Protonix (Pantoprazole)

• Read the Medication Guide provided by your pharmacist before starting Protonix and each time you get a refill. If you have any questions, ask your healthcare provider.
• Take this medication by mouth as directed by your healthcare provider, usually once daily. The dosage and length of treatment are based on your medical condition and response to treatment.
• If you are taking the tablets, you may take them with or without food. Swallow the tablets whole. Do not split, crush, or chew the medication, as doing so may destroy the drug.
• If you are taking the granules, take your dose 30 minutes before a meal. Open the packet and mix the granules in applesauce or apple juice. Do not mix with other foods or liquids. Do not crush or chew the granules.
• Sprinkle the granules on 1 teaspoon (5 milliliters) of applesauce and swallow all of the mixture right away (within 10 minutes). Follow with sips of water.
• Alternatively, you can mix the granules with 1 teaspoon (5 milliliters) of apple juice in a small cup, stir for 5 seconds, and swallow all of the mixture right away. Rinse the cup once or twice with apple juice to mix any remaining granules, and swallow the juice. Do not prepare the mixture ahead of time for later use.
• If you are giving the granules through a tube into the stomach (nasogastric or gastric tube), ask your healthcare provider for detailed instructions on how to properly mix and administer it.
• If needed, antacids may be taken along with this medication. If you are also taking sucralfate, take Protonix at least 30 minutes before sucralfate.
• Use this medication regularly to get the most benefit from it. Take it at the same time each day and continue to take this medication for the prescribed length of treatment even if you are feeling better.
• Tell your healthcare provider if your condition lasts or gets worse. The risk of side effects goes up over time. Ask your healthcare provider how long you should take this medication.

• Headache
• Diarrhea
• Nausea
• Stomach pain
• Vomiting
• Gas
• Dizziness
• Joint pain
• Flatulence
• Cold-like symptoms (sore throat, congested nose, sneezing)

• Symptoms of a low magnesium blood level (such as muscle spasms, irregular heartbeat, seizures)
• Signs of lupus (such as rash on nose and cheeks, new or worsening joint pain)
• Seizures
• Trouble breathing
• Watery or bloody diarrhea
• Blurred vision
• Dry mouth
• Flushed dry skin
• Fruit-like breath odor
• Increased hunger
• Increased thirst
• Increased urination
• Sweating
• Unexplained weight loss
• Elevated liver enzymes

In adults, symptomatic response to therapy with Protonix does not preclude the presence of gastric malignancy. Additional follow-up and diagnostic testing may be considered in adult patients who have a suboptimal response or an early symptomatic relapse after completing treatment with a PPI. In older patients, an endoscopy should also be considered.

Acute tubulointerstitial nephritis (TIN) has been observed in patients taking PPIs and may occur at any point during PPI therapy. Patients may present with varying signs and symptoms from symptomatic hypersensitivity reactions to non-specific symptoms of decreased renal function. Discontinue Protonix and evaluate patients with suspected acute TIN.

Protonix may be associated with other serious adverse reactions, including Clostridium difficile-associated diarrhea, bone fracture, severe cutaneous adverse reaction, cutaneous and systemic lupus erythematosus, cyanocobalamin (Vitamin B-12) deficiency, hypomagnesemia and mineral metabolism, and fundic gland polyps.

This is not a complete list of warnings and precautions, and other considerations may apply. Always consult a healthcare provider for comprehensive information about the warnings and precautions associated with Protonix.