®).

Check with your doctor right away if you have a fever, joint pain, skin rash, swelling of the body, feet, or ankles, or unusual weight gain after receiving this medicine. These could be symptoms of a serious kidney problem called acute interstitial nephritis.

Cutaneous or systemic lupus erythematosus may occur or get worse in patients receiving a PPI. Call your doctor right away if you have joint pain or a skin rash on your cheeks or arms that gets worse when exposed to the sun.

Taking this medicine for a long time may make it harder for your and your child's body to absorb vitamin B12. Tell your doctor if you have concerns about this.

This medicine may cause diarrhea, and in some cases it can be severe. Do not take any medicine to treat diarrhea without first checking with your doctor. Check with your doctor right away if you or your child have watery stool that does not go away, stomach pain, and fever while taking this medicine.

Pantoprazole may increase your risk of having fractures of the hip, wrist, and spine. This is more likely if you take several doses per day or use it for one year or more. Call your doctor right away if you have severe bone pain or are unable to walk or sit normally.

This medicine may cause hypomagnesemia (low magnesium in the blood). This is more likely to occur if you are taking this medicine for more than one year, or if you are taking this medicine together with digoxin (Lanoxin®) or certain diuretics or "water pills". Check with your doctor right away if you have convulsions (seizures), fast, racing, or uneven heartbeat, muscle spasms (tetany), tremors, or unusual tiredness or weakness.

This medicine may increase your risk for fundic gland polyps (abnormal tissue growth in the upper part of your stomach). This is more likely if you are receiving this medicine for more than 1 year. Talk ti your doctor if you have concerns.

Do not stop taking this medicine without first checking with your doctor, or unless told to do so by your doctor.

Before you have any medical tests, tell the medical doctor in charge that you are taking this medicine. The results of some tests may be affected by this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription (eg, atazanavir, nelfinavir, Reyataz®, Viracept®) or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.